bluuebunny/crossref_metadata_2025_split huggingface dataset:
A 45-year-old female patient with Sheehan’s syndrome presenting with imminent adrenal crisis: a case report
Authors: Genetu Abere , Anemen Yibeltal , Abay Sinshaw , Bante Simachew Anemen , Mihrete Kebadnew Mulatu 
Published: May 2021

Abstract
Background
Sheehan's syndrome is hypopituitarism due to pituitary gland necrosis resulting from hemorrhagic shock during pregnancy. It is a rare complication with varied manifestations and a considerable delay in diagnosis.

Case presentation
We describe the case of a 45-year-old Ethiopian woman who presented with generalized fatigue for 18 years which progressed to anorexia, nausea, vomiting, diarrhea, and abdominal pain of 6 years' duration, for which she was treated symptomatically throughout these years. Complete clinical evaluation, endocrine studies, and pituitary magnetic resonance scan revealed hypopituitarism secondary to Sheehan’s syndrome. She had significant improvement noted following the commencement of hormone replacement therapy.

Conclusion
Previous case reports describe patients being diagnosed after one or more complications from long-term panhypopituitarism. The present case illustrates that undiagnosed Sheehan's syndrome is associated with long-term morbidity, and we want to emphasize that a high index of suspicion is crucial for the early diagnosis of the syndrome in routine clinical visits in order to prevent complications arising with delayed diagnosis. Awareness among clinicians is also essential so that such cases are not overlooked, especially in developing nations, where home delivery is still common and obstetric care is limited.
Repurposing existing medications for coronavirus disease 2019: protocol for a rapid and living systematic review
Authors: Geisler Benjamin P. , Zahabi Lara , Lang Adam Edward , Eastwood Naomi , Tennant Elaine , Lukic Ljiljana , Sharon Elad , Chuang Hai-Hua , Kang Chang-Berm , Clayton-Johnson Knakita , Aljaberi Ahmed , Yu Haining , Bui Chinh , Le Mau Tuan , Li Wen-Cheng , Teodorescu Debbie , Hinske Ludwig Christian , Sun Dennis L. , Manian Farrin A. , Dunn Adam G. 
Published: May 2021

AbstractBackgroundCoronavirus disease 2019 (COVID-19) has no confirmed specific treatments. However, there might be in vitro and early clinical data as well as evidence from severe acute respiratory syndrome and Middle Eastern respiratory syndrome that could inform clinicians and researchers. This systematic review aims to create priorities for future research of drugs repurposed for COVID-19.MethodsThis systematic review will include in vitro, animal, and clinical studies evaluating the efficacy of a list of 34 specific compounds and 4 groups of drugs identified in a previous scoping review. Studies will be identified both from traditional literature databases and pre-print servers. Outcomes assessed will include time to clinical improvement, time to viral clearance, mortality, length of hospital stay, and proportions transferred to the intensive care unit and intubated, respectively. We will use the GRADE methodology to assess the quality of the evidence.DiscussionThe challenge posed by COVID-19 requires not just a rapid review of drugs that can be repurposed but also a sustained effort to integrate new evidence into a living systematic review.Trial registrationPROSPERO 2020CRD42020175648
Epiphyseal enchondroma masking as osteoid osteoma: a case report
Authors: Cao Xuyang , Ren Qiang , Li Xiangnan , Tian Yiren , Wang Zhendong 
Published: May 2021

Abstract
Background
Enchondromas originating in the epiphyses of long bones are rare and epiphyseal osteoid osteomas are also uncommon. Diagnosis can become elusive when enchondromas or osteoid osteomas occur in atypical locations and present with nonspecific clinical and imaging characteristics.

Case presentation
We report a case of epiphyseal enchondroma of the left proximal femur in a 15-year-old girl with a 2-month history of left lower extremity pain. Preoperative CT displayed thickened cortex in the anterior surface of the left proximal femur with specks of calcification and inhomogeneity of the adjacent bone marrow cavity. She was diagnosed with osteoid osteoma. Postoperative pathological examination of surgically excised specimens revealed a diagnosis of enchondromas.

Conclusions
Our case highlights that enchondroma should be considered in lesions of the epiphysis.
Cutaneous leishmaniasis control in Alta Verapaz (northern Guatemala): evaluating current efforts through stakeholders’ experiences
Authors: Mendizábal-Cabrera Renata , Pérez Isabel , Becerril Montekio Víctor , Pérez Freddy , Durán Erick , Trueba Mei L. 
Published: May 2021

Abstract
Background
Cutaneous leishmaniasis (CL), endemic in Guatemala, mostly affects poor people living in the northern region. A national control program that includes surveillance, diagnose, and treatment offered free of cost by the Ministry of Health (MoH) has been in place since 2003. However, the incidence is increasing and treatment rates are not optimal, suggesting that current efforts are not being effective. This study aimed to understand barriers and facilitators of CL control in Guatemala as experienced and perceived by key stakeholders in order to comprehend what works well and does not and suggest evidence-informed interventions.

Methods
The study was conducted in the Cobán municipality, the most endemic of Guatemala, situated in the Department of Alta Verapaz. Data were collected during May and June 2019 via focus groups and semi-structured interviews with key stakeholders, including local and national health personnel and residents of four communities of the endemic region. Thematic and content analysis of the collected data was conducted using NVIVO.

Results
Three overarching issues hamper the effectiveness of current CL efforts: resource scarcity, treatment challenges, and knowledge-action gaps. Scarce economic resources from the MoH and community residents negatively impact incidence, detection of cases and treatment rates in that preventive action is insufficient and healthcare access is low. In addition, local health workers often lack specialized CL training and access to the national CL control guidelines. With regards to the population living in the study area, misunderstanding of disease causation, shame associated with CL lesions, treatment pain fear, and long (often uncertain) waiting times for diagnose and treatment negatively affect people’s willingness to seek help, treatment adherence, and their trust on the healthcare provided.

Conclusions
Culturally sensitive CL preventive action must be developed. Given the scarce economic resources available for CL control in the country, the involvement of trained community health workers and the inclusion of thermotherapy as a treatment option is also advised. Other cost-effective actions include: ensuring all health workers receive CL training and have access to national CL control guidelines, improving national procurement system to avoid treatment shortages, and provision of motorized vehicles to increase active surveillance and treatment rates.

Graphical abstract
The development of a capacity-strengthening program to promote self-care practices among people with lymphatic filariasis-related lymphedema in the Upper West Region of Ghana
Authors: Atinbire Solomon Abotiba , Marfo Benjamin , Alomatu Bright , Ahorlu Collins , Saunderson Paul , Weiland Stefanie 
Published: May 2021

Abstract
Background
The Upper West region of Ghana is mostly made up of rural communities and is highly endemic for lymphatic filariasis (LF), with a significant burden of disability due to lymphedema and hydrocele. The aim of this paper is to describe an enhanced, evidence-based cascading training program for integrated lymphedema management in this region, and to present some initial outcomes.

Main text
A baseline evaluation in the Upper West Region was carried out in 2019. A cascaded training program was designed and implemented, followed by a roll-out of self-care activities in all 72 sub-districts of the Upper West Region. A post implementation evaluation in 2020 showed that patients practiced self-care more frequently and with more correct techniques than before the training program; they were supported in this by health staff and family members.

Conclusions
Self-care for lymphedema is feasible and a program of short workshops in this cascaded training program led to significant improvements. Efforts to maintain momentum and sustain what has been achieved so far, will include regular training and supervision to improve coverage, the provision of adequate resources for limb care at home, and the maintenance of district registers of lymphedema cases, which must be updated regularly.
A high-impact practice for online students: the use of a first-semester seminar course to promote self-regulation, self-direction, online learning self-efficacy
Authors: Stephen Jacqueline S. , Rockinson-Szapkiw Amanda J. 
Published: May 2021

AbstractStudent enrollment continues to increase in online programs, but there is concern surrounding the reportedly high rates of attrition in online classes compared to face-to-face classes. Undergraduate students are poorly prepared and lack the human agency necessary for success in the online learning environment. To address the lack of persistence of undergraduate online students, universities must create and implement interventions that prepare students for the online learning environment and help them develop as autonomous learners. This study examined whether differences in self-regulation, self-direction, and online learning self-efficacy exist between students participating in an experimental high-impact First-Semester Seminar (FSS) class and a traditional FSS class while controlling for pre-existing factors. A quantitative, quasi-experimental, pretest-posttest research design was used for this study with nonequivalent control groups, and multivariate analysis of covariance (MANCOVA) and follow up analyses of covariances (ANCOVA) were used to analyze the data. MANCOVA results revealed a statistically significant difference between groups. Follow-up ANCOVAs revealed differences between the posttest scores of the traditional FSS class and the high-impact FSS class on the measurements for self-directed learning and self-regulated learning.
Thoracoscopic esophagectomy in the prone position for esophageal cancer patients with pectus excavatum: a report of two cases
Authors: Tsukada Tomoya , Kitano Yuto , Sugimoto Yuya , Kaji Masahide 
Published: May 2021

Abstract
Background
Pectus excavatum is a common thoracic deformity that can be encountered during thoracoscopic esophagectomy. Here, we report two cases of esophageal cancer complicated by pectus excavatum that were treated with thoracoscopic esophagectomy with the patients in the prone position.

Case presentation
The first patient was a 64-year-old male diagnosed with esophageal cancer (cT3N0M0, Haller index 8.5) and underwent radical thoracoscopic esophagectomy in the prone position following neoadjuvant chemotherapy. The second patient was a 67-year-old male diagnosed with esophageal cancer (cT1bN0M0, Haller index 4.3), and the same procedure was performed in this patient. In cases of patients with a high Haller index, where securing the surgical field is difficult, preoperative computed tomography in the prone position can help surgeons to understand the mediastinal field of view and is safe.

Conclusions
Radical thoracoscopic esophagectomy in the prone position may be a surgical option in patients with pectus excavatum.
The promotion of healthy breakfast and snacks based on the social marketing model: a mixed-methods study
Authors: Mostafavi Firoozeh , Zamani-Alavijeh Fereshteh , Mansourian Marjan , Bastami Fatemeh 
Published: May 2021

Abstract
Background
Skipping breakfast and replacing it with non-nutritious snacks are progressively increasing among adolescents. This study aimed to develop an educational intervention based on the Social Marketing Model and evaluate its effects on healthy breakfast and snack consumption among female adolescent students.

Methods
This mixed-methods study was conducted in 2016–2019 in two phases. In the first phase, a qualitative study was conducted through directed content analysis in guidance schools in Khorramabad, Isfahan, and Tehran, Iran, to explore factors affecting breakfast consumption. The results of this phase were set in the benchmarks of the Social Marketing Model. In the second phase, a randomized controlled trial was conducted based on the benchmarks of the Social Marketing Model on 94 students randomly recruited from guidance schools in Khorramabad, Iran.

Results
The findings of the qualitative phase were categorized into the benchmarks of the Social Marketing Model, namely the social marketing mix, the intended behavior, internal and external competing factors for behavior modification, theoretical concepts related to the behavior, and the role of supporters. In the quantitative phase, the univariate analysis showed significant between-group differences concerning the product, price, promotion, and behavior (p < 0.05).

Conclusion
Healthy breakfast and snack consumption can be promoted through making acceptable the tastes, costs, preparations, and consumption places of breakfast and snack.

Trial registration
The trial was registered in the Iranian Registry of Clinical Trials (code: IRCT20170201032347N1).
The trial was registered in 11/07/2018 and is accessible on the Iranian Clinical Trial Registration website.
Moisture and vegetation cover limit ponderosa pine regeneration in high-severity burn patches in the southwestern US
Authors: Singleton Megan P. , Thode Andrea E. , Sánchez Meador Andrew J. , Iniguez Jose M. 
Published: May 2021

AbstractBackgroundFire regimes are shifting in ponderosa pine (Pinus ponderosaLawson & C. Lawson)-dominated forests, raising concern regarding future vegetation patterns and forest resilience, particularly within high-severity burn patches. The southwestern US has recently experienced a marked increase in large fires that produce large, high-severity patch interiors, with few surviving trees. These areas could be more susceptible for forest loss and conversions to alternative vegetation types than areas closer to the forest edge with more available seed sources. To better understand forest recovery, we surveyed ponderosa pine regeneration within edge and core areas (>200 m from edge) of high-severity patches in ten fires that burned between 1996 to 2008 across Arizona and New Mexico, USA. Specifically, we compared regeneration density, height, and canopy cover in patch edge and core areas and used generalized linear models to investigate the abiotic and biotic factors that contribute to ponderosa pine seedling establishment and density.ResultsHigh-severity burn-patch edge and core plots were not significantly different in seedling density, height, or canopy cover across fires. Seedling establishment was more likely at higher-elevation mesic sites and less likely when Gambel oak (Quercus gambeliiNutt.) was more abundant. Seedling density was negatively impacted by shrub, grass, and Gambel oak cover.ConclusionsRegeneration density varied among fires but analysis of regeneration in aggregated edge and core plots showed that abundance of seed availability was not the sole factor that limited ponderosa pine regeneration, probably because of surviving tree refugia within high-severity burn patches. Furthermore, our findings emphasize that ponderosa pine regeneration in our study area was significantly impacted by xeric topographic environments and vegetation competition. Continued warm and dry conditions and increased wildfire activity may delay the natural recovery of ponderosa pine forests, underscoring the importance of restoration efforts in large, high-severity burn patches.
Assessing implementation fidelity in the First Episode Rapid Early Intervention for Eating Disorders service model
Authors: Richards Katie L. , Flynn Michaela , Austin Amelia , Lang Katie , Allen Karina L. , Bassi Ranjeet , Brady Gabrielle , Brown Amy , Connan Frances , Franklin-Smith Mary , Glennon Danielle , Grant Nina , Jones William Rhys , Kali Kuda , Koskina Antonia , Mahony Kate , Mountford Victoria A. , Nunes Nicole , Schelhase Monique , Serpell Lucy , Schmidt Ulrike 
Published: May 2021

BackgroundThe First Episode Rapid Early Intervention for Eating Disorders (FREED) service model is associated with significant reductions in wait times and improved clinical outcomes for emerging adults with recent-onset eating disorders. An understanding of how FREED is implemented is a necessary precondition to enable an attribution of these findings to key components of the model, namely the wait-time targets and care package.AimsThis study evaluated fidelity to the FREED service model during the multicentre FREED-Up study.MethodParticipants were 259 emerging adults (aged 16–25 years) with an eating disorder of <3 years duration, offered treatment through the FREED care pathway. Patient journey records documented patient care from screening to end of treatment. Adherence to wait-time targets (engagement call within 48 h, assessment within 2 weeks, treatment within 4 weeks) and care package, and differences in adherence across diagnosis and treatment group were examined.ResultsThere were significant increases (16–40%) in adherence to the wait-time targets following the introduction of FREED, irrespective of diagnosis. Receiving FREED under optimal conditions also increased adherence to the targets. Care package use differed by component and diagnosis. The most used care package activities were psychoeducation and dietary change. Attention to transitions was less well used.ConclusionsThis study provides an indication of adherence levels to key components of the FREED model. These adherence rates can tentatively be considered as clinically meaningful thresholds. Results highlight aspects of the model and its implementation that warrant future examination.
How Protein Methylation Regulates Steroid Receptor Function
Authors: Malbeteau Lucie , Pham Ha Thuy , Eve Louisane , Stallcup Michael R , Poulard Coralie , Le Romancer Muriel 
Published: May 2021

AbstractSteroid receptors (SRs) are members of the nuclear hormonal receptor family, many of which are transcription factors regulated by ligand binding. SRs regulate various human physiological functions essential for maintenance of vital biological pathways, including development, reproduction, and metabolic homeostasis. In addition, aberrant expression of SRs or dysregulation of their signaling has been observed in a wide variety of pathologies. SR activity is tightly and finely controlled by post-translational modifications (PTMs) targeting the receptors and/or their coregulators. Whereas major attention has been focused on phosphorylation, growing evidence shows that methylation is also an important regulator of SRs. Interestingly, the protein methyltransferases depositing methyl marks are involved in many functions, from development to adult life. They have also been associated with pathologies such as inflammation, as well as cardiovascular and neuronal disorders, and cancer. This article provides an overview of SR methylation/demethylation events, along with their functional effects and biological consequences. An in-depth understanding of the landscape of these methylation events could provide new information on SR regulation in physiology, as well as promising perspectives for the development of new therapeutic strategies, illustrated by the specific inhibitors of protein methyltransferases that are currently available.
Environmental oxygen regulates astrocyte proliferation to guide angiogenesis during retinal development
Authors: Perelli Robin M. , O'Sullivan Matthew L. , Zarnick Samantha , Kay Jeremy N. 
Published: May 2021

ABSTRACT
Angiogenesis in the developing mammalian retina requires patterning cues from astrocytes. Developmental disorders of retinal vasculature, such as retinopathy of prematurity (ROP), involve arrest or mispatterning of angiogenesis. Whether these vascular pathologies involve astrocyte dysfunction remains untested. Here, we demonstrate that the major risk factor for ROP – transient neonatal exposure to excess oxygen – disrupts formation of the angiogenic astrocyte template. Exposing newborn mice to elevated oxygen (75%) suppressed astrocyte proliferation, whereas return to room air (21% oxygen) at postnatal day 4 triggered extensive proliferation, massively increasing astrocyte numbers and disturbing their spatial patterning prior to the arrival of developing vasculature. Proliferation required astrocytic HIF2α and was also stimulated by direct hypoxia (10% oxygen), suggesting that astrocyte oxygen sensing regulates the number of astrocytes produced during development. Along with astrocyte defects, return to room air also caused vascular defects reminiscent of ROP. Strikingly, these vascular phenotypes were more severe in animals that had larger numbers of excess astrocytes. Together, our findings suggest that fluctuations in environmental oxygen dysregulate molecular pathways controlling astrocyte proliferation, thereby generating excess astrocytes that interfere with retinal angiogenesis.
The role of profilin-1 in cardiovascular diseases
Authors: Allen Abigail , Gau David , Roy Partha 
Published: May 2021

ABSTRACT
Dynamic remodeling of the actin cytoskeleton is an essential feature for virtually all actin-dependent cellular processes, including cell migration, cell cycle progression, chromatin remodeling and gene expression, and even the DNA damage response. An altered actin cytoskeleton is a structural hallmark associated with numerous pathologies ranging from cardiovascular diseases to immune disorders, neurological diseases and cancer. The actin cytoskeleton in cells is regulated through the orchestrated actions of a myriad of actin-binding proteins. In this Review, we provide a brief overview of the structure and functions of the actin-monomer-binding protein profilin-1 (Pfn1) and then discuss how dysregulated expression of Pfn1 contributes to diseases associated with the cardiovascular system.
Luminescence lifetime imaging of three-dimensional biological objects
Authors: Dmitriev Ruslan I. , Intes Xavier , Barroso Margarida M. 
Published: May 2021

ABSTRACT
A major focus of current biological studies is to fill the knowledge gaps between cell, tissue and organism scales. To this end, a wide array of contemporary optical analytical tools enable multiparameter quantitative imaging of live and fixed cells, three-dimensional (3D) systems, tissues, organs and organisms in the context of their complex spatiotemporal biological and molecular features. In particular, the modalities of luminescence lifetime imaging, comprising fluorescence lifetime imaging (FLI) and phosphorescence lifetime imaging microscopy (PLIM), in synergy with Förster resonance energy transfer (FRET) assays, provide a wealth of information. On the application side, the luminescence lifetime of endogenous molecules inside cells and tissues, overexpressed fluorescent protein fusion biosensor constructs or probes delivered externally provide molecular insights at multiple scales into protein–protein interaction networks, cellular metabolism, dynamics of molecular oxygen and hypoxia, physiologically important ions, and other physical and physiological parameters. Luminescence lifetime imaging offers a unique window into the physiological and structural environment of cells and tissues, enabling a new level of functional and molecular analysis in addition to providing 3D spatially resolved and longitudinal measurements that can range from microscopic to macroscopic scale. We provide an overview of luminescence lifetime imaging and summarize key biological applications from cells and tissues to organisms.