bluuebunny/crossref_metadata_2025_split huggingface dataset:
Planned vaginal and planned cesarean delivery outcomes in pregnancies complicated with pregestational type 1 diabetes – A three-year academic tertiary hospital cohort study
Authors: Kruit Heidi , Mertsalmi Saara , Rahkonen Leena 
Published: March 2022

Abstract
Background
Finland has the world’s highest incidence of 62.5/100000 of diabetes mellitus type 1 (DM1) with approximately 400 (1%) DM1 pregnancies annually. Pregnancies complicated by DM1 are accompanied with increased risk for perinatal morbidity and mortality. Timing and mode of delivery are based on the risk of complications, yet the data on labor induction is limited. The aim of this study was to compare delivery outcomes in planned vaginal (VD) and planned cesarean deliveries (CD) in late preterm and term DM1 pregnancies, and to evaluate the feasibility of labor induction.

Materials and Methods
Pregnant women with DM1, live singleton fetus in cephalic presentation ≥34 gestational weeks delivering in Helsinki University Hospital between January 1st 2017 and December 31st 2019 were included. The primary outcome were the rates of adverse maternal and perinatal outcome. The study population was classified according to the 1980-revised White’s classification. Statistical analyses were performed by IBM SPSS Statistics for Windows.

Results
Two hundred four women were included, 59.8% (n = 122) had planned VD. The rate of adverse maternal outcome was 27.5% (n = 56), similar between the planned modes of delivery and White classes. The rate of perinatal adverse outcome was 38.7% (n = 79), higher in planned CD (52.4% vs. 29.5%;p = 0.001). The most common adverse perinatal event was respiratory distress (48.8% vs. 23.0%;p <  0.001). The rate of adverse perinatal outcome was higher in White class D + Vascular compared to B + C (45.0% vs. 25.0%, OR after adjustment by gestational age 2.34 [95% CI 1.20–4.50];p = 0.01). The total rate of CD was 63.7% (n = 130), and 39.3% (n = 48) in planned VD. Women with White class D + Vascular more often had emergency CD compared to White Class B + C (48.6% vs. 25.0%;p = 0.009). The rate of labor induction was 51%, being 85.2% in planned VD. The rate of VD in induced labor was 58.7% (n = 61) and the rate of failed induction was 14.1% (n = 15).

Conclusion
Planned VD was associated with lower rate of adverse perinatal outcome compared to planned CS, with no difference in the rates of adverse maternal outcome. Induction of labor may be feasible option but should be carefully considered in this high-risk population.
Primary central nervous system lymphoma high incidence and poor survival in Finnish population-based analysis
Authors: Puhakka Inka , Kuitunen Hanne , Jäkälä Pekka , Sonkajärvi Eila , Turpeenniemi-Hujanen Taina , Rönkä Aino , Selander Tuomas , Korhonen Miika , Kuittinen Outi 
Published: March 2022

Abstract
Background
We report here the first population-based incidence rates and prognosis of primary central nervous system lymphoma (PCNSL) in Finland.

Methods
Finnish Cancer Registry data by histological diagnosis and tumor location (2007–2017) for cases with diffuse large B-cell lymphoma.

Results
During 2007–2017, 392 new cases of PCNSL were reported (195 males, 197 females). The average age-adjusted incidence was 0.68/100,000 person-years. Incidence for males was 0.74/100,000 and for females 0.63/100,000, respectively. The incidence was highest, 2.93/100,000, among people aged 75–79 years. Concerning all cases in 2007–2017 the 2-year age-adjusted relative survival rate was 33% and the corresponding 5-year survival rate was 26%. Among patients under the age of 70, the age-adjusted 5-year relative survival rate increased from 36% in 2007–2012 to 43% for 2013–2017. Among patients aged 70+ the corresponding survival rates were poor, 7 and 9%.

Conclusions
PCNSL incidence in Finland is among the highest reported in the world. The annual increase in incidence was 2.4%. The prognosis is still dismal, especially in elderly patients.
Magnitude of common mental disorders and factors associated among people living in Addis Ababa Ethiopia 2018: community based cross-sectional study
Authors: Habtamu Yodit , Admasu Kalkidan , Tullu Mikiyas , Kebede Alem 
Published: March 2022

AbstractBackgroundCommon mental disorders are a group of distress states manifesting with anxiety, depressive and unexplained somatic symptoms, affecting individuals in different age groups, causes suffering to the individuals, families and community.ObjectiveThis study assessed the magnitude of Common mental disorder and associated factors among people living in Addis Ababa, Ethiopia.MethodsCommunity based cross sectional study design was conducted from November 1 to 30, 2018 among people living in Addis Ababa, Ethiopia. Multistage sampling technique was used to get a total of 755 samples. Common Mental Disorder was assessed through interview using Self-Reported questionnaire (SRQ-20). The collected data were coded, entered into EPI-Info 7 and analysed by using SPPS version 20. Descriptive, analytical statistical procedure; bivariate and multivariate binary logistic regressions with odds ratios and 95% confidence interval was employed. The statistical significance was accepted atpvalue < 0.05.ResultIn this study a total of 723 study subjects were participated, with response rate of 95.7%.The prevalence of common mental disorders was 24.7% with [95%CI; 21.6 – 27.7]. Females (AOR=2.1; 95% CI; 1.39- 3.23), Divorced/widowed (AOR=2.55; 95% CI; 1.16- 5.59), daily labourers (AOR=2.52; 95% CI; 1.3- 4.88, chronic medical illness (AOR=4.5; 95% CI; 2.46- 8.24). are independent predictors of CMD and educational status (primary, secondary and diploma) was positively associated with CMD. in this study. Regarding education (primary, secondary and diploma) (AOR=0.34; 95% CI; 0.17-0.66) and (AOR=0.35; 95% CI; 0.19-0.67) has positively associated with common mental disorders.ConclusionThe prevalence of common mental disorders was found high. Female sex, marital status like Divorced/Widowed, daily labour workers and chronic medical illness were found to be independent predictors of CMD and educational status (primary, secondary school and diploma holders) was were found to be protective factors.
Blood biomarkers of post-stroke depression after minor stroke at three months in males and females
Authors: Qiu Xiuli , Wang He , Lan Yan , Miao Jinfeng , Pan Chensheng , Sun Wenzhe , Li Guo , Wang Yanyan , Zhao Xin , Zhu Zhou , Zhu Suiqiang 
Published: March 2022

Abstract
Background
Post-stroke depression (PSD) is one of the most common neuropsychiatric complications after stroke. Studies on the underlying mechanisms and biological markers of sex differences in PSD are of great significance, but there are still few such studies. Therefore, the main objective of this study was to investigate the association of biomarkers with PSD at 3 months after minor stroke in men and women.

Methods
This was a prospective multicenter cohort study that enrolled 530 patients with minor stroke (males, 415; females, 115). Demographic information and blood samples of patients were collected within 24 h of admission, and followed up at 3 months after stroke onset. PSD was defined as a depressive disorder due to another medical condition with depressive features, major depressive-like episode, or mixed-mood features according to the Diagnostic and Statistical Manual of Mental Disorders, 5th edition (DSM-V). Univariate analysis was performed using the chi-square test, Mann–Whitney U test, or t-test. Partial least-squares discriminant analysis (PLS-DA) was used to distinguish between patients with and without PSD. Factors with variable importance for projection (VIP) > 1.0 were classified as the most important factors in the model segregation.

Results
The PLS-DA model mainly included component 1 and component 2 for males and females. For males, the model could explain 13% and 16.9% of the variables, respectively, and 29.9% of the variables in total; the most meaningful predictors were exercise habit and fibrinogen level. For females, the model could explain 15.7% and 10.5% of the variables, respectively, and 26.2% of the variables in total; the most meaningful predictors in the model were brain-derived neurotrophic factor (BDNF), magnesium and free T3. Fibrinogen was positively correlated with the Hamilton Depression Scale-17 items (HAMD-17) score. BDNF, magnesium, and free T3 levels were negatively correlated with the HAMD-17 score.

Conclusions
This was a prospective cohort study. The most important markers found to be affecting PSD at 3 months were fibrinogen in males, and free T3, magnesium, and BDNF in females.

Trial registration
ChiCTR-ROC-17013993.
Official social media and its impact on public behavior during the first wave of COVID-19 in China
Authors: Liu Huan 
Published: March 2022

Abstract
Background
During the COVID-19 pandemic, official social media became a critical channel for the public to obtain pandemic information. No matter the positive function or negative effect of information dissemination, it involves the public’s risk perception and behavior. This study was designed to contribute to the existing research on how official social media information quality (IQ) and risk perception (RP) affect preventive behavior (PB) and continued use behavior (CB) of official social media during the first wave of COVID-19.

Methods
The required data were extracted from a national online survey of the Chinese Mainland during March 24–30 2020, a random sample was asked to participate in the survey (n = 666). Data analysis was performed using regression analysis, structural equation modeling, mediating effect analysis, and one-way ANOVA analysis.

Results
The results show that IQ (10.010 ± 3.568) has direct and indirect positive impact on PB (9.475 ± 3.571), and has a low significant positive indirect impact on CB (3.739 ± 1.566). The IQ has a significant positive impact on RP (β = 0.548), which show that there is no “risk perception paradox” in COVID-19. Furth more, this study also provides new evidence indicating that RP mediates the relationship between IQ and PB. According to the region, gender, age and annual income, and there are significant differences in PB and CB.

Conclusion
The study findings have remarkable implications for improving the information quality and public behaviors. Too high or too low level of risk perception is not conducive to pandemic prevention and control. Official social media should indirectly affect information flow through the reasonable supply of pandemic information and constantly improve the quality of pandemic information to avoid public’s undue panic and excessive health concerns during this ongoing outbreak and subsequent national public emergency events.
Rehabilitative interventions for ischaemic digital ulcers, pain, and hand functioning in systemic sclerosis: a prospective before-after study
Authors: Scaturro Dalila , Guggino Giuliana , Terrana Pietro , Vitagliani Fabio , Falco Vincenzo , Cuntrera Daniele , Benedetti Maria Grazia , Moretti Antimo , Iolascon Giovanni , Letizia Mauro Giulia 
Published: March 2022

Abstract
Background
Systemic sclerosis (SSc) is a rare connective tissue disease characterised by immune dysfunction, vasculopathy, cellular inflammation, fibrosis of the skin associated with multiple internal organs involvement. Ischaemic digital ulcers (IDU) of the hands commonly occur in patients with SSc adversely affecting functional independence.

Purpose
Aim of the study is to investigate the effectiveness of a rehabilitation protocol based on the combined use of ultrasound (US) therapy and therapeutic exercise in terms of ulcers healing, pain relief, and hand functioning in patients affected by SSc with IDUs. Moreover, we also investigated the safety of the proposed intervention.

Study design
Prospective before-after study.

Methods
We included 20 patients with IDUs secondary to SSc. All patients were treated with US combined with manual therapy, including McMennel joint manipulation, pompage mobilization technique and connective tissue massage, for 10 sessions. We evaluated softness, dyschromia, pain, and hand mobility using the Pressure Sore Status Tool (PSST), the Numerical Rating Scale (NRS), and the Duruoz Hand Index (DHI) at T0 and at the end of the treatment (T1).

Results
Treatment with US combined with manual therapy significantly reduced ulcers depth, improved ulcers margins, and reduced periwound skin damage (median PSST score 16 at T1, p<0.0001). Moreover, significant benefits were reported in terms of pain relief (NRS 3 at T1; p<0.0005), and hand function (DHI score 19 at T1; p<0.0005). Finally, this approach seems to be safe, without side effects reported at the end of treatment, along with an optimal compliance.

Conclusion
Therapeutic US combined with manual therapy should be used as additional intervention to manage IDUs in SSc patients.
Preoperative incidence and risk factors of deep vein thrombosis in patients with an isolated patellar fracture
Authors: Yang Weijie , Wang Haicheng , Wei Qun , Ding Kai , Jia Yuxuan , Li Chao , Zhu Yanbin , Chen Wei 
Published: March 2022

Abstract
Purpose
This study aimed to investigate the incidence, location, and related factors of preoperative deep venous thrombosis (DVT) in patients with isolated patellar fractures.

Methods
Patients with an isolated patellar fracture, admitted between January 2013 and December 2019 at our institution, were retrospectively analyzed. Upon admission, patients underwent routine Doppler ultrasound scanning (DUS) of the bilateral lower extremities to detect DVT; those with DVT were assigned to the case group and those without DVT to the control group. Patients in both groups did not perform preoperative off-bed weight-bearing exercises. Data on demographics, comorbidities, and laboratory test results upon admission were extracted. Variables were evaluated between the two groups using univariate analyses, and independent risk factors associated with DVT were identified by logistic regression analysis.

Results
During the study period, 827 patients were included, of whom 5.8% (48/827) were found to have preoperative DVT. In DVT patients, 85.4%(41/48) were injured, 8.3%(4/48) were not injured, and 6.3%(3/48) were lower limbs. Multivariate analysis showed that male (male vs. female, odds ratio, OR = 2.25), delayed from injury to DUS (in each day, OR = 1.29), and elevated plasma D-dimer level (> 0.5 µg/mL, OR = 2.47) were independent risk factors associated with DVT.

Conclusions
Despite the low prevalence of DVT after an isolated patellar fracture, this study underscores the importance of identifying those with a high risk of DVT, especially those with multiple identifiable factors, and encourage the early targeted use of anti-thromboembolic agents to reduce DVT occurrence.
Does ultrasound evaluation of the axilla increase the rate of axillary lymph node dissection in early stage clinically node negative breast cancer patients?
Authors: Vasigh Mahtab , Meshkati Yazd Seyed Mostafa , Karoobi Mohammadreza , Hajebi Reza , Yazdankhah Kenari Adel 
Published: March 2022

Abstract
Background
Management and axillary staging of breast cancer has become less invasive and more conservative, over the decades. Considering Z011, axillary lymph node dissection (ALND) can be avoided in T1-2 N0-1 breast cancers with one or two positive sentinel lymph nodes (SLNs), if they are candidates for breast conserving surgery and radiotherapy. The aim of this study was to recognize if pre-operative axillary US evaluation in early-stage breast cancer could lead to more ALND in post Z011 era.

Method
463 breast cancer patients were evaluated. 368 early-stage breast cancer patients (T1-2 N0) were included. We did not perform axillary US in early stage clinically node negative patients; however, 97 patients had axillary US prior to our visit. If axillary US could detect more than two suspicious LNs, US guided biopsy was performed. The remaining clinically node negative patients underwent upfront SLNB. ALND was performed if more than two SLNs were metastatic, or US-guided ALN biopsy proved metastatic involvement.

Results
97 patients had axillary US evaluation before the surgery. 67 patients (69.2%) did not have any suspicious US detected axillary LNs, 17 patients (17.5%) had one, 7 patients (7.2%) had two, and 6 patients (6.2%) had more than two suspicious LNs according to their axillary US evaluation. Those with more than two suspicious LNs underwent ALN US-guided biopsy. Metastatic involvement of the LNs was proved in all of them and they underwent upfront ALND. ALND revealed more than 2 metastatic LNs in 2/6 patients (33.3%). 91 patients who were evaluated by axillary US, had less than two US detected suspicious LNs and underwent SLNB. Amongst 24 patients with one or two US detected suspicious LNs, 1/24 patient had more than two positive SLNs and underwent ALND. In this group 15.6% underwent ALND and 5.2% of them were unnecessary according to the recent guidelines. Axillary US had a false positive rate of 36.6%. The sensitivity of axillary US in distinguishing patients with more than two suspicious LNs in clinically node negative patients was 25%. In the second group (without pre-operative axillary US evaluation), SLNB was performed. 204/272 patients (75%) did not have LN metastasis. 54/272 patients (19.9%) had one or two metastatic SLNs and according to Z011, ALND was omitted. 5.1% had more than two metastatic SLNs and underwent ALND.

Conclusion
US evaluation of the axilla in early stage, clinically node negative breast cancer patients, is not sensitive enough to recognize more than two metastatic ALNs. It leads to more unnecessary ALND. Despite the small number of patients in this study, these results question the rationale of axillary US guided biopsy in low burden (less than two) suspicious LNs. looking for an imaging modality with a higher sensitivity in detecting the Burdon of axillary metastatic involvement is mandatory.
Using noninvasive anthropometric indices to develop and validate a predictive model for metabolic syndrome in Chinese adults: a nationwide study
Authors: Xu Qian , Wang Li , Ming Jie , Cao Hongwei , Liu Tao , Yu Xinwen , Bai Yuanyuan , Liang Shengru , Hu Ruofan , Wang Li , Chen Changsheng , Zhou Jie , Ji Qiuhe 
Published: March 2022

Abstract
Purpose
Metabolic syndrome (Mets) is a pathological condition that includes many abnormal metabolic components and requires a simple detection method for rapid use in a large population. The aim of the study was to develop a diagnostic model for Mets in a Chinese population with noninvasive anthropometric and demographic predictors.

Patients and methods
Least absolute shrinkage and selection operator (LASSO) regression was used to screen predictors. A large sample from the China National Diabetes and Metabolic Disorders Survey (CNDMDS) was used to develop the model with logistic regression, and internal, internal-external and external validation were conducted to evaluate the model performance. A score calculator was developed to display the final model.

Results
We evaluated the discrimination and calibration of the model by receiver operator characteristic (ROC) curves and calibration curve analysis. The area under the ROC curves (AUCs) and the Brier score of the original model were 0.88 and 0.122, respectively. The mean AUCs and the mean Brier score of 10-fold cross validation were 0.879 and 0.122, respectively. The mean AUCs and the mean Brier score of internal–external validation were 0.878 and 0.121, respectively. The AUCs and Brier score of external validation were 0.862 and 0.133, respectively.

Conclusions
The model developed in this study has good discrimination and calibration performance. Its stability was proved by internal validation, external validation and internal-external validation. Then, this model has been displayed by a calculator which can exhibit the specific predictive probability for easy use in Chinese population.
Oral adverse events due to zinc deficiency after pancreaticoduodenectomy requiring continuous intravenous zinc supplementation: a case report and literature review
Authors: Hata Hironobu , Ota Yojiro , Uesaka Katsuhiko , Yamazaki Yutaka , Murata Tsubasa , Murai Chika , Yoshikawa Kazuhito , Imamachi Kenji , Yurikusa Takashi , Kitagawa Yoshimasa 
Published: March 2022

Abstract
Background
Zinc is mainly absorbed in the duodenum and proximal jejunum, which are removed during pancreaticoduodenectomy (PD). Little is known about the adverse oral events and skin disorders caused by zinc deficiency after PD. Herein, we reviewed studies on the development of zinc deficiency after PD and reported about a patient with zinc deficiency after PD who required home intravenous zinc replacement.

Case presentation
A 73-year-old woman with glossitis, taste disorder, and acrodermatitis enteropathica-like eruption on her fingers presented to the Division of Dentistry and Oral Surgery 69 days after PD. Her serum zinc level markedly decreased to 30 μg/dL. Oral zinc administration was inadequate to treat hypozincemia after PD; therefore, multi-trace elements were injected intravenously during readmission. Her serum zinc levels recovered, and her lesions gradually improved. Furthermore, a central venous port was implanted to maintain normal serum zinc levels, and she continued self-injecting zinc at home.

Conclusions
Zinc deficiency after PD rarely occurs. The clinical oncologist community, including dentists responsible for the oral care of cancer patients, should be aware of the oral adverse events, such as dysgeusia, glossitis, and oral pain, associated with zinc deficiency after cancer surgery and that induced by chemotherapy or head and neck radiation therapy.
Measuring impostor phenomenon in healthcare simulation educators: a validation of the Clance Impostor Phenomenon Scale and Leary Impostorism Scale
Authors: Freeman Kirsty J. , Houghton Stephen , Carr Sandra E. , Nestel Debra 
Published: March 2022

AbstractBackgroundImpostor phenomenon is a term used to describe feelings of intellectual and professional fraudulence. The Clance Impostor Phenomenon Scale and the Leary Impostorism Scale are two self-report measures used to determine whether an individual experiences impostor phenomenon. This study examined the psychometric properties of both measures in healthcare simulation educators.MethodsThe study sample comprised 148 educators, 114 (77%) females, 34 (23%) males, who completed an online version of each instrument. Exploratory factor analysis was used to examine the factor structure of the Clance Impostor Phenomenon Scale and the Leary Impostorism Scale.ResultsExploratory factor analysis revealed that for both instruments a one-factor solution best fit the data, suggesting all items in both measures fit onto a single theoretical construct.Both instruments demonstrated high internal reliability, with the Cronbach’s alpha for the Clance Impostor Phenomenon Scale being α = .96 and the Leary Impostorism Scale α = .95.ConclusionsThis study suggests that impostor phenomenon as measured by the Clance Impostor Phenomenon Scale and the Leary Impostorism Scale is a unidimensional construct among healthcare simulation educators. With a growing interest in impostor phenomenon, the present findings will assist researchers to evaluate the phenomenon in healthcare settings.