bluuebunny/crossref_metadata_2025_split huggingface dataset:
Effect of bicalutamide on serum total testosterone concentration in transgender adults: a case series
Authors: Angus Lachlan M. , Hong Quoc Vinh , Cheung Ada S. , Nolan Brendan J. 
Published: December 2024

Background: There is interest in repurposing bicalutamide for gender-affirming hormone therapy, but little data regarding efficacy and safety in the transgender population. Objectives: To determine the effect of bicalutamide on serum total testosterone concentrations and liver function. Given bicalutamide is a pure androgen receptor antagonist, we hypothesized that serum total testosterone concentrations would be higher than the cisgender female reference range and those recommended for transgender individuals in consensus guidelines. Design: Case series. Methods: We identified transgender people attending outpatient clinics who were using bicalutamide for gender affirmation. The primary outcome was serum total testosterone concentration. Secondary outcomes included serum alanine transferase (ALT) concentration. Results: Twenty-four transfeminine people prescribed bicalutamide were identified. The median (interquartile range) age was 29 (24–38) years, bicalutamide dose 25 (25–50) mg daily and bicalutamide duration 6 (4–10) months. The median serum total testosterone concentration was 7.7 (0.7–17.5) nmol/L, luteinizing hormone 2.9 (0.5–6.0) IU/L and ALT 20 (13–29) IU/L. One individual had asymptomatic transaminitis. Six individuals discontinued bicalutamide due to a lack of perceived benefit. Conclusion: Bicalutamide was associated with significant variation in serum total testosterone concentration, likely related to concomitant estradiol or previous anti-androgen therapy. Median serum ALT concentrations remained within the normal reference range. Guideline recommendations for serum total testosterone within the cisgender female reference range may be inappropriate for people using bicalutamide. Further research is needed to establish the longer-term efficacy and safety of bicalutamide in the transfeminine population.
Weight bearing versus non-weight bearing total contact cast in the management of active Charcot foot: A systematic review
Authors: Prem Rachna , Vignaraja Vikramman , Lewis Thomas , Budair Basil 
Published: December 2024

Aim: Diabetic Charcot neuro-osteoarthropathy carries a significant worldwide disease burden including diabetic foot infection, ulceration and amputation. The current accepted standard of treatment during the active phase of Charcot neuro-osteoarthropathy is offloading with total contact casting; however, controversy remains regarding weight-bearing status during this period. Methods: A systematic review was performed following PRISMA guidelines of Pubmed, EMBASE, MEDLINE and the Cochrane central register of controlled trials for clinical studies from inception until June 2024 investigating weight-bearing and non-weight-bearing total contact casting for active Charcot neuro-osteoarthropathy. Results: Four hundred ninety-three studies were identified in the search strategy of which 5 studies met the inclusion criteria comprising 158 patients. These studies found that allowing patients to weight-bear during total contact casting does not have a negative impact on the healing process. There were no comparative studies between weight-bearing and non-weight-bearing total contact casting. Conclusions: There is limited evidence to support current practice of non-weight bearing in a total contact casting for active Charcot neuro-osteoarthropathy. Allowing patients to weight bear carries advantages to patient independence and quality of life. Further investigation with randomised control trial should be considered to investigate if weight bearing is associated with negative outcomes.
Antibiotic susceptibility and phenotypic profile of Staphylococcus species isolated from different clinical samples from health facilities: A cross-sectional study
Authors: Anwar Khanda Abdulateef , Saadalla Shyar Mustafa , Muhammad Amin Aran Jabar , Ahmed Shad Mahdi , Qadir Mina Kawa 
Published: December 2024

Background: Staphylococcus species are widely distributed in nature and found in various human body sites. Objectives: To determine the antibiotic susceptibility pattern of Staphylococcus species isolated from different clinical samples. Methods: This cross-sectional study was conducted on 400 clinical specimens from conveniently sampled patients seeking healthcare at two health facilities in sulaimani / Iraq. Bacterial isolation and identification were done using conventional techniques, after which the antibiotic susceptibility profile of Staphylococcus species commonly prescribed antibiotics used in treating infections at the facilities was done using the disc diffusion method. Finally, MecA, methicillin-resistant Staphylococcus aureus and macrolides-lincosamide and streptogramin genes with mupirocin-resistant, beta-lactamase and vancomycin-resistance phenotypes were identified. Results: Staphylococcus aureus was the prevalent isolated species ( n = 197, 49.3%), followed by Staphylococcus hemolyticus ( n = 115, 28.8%), Staphylococcus epidermidis ( n = 49, 12.3%), Staphylococcus hominis ( n = 9.0, 2.3%), Staphylococcus sciuri ( n = 8.0, 2.0%) and Staphylococcus lentus ( n = 4.0, 1.0%). All isolated species resisted Penicillin G, Ampicillin, Cefotaxime and Cefoxitin. Most of the isolates, 89.5% ( n = 358) had the beta-lactamase phenotype, 18.0% ( n = 72) had the MecA gene, 2.8% ( n = 11) the Mupirocin-resistant phenotype, and 2.0% ( n = 8.0) the vancomycin-resistance phenotype. Additionally, 12 isolates had both methicillin-resistant Staphylococcus aureus (66.7%) and macrolides-lincosamide and streptogramin (65.2%) genes. The majority of the patients, 43% ( n = 172) were >50 years old and 52.25% ( n = 209) males. Also, most samples were from patients with urinary tract infection ( n = 73), wound ( n = 71), blood ( n = 35), sputum ( n = 29), pus ( n = 28), seminal fluid ( n = 27), cerebrospinal fluid ( n = 1.0) and stool ( n = 1.0). Most isolates that had the MSLb gene were highly significantly resistant to both Clindamycin (94.6%) and Erythromycin (84.7%) ( p < 0.001). Conclusions: Staphylococcus aureus was the predominant Staphylococcus species isolated from the clinical samples, most of which were resistant to most commonly prescribed antibiotics and had developed resistant genes and phenotypes.
Physical Frailty and Functional Status in Kidney Transplantation: A Systematic Review
Authors: Karnabi Priscilla , Massicotte-Azarniouch David , Marshall Shawn , Knoll Greg A. 
Published: December 2024

Background: Frailty and functional decline are being recognized as important conditions in kidney transplant candidates. However, the ideal measures of functional status and frailty remain unknown as there is not a complete understanding of the relationship between these conditions and important post-transplant outcomes. Objective: The objective was to examine the association between different measures of frailty and functional status evaluated before or at the time of transplant with adverse clinical outcomes post-transplantation. Design: This study is a systematic review. Setting: Observational studies including cohort, case-control, or cross-sectional studies examining the effect of frailty and functional status on clinical outcomes. There were no restrictions on type of setting or country of origin. Patients: Adults who were waitlisted for kidney transplant or had received a kidney transplant. Measurements: Data including demographic information (eg, sample size, age, country), assessments of frailty or functional status and their domains, and outcomes including mortality, transplantation, graft loss, delayed graft function and hospital readmission were extracted. Methods: A search was performed in Medline, Embase, and Cochrane Central Register for Controlled Trials. Studies were included from inception to February 7, 2023. The eligibility of studies was screened by 2 independent reviewers. Data were presented by frailty/functional status instrument and clinical outcome. Point estimates and 95% confidence intervals from fully adjusted statistical models were reported or calculated from the raw data. Results: A total of 50 studies were identified, among which 36 unique instruments were found. Measurements of these instruments occurred mostly at time of kidney transplant, transplant evaluation, and waitlisting. The median sample size of studies was 457 patients (interquartile range = 183-1760). Frailty and lower functional status were associated with an increased risk for mortality. Similar trends were observed among other clinical outcomes such as graft loss and rehospitalization. Limitations: The heterogeneity in measurement instruments, study designs, and outcome definitions prevents pooling of the data. Selection bias and the validity of data collection could not be ascertained for some studies. Conclusion: Frailty and functional status measures are important predictors of post-kidney transplant outcomes. Further studies are needed to evaluate the best instruments to assess frailty and functional status, and importantly, interventional studies are needed to determine whether prehabilitation strategies can improve post-transplant outcomes. Registration (PROSPERO): CRD42016045251.
Graft Length Changes and Optimal Knee Flexion Angles for Fixation in Posterolateral Corner Reconstruction: An In Vivo 3-Dimensional Simulation Analysis
Authors: Chung Kwangho , Jung Min , Hyuk Choi Chong , Jung Se-Han , Hong Junseok , Kim Sung-Hwan 
Published: December 2024

Background: Changes in graft length according to knee flexion and the ideal knee flexion angle at the time of graft fixation for posterolateral corner (PLC) reconstruction have yet to be clearly defined. Purposes: To investigate graft length changes according to knee flexion and determine the optimal graft fixation angle for knee flexion in PLC reconstruction. Study Design: Descriptive laboratory study. Methods: Ten healthy male volunteers underwent computed tomography at varying knee flexion angles (0°, 30°, 45°, 60°, and 90°). The Larson, LaPrade, Arciero, and Kim techniques were performed on 3-dimensional knee models reconstructed from the computed tomography scans. The lengths of each theoretically reconstructed graft were recorded and compared according to knee flexion angle changes. Results: In the Larson technique, the lengths of both arms of the sling were the longest at 30° of knee flexion but were not significantly different between 45° and 60° of knee flexion. In the LaPrade, Arciero, and Kim techniques, the length of the lateral collateral ligament arm at 30° of knee flexion was significantly longer than that at other knee flexion angles ( P < .05), except at 0° of knee flexion. The length of the popliteus tendon arm in the LaPrade and Kim techniques, and the length of the popliteofibular ligament arm in the Arciero technique, increased with knee flexion and became the longest at 60° of knee flexion ( P < .05). Conclusion: In the LaPrade, Arciero, and Kim techniques, the lengths of the lateral collateral ligament and popliteus complex component arms were greatest at 30° and 60° of knee flexion, respectively. In the Larson technique, the lengths of the anterior and posterior arms were greatest at 30° of knee flexion. The authors recommend securing each arm of the graft at the point of its greatest length. Clinical Relevance: This study presents in vivo data regarding graft length changes according to knee flexion and offers an optimal graft fixation angle for PLC reconstructions through various techniques.
Digital Health/e-Health Literacy among University Students in the COVID-19 Era: A Systematic Review
Authors: Fallahi Mohammad Sadegh , Faridzadeh Arezoo , Salahi Mehrnaz , Mehrabani Reyhaneh , Karimi Hanieh , Faraji Ali , Imanparvar Saba , Falahatian Masih , Bayat Mohammadamin , Norouzkhani Narges , Mazhari Seyed Amirhossein , Roostaie Minoo , Sadatmadani Seyedeh Fatemeh , Fathi Mobina , Behshood Parisa , Deravi Niloofar 
Published: December 2024

OBJECTIVE During the severe acute respiratory syndrome coronavirus 2 pandemic, could be observed an established use of online information in the field of coronavirus disease worldwide. As a systematic review study, the present investigation aimed to evaluate related studies about digital health/e-health literacy among university students in the coronavirus disease 2019 era. METHODS Three electronic bibliographic databases (PubMed/Medline, Scopus, and Google Scholar) were searched from 2020 until June 2022, and articles were screened according to pre-established inclusion criteria. RESULTS Fifteen studies were included in this systematic review study. All of the studies were cross-sectional in design, and in total, 45,255 students were evaluated. The majority of studies report health literacy scores among university students that are lower compared to reference samples. Students’ health literacy is influenced by different variables (age, gender, socioeconomic background, sources of online information, well-being, and satisfaction with data). CONCLUSION Digital health literacy (DHL) shapes health behaviors and actions. To enhance DHL, multidisciplinary teams from diverse fields can design curricula suitable for students. The internet’s role in DHL is crucial, but it can also spread misleading content. Therefore, professionals should provide clear, evidence-based information and encourage critical data evaluation. Future studies should use robust sampling methods, consider students with limited internet access, and address the unique needs of specific populations, such as those with disabilities and low socioeconomic status.
A nationwide survey of bereavement care for siblings provided by paediatric palliative care teams
Authors: Ridley Ashley , Aubry Régis , Frache Sandra 
Published: December 2024

Background: Bereavement support is considered a core standard of care for paediatric palliative care (PPC) teams. Support for grieving siblings can present unique challenges. Developmentally appropriate care can help children navigate their grief experience. Objectives: To describe the provider perspectives (mission and development) of bereavement care for siblings, and to describe the bereavement follow-up interventions offered for siblings by hospital-based PPC teams nationwide. Design and methods: Qualitative study conducted by semidirected telephone interviews. At least one member from each PPC team was interviewed. Interviews transcribed verbatim were analysed using grounded theory. Results: Twenty-one teams participated (response rate 91%). Most teams (80%) provided individual psychotherapy to families, and a few (28%) offered group interventions. PPC teams endeavour to expand their bereavement services and create a stronger collaboration network with community services. However, limited human resources, lack of facilities and financing, and geographical distances were frequent obstacles to bereavement care program development. Conclusion: PPC teams support bereaved siblings as an integral part of palliative care. Although PPC teams cannot meet all the needs of bereaved families, they can serve as important reference points to consolidate knowledge of available local resources and offer well-informed guidance to families and community users. Greater public awareness of childhood bereavement and engaging with community structures could help overcome some of the common obstacles to service development. Further studies are warranted in evaluating bereavement services in France and in other healthcare systems.
Barriers to establishing teledermatoscopy in primary health care in Sweden
Authors: Hernström Nils , Ingvar Åsa 
Published: December 2024

Abstract
Introduction
Teledermatoscopy (TDS) has proven to be effective and reliable for diagnosis of skin malignancies. The factors that determine the success of implementation of TDS are largely unknown.

Objectives
To investigate barriers to implementation of TDS in primary health care (PHC) at center and individual level.

Methods
Following introduction of TDS, cross-sectional quantitative data and free text comments were collected by surveys sent to PHC centers and PCH practitioners. Successful implementation was defined as regularly sent cases at center level and self-reported usage at individual level. Factors associated with implementation were evaluated with Chi-square, Kruskal-Wallis test and logistic regression.

Results
93/117 (78.2%) of PHC centers and 239/725 (32.9%) of PHC practitioners answered the surveys. 54.8% (n = 51) of PHC centers and 64.3% (n = 153) of PHC practitioners had implemented TDS.
There was a strong association between hardware arrival before introduction and TDS usage at center level (OR 6.0; 95% CI 1.5–24.3). At individual level, male sex was positively associated with usage (OR 1.9; 95%, CI 1.0–3.4), and for every year of increased age, the chance of using TDS decreased with 3% (OR 1.0, 95% CI 0.9–1.0). No other factor was associated with implementation. “Good” was the most common overall impression (54.8%), and the majority found no problems using the system (> 85%). The most common complaint was technical issues followed by no added value.

Conclusions
Successful implementation of TDS was strongly associated with hardware arrival at center level, and to male sex and younger age at individual level. Satisfaction was overall high.
Motivators and barriers for smoking cessation in people with multiple sclerosis: a qualitative study to inform the design of a tailored intervention
Authors: Keller Alex M. , von Glasenapp Barbara , Kotz Daniel , Marck Claudia H. , Heesen Christoph , Riemann-Lorenz Karin 
Published: December 2024

Abstract
Background
Tobacco smoking is a relevant determinant of multiple sclerosis (MS) onset, and smokers have increased risk for faster progression of MS compared to non-smokers. While the smoking prevalence is high in Germany, no smoking cessation programs have been developed specifically in MS populations to date, and only little is known about the motivators and barriers influencing smoking cessation in people with MS (pwMS) in Germany. This study aims to identify these factors to inform the design of a tailored smoking cessation intervention.

Methods
As part of a larger program of work, we conducted semi-structured interviews in people with MS (pwMS) to explore their needs, motivators and barriers regarding smoking cessation. We recruited via MS-websites and the email-newsletter of our institution at the University Medical Centre Hamburg-Eppendorf. Participants were eligible if they had a self-reported MS-diagnosis and currently smoked or quit smoking within the last two years but after their MS-diagnosis. Interviews were conducted online and via telephone during May and June 2023. Data were analysed using thematic analysis based on a realistic approach.

Results
Eight women and seven men participated in our interviews. Eleven were current, four were former smokers. Median time since diagnosis was 4 years (range: 1–26). Interviews identified MS-diagnosis, concerns about general health, and social factors as relevant motivators to stop smoking. Furthermore, worries about negative consequences when quitting (e.g. fear of missing out on social interactions or weight gain) were identified as a great barrier to smoking cessation. Knowledge about the connection between MS and smoking, and satisfaction with communication with MS clinicians were low. PwMS expressed a need for better conversations with neurologists and expert-led smoking cessation interventions. Additionally, we found that the wish for peer-exchange and the willingness to participate in smoking cessation programs was high.

Conclusion
Our results confirm findings of previous studies from other countries, identifying lack of knowledge, unsatisfactory communication with MS clinicians, and worries about negative consequences when quitting as barriers, and the MS-diagnosis as a motivator for smoking cessation. In a next step, we will use our findings for the development of an MS-specific online smoking cessation program.
Prediction of bioactive compounds hepatotoxicity using in silico and in vitro analysis
Authors: Choi Kwanyong , Lee Soyeon , Yoo Sunyong , Han Hyoung-Yun , Park Soo-yeon , Kim Ji Yeon 
Published: December 2024

AbstractThe leading safety issue and side effect associated with natural herb products is drug-induced liver injury (DILI) caused by bioactive compounds derived from the herb products. Herein, in silico and in vitro analyses were compared to determine the hepatotoxicity of compounds. The results of in silico analyses, which included an integrated database and an interpretable DILI prediction model, identified calycosin, biochanin_A, xanthatin, piperine, and atractyloside as potential hepatotoxic compounds and tenuifolin as a non-hepatotoxic compound. To evaluate the viability of HepG2 cells exposed to the selected compounds, we determined the IC50 and IC20 values of viability using MTT assays. For in-depth screening, we performed hematoxylin and eosin-stained morphological screens, JC-1 mitochondrial assays, and mRNA microarrays. The results indicated that calycosin, biochanin_A, xanthatin, piperine, and atractyloside were potential hepatotoxicants that caused decreased viability and an apoptotic phase in morphology, while these effects were not observed for tenuifolin, a non-hepatotoxicant. In the JC-1 assay, apoptosis was induced by all the predicted hepatotoxicants except atractyloside. According to transcriptomic analysis, all the compounds predicted to induce DILI showed hepatotoxic effects. These results highlighted the importance of using in vitro assays to validate predictive in silico models and determine the potential of bioactive compounds to induce hepatotoxicity in humans.