bluuebunny/crossref_metadata_2025_split huggingface dataset:
RT-QuIC detection of pathological prion protein in subclinical goats following experimental oral transmission of L-type BSE
Authors: Favole Alessandra , Mazza Maria , D’Angelo Antonio , Lombardi Guerino , Palmitessa Claudia , Dell’Atti Luana , Cagnotti Giulia , Berrone Elena , Gallo Marina , Avanzato Tiziana , Messana Erika , Masoero Loretta , Acutis Pier Luigi , Meloni Daniela , Cardone Franco , Caramelli Maria , Casalone Cristina , Corona Cristiano 
Published: December 2021

Abstract
Objective
The spread of bovine spongiform encephalopathy (BSE) agent to small ruminants is still a major issue in the surveillance of transmissible spongiform encephalopathies (TSEs). L-type bovine spongiform encephalopathy (L-BSE) is an atypical form of BSE with an unknown zoonotic potential that is transmissible to cattle and small ruminants. Our current knowledge of bovine atypical prion strains in sheep and goat relies only on experimental transmission studies by intracranial inoculation. To assess oral susceptibility of goats to L-BSE, we orally inoculated five goats with cattle L-BSE brain homogenates and investigated pathogenic prion protein (PrPsc) distribution by an ultrasensitive in vitro conversion assay known as Real-Time Quaking Induced Conversion (RT-QuIC).

Results
Despite a prolonged observation period of 80 months, all these animals and the uninfected controls did not develop clinical signs referable to TSEs and tested negative by standard diagnostics. Otherwise, RT-QuIC analysis showed seeding activity in five out of five examined brain samples. PrPsc accumulation was also detected in spinal cord and lymphoreticular system. These results indicate that caprine species are susceptible to L-BSE by oral transmission and that ultrasensitive prion tests deserve consideration to improve the potential of current surveillance systems against otherwise undetectable forms of animal prion infections.
Methotrexate-induced toxidermia and pancytopenia in a patient with ectopic pregnancy: a case report
Authors: Refeno Valéry , Rasamimanana Naharisoa Giannie , Abasse Baco Abdallah , Ramarokoto Malalafinaritra Patrick Marco , Fanomezantsoa Mahefaniaina Jean Eustache , Randaoharison Pierana Gabriel 
Published: December 2021

Abstract
Background
Methotrexate is an anticancer drug from the antimetabolite class. It is also used in gynecology and obstetrics and is the molecule of choice for the medical treatment of ectopic pregnancies. We report a case of toxidermia associated with severe pancytopenia induced by methotrexate for ectopic pregnancy.

Case presentation
A 30-year-old Malagasy (African) woman was admitted to the Emergency and Intensive Care Department for probable toxidermia following injection of 75 mg of methotrexate for an ectopic pregnancy. She had developed generalized erythema, which started 48 hours after the injection. The secondary onset of phlyctenular maculopapular skin lesions, generalized purpura, and erosions of the oral mucosa in a context of febrile jaundice prompted her hospitalization. On admission, the patient presented with febrile neutropenia, pancytopenia, renal failure, and hepatic cytolysis. She received transfusions of fresh whole blood, erythromycin, and amphotericin B. The course was fatal within 2 days of hospitalization. The patient died of multiple organ failure.

Conclusions
Our case is mainly distinguished by the lack of use of granulocyte growth factors and folinic acid. In the event of severe reactions to methotrexate, the management should be multidisciplinary and as much as possible within an intensive care unit.
Role of barium enema examination for the diagnosis of submucosal invasion depth in T1 colorectal cancers
Authors: Kawasaki Keisuke , Torisu Takehiro , Nagahata Takahisa , Esaki Motohiro , Kurahara Koichi , Eizuka Makoto , Tanaka Yoshihito , Fujiwara Minako , Kawatoko Shinichiro , Oshiro Yumi , Yamada Shun , Ikegami Koji , Fujioka Shin , Fuyuno Yuta , Matsuno Yuichi , Umeno Junji , Moriyama Tomohiko , Kitazono Takanari , Sugai Tamotsu , Matsumoto Takayuki 
Published: December 2021

Abstract
Background
The indication for endoscopic resection for submucosally invasive colorectal cancer (T1-CRC) depends on the preoperative diagnosis of invasion depth. The aim of this investigation was to evaluate the association between barium enema examination (BE) profile views and depth of submucosal (SM) invasion in CRCs.

Methods
We reviewed the radiographic and endoscopic findings of 145 T1-CRCs diagnosed from 2008 to 2019. We measured the widths of horizontal and vertical rigidity under a BE profile view corresponding to CRC and compared the values with SM invasion depth. Horizontal rigidity was defined as the horizontal length and vertical rigidity as the vertical width of the barium defect corresponding to each target lesion. The most appropriate cut-off values for predicting SM invasion ≥1.8 mm were calculated by receiver operating characteristic curve analysis.

Results
Values of horizontal rigidity (r = 0.626, P < 0.05) and vertical rigidity (r = 0.482, P < 0.05) correlated significantly with SM invasion depth. The most appropriate cut-off values for the prediction of SM invasion depth ≥ 1.8 mm were 4.5 mm for horizontal rigidity, with an accuracy of 80.7%; and 0.7 mm for vertical rigidity, with an accuracy of 77.9%. The prevalence of lympho-vascular invasion was significantly different when those cut-off values were applied (43.2% vs. 17.5% for horizontal rigidity, P < 0.005).

Conclusions
In T1-CRC, values of horizontal and vertical rigidities under a BE profile view were correlated with SM invasion depth. While the accuracy of the rigidities for the prediction of SM invasion depth ≥ 1.8 mm was not high, horizontal rigidity may be predictive of lympho-vascular invasion, thus aiding in therapeutic decision-making.
Increasing power in the analysis of responder endpoints in rheumatology: a software tutorial
Authors: McMenamin Martina , Grayling Michael J. , Berglind Anna , Wason James M. S. 
Published: December 2021

Abstract
Background
Composite responder endpoints feature frequently in rheumatology due to the multifaceted nature of many of these conditions. Current analysis methods used to analyse these endpoints discard much of the data used to classify patients as responders and are therefore highly inefficient, resulting in low power. We highlight a novel augmented methodology that uses more of the information available to improve the precision of reported treatment effects. Since these methods are more challenging to implement, we developed free, user-friendly software available in a web-based interface and as R packages. The software consists of two programs: one that supports the analysis of responder endpoints; the second that facilitates sample size estimation. We demonstrate the use of the software to conduct the analysis with both the augmented and standard analysis method using the MUSE study, a phase IIb trial in patients with systemic lupus erythematosus.

Results
The software outputs similar point estimates with smaller confidence intervals for the odds ratio, risk ratio and risk difference estimators using the augmented approach. The sample size required in each arm for a future trial using the novel approach based on the MUSE data is 50 versus 135 for the standard method, translating to a reduction in required sample size of approximately 63%.

Conclusions
We encourage trialists to use the software demonstrated to implement the augmented methodology in future studies to improve efficiency.
Cardiac magnetic resonance imaging in patients with Behçet's disease
Authors: Ahmed Ali A. , Tharwat Samar , Batouty Nihal M. , El Bahy Ahmed , Tawfik Ahmed M. , Shahin Dina A. 
Published: December 2021

Abstract
Background
Behçet’s disease (BD) is a multisystemic vasculitis that may affect the heart. However, the incidence and nature of cardiac involvement in BD have not been clearly documented yet. The aim of this study was to delineate the cardiac magnetic resonance imaging (MRI) appearances of cardiac involvement in BD patients.

Methods
This cross-sectional observational study was carried out 30 BD patients without known cardiac disease. Patients were subjected to history taking, physical examination, echocardiography and cardiac MRI.

Results
At least one abnormality on cardiac MRI was observed in 20/30 patients (66.67%). Myocardial oedema was observed in 3 patients (10%) and late gadolinium enhancement in 1 patient (3.3%). Pericardial effusion was found in 3 patients (10.0%), global hypokinesia in 6 patients (20.0%) and intra-cardiac thrombosis in only 1 patient (3.3%). Pulmonary artery was dilated in 4 patients (13.3%). Left ventricular (LV) and right ventricular (RV) end diastolic volume were altered in 4 patients (13.3%) and 7 patients (23.3%) respectively. LV and RV end systolic volume were abnormal in 7 patients (23.3%) and 5 patients (16.7%) respectively. There was aortic valve regurge in 2 patients (6.7%), tricuspid valve regurge in 9 patients (30%), and mitral valve regurge in 9 patients (30%). Dilated left main coronary artery was found in 2 patients (6.7%) and arrhythmogenic right ventricular dysplasia in only one patient 1 patient (3.3%). On logistic regression analysis, BD activity index score was a significant predictor of cardiac abnormalities.

Conclusion
BD may cause cardiac abnormalities without clinical manifestations and cardiac MRI may represent a tool for early detection of these subtle abnormalities. Higher BD activity index scores are strongly linked to cardiac problems.
The psychological impact of inflammatory bowel disease as regards anxiety and depression: a single-center study
Authors: Askar Safaa , Sakr Mohamed Amin , Alaty Waleed Hamed Abd , Aufa Ola M. , Kamel Shimaa Y. , Eltabbakh Mohamed , Sherief Ahmed F. , Shamkh Mostafa A. A. , Rashad Heba 
Published: December 2021

Abstract
Background
Patients suffering from inflammatory bowel disease (IBD) are not systematically screened against depression as well as anxiety, although there are high prevalence and adverse influence on the quality of life. The aim of this work was to determine generalized anxiety disorder and major depressive disorder prevalence in patients with IBD, and the secondary objective was to identify patient properties linked to higher psychiatric disorder rates.

Results
We determined anxiety and depression prevalence in 105 IBD patients (82 having ulcerative colitis and 23 suffering from Crohn’s disease) through a psychiatric interview using the Arabic version of Structured Clinical Interview for DSM IV Axis I diagnosis (SCID I), in addition to severity assessment of major depressive disorder and generalized anxiety disorder using the Hamilton Depression Scale (HAM-D) and the Hamilton Anxiety Scale (HAM-A), respectively. Patient data, disease characteristics, and drug information were also gathered. We found a high depression prevalence of 56.2% (n = 59), followed by 37.1% (n = 39), with no significant association between IBD severity and anxiety and depression severity.

Conclusion
Depression and/or anxiety affected a large number of IBD patients. Such psychiatric disorders’ frequency would warrant detection as well as referral to psychiatric treatment.
Multidisciplinary approach of teaching radiology to medical students in Egypt: Is this an effective method?
Authors: Nabhani Yasmeen , Xie Victoria K. , Badawy Mohamed , Karim Rehan , Abdullatif Umayma , Negm Ahmed S. , Bhosale Hrishabh , Rohren Scott , Elhatw Ahmed , Ghannam Sammar , Abusaif Abdelrahman , Elsamaloty Mazzin , Shalaby Nada , Choucair Ferial , Khalifa Islam , Saad Mariam Ahmed , Patel Parth , Almubaid Zaid , Shehata Mostafa Ahmed , ElHefnawi Yara , Kamal Serageldin , Hammad Mahmoud F. , Elsayes Khaled M. 
Published: December 2021

Abstract
Background
In multidisciplinary education, different perspectives from more than one discipline are used to illustrate a certain topic. The aim of this study was to evaluate the effectiveness of an online, multidisciplinary radiology curriculum to teach radiology to medical students in Egypt. A multidisciplinary team of radiologists, surgeons, and internists taught a series of 5 case-based radiology sessions on a web conference platform. Topics included common clinical case scenarios for various body systems. Undergraduate medical students across Egypt were enrolled in the course. A pre-test–post-test design was used to evaluate the efficacy of each session. Upon course completion, students filled out a subjective survey to assess the radiology education series.

Results
On average, 1000 students attended each session. For each session, an average of 734 students completed both the pre-test and post-test. There was a statistically significant increase in post-test scores compared to pre-test scores across all 5 sessions (p < 0.001) with an overall average score improvement of 63%. A subjective survey at the end of the course was completed by 1027 students. Over 96% of students found the lecture series to be a worthwhile experience that increased their imaging knowledge and interest in radiology, and that the use of a multidisciplinary approach added educational value. About 66% of students also reported that the session topics were “excellent and clinically important.” There was a marked increase in reported confidence levels in radiology competencies before and after attendance of the sessions.

Conclusions
An online radiology curriculum with a multidisciplinary approach can be implemented successfully to reach a large group of medical students and meet their educational objectives.
Del Nido versus warm blood cardioplegia in adult patients with a low ejection fraction
Authors: Arafat Amr A. , Hassan Essam , Alfonso Juan J. , Alanazi Ebtesam , Alshammari Ahmad S. , Mahmood Asif , Al-Otaibi Khaled , Adam Adam I. , Algarni Khaled D. , Pragliola Claudio 
Published: December 2021

AbstractBackgroundDel Nido cardioplegia was recently introduced to adult cardiac surgery with encouraging results. The effect of Del Nido cardioplegia in patients with low ejection fraction (EF) has not been thoroughly evaluated. The objective of this study was to assess the safety of Del Nido cardioplegia in adult patients with low EF compared to intermittent warm blood cardioplegia.ResultsDuring 2018 and 2019, 73 adult patients with an EF of ≤ 40% underwent cardiac surgery using Del Nido cardioplegia. The patients were compared to a historical cohort of consecutive patients with low EF who had intermitted warm blood cardioplegia (n= 81). Patients who had Del Nido cardioplegia had significantly lower EuroSCORE II (2.73 (1.7–4.1) vs. 4.5 (2.4–7.4),P= 0.004). There were no differences in creatinine clearance and preoperative echocardiographic data between the groups. Cardiopulmonary bypass and cross-clamp times were non-significantly lower with Del Nido cardioplegia. There were no differences in stroke and postoperative echocardiographic data between the groups. No hospital mortality was reported in both groups. Peak troponin levels were significantly higher in patients who had Del Nido cardioplegia (0.88 (0.58–1.47) vs. 0.7 (0.44–1.01) ng/dL;P= 0.01); however, after multivariable regression analysis, cardiopulmonary bypass time was the only predictor of postoperative troponin level (coefficient 0.005 (95% CI: 0.003–0.008);P< 0.001). ICU stay was significantly longer in patients who had Del Nido cardioplegia (4 (3–6) vs. 2(1–4) days,P< 0.001), while postoperative hospital stay did not differ between the groups. After multivariable regression, the use of intermittent warm blood cardioplegia was significantly associated with shorter ICU stay (coefficient − 1.80 (95% CI − 3.06 – -0.55);P= 0.01).ConclusionsProlonged ICU was reported with Del Nido cardioplegia; however, there were no differences in the duration of hospital stay and the clinical outcomes between the groups. Despite the proven efficacy of intermittent warm blood cardioplegia, the use of Del Nido cardioplegia might be safe in patients with low EF.
Πρέβεζα 1940: Η ανεκπλήρωτη απόβαση. Ιστορικό μιας συνεχούς αποτυχίας
Authors: Ιωνάς Σπύρος 
Published: December 2021

Κατά τη σχεδίαση της ιταλικής επίθεσης στην Ελλάδα του 1940 αλλά και κατά τη διάρκεια του Ελληνοϊταλικού πολέμου, από την έναρξή του και μέχρι τη λήξη του, το ενδιαφέρον της ιταλικής ηγεσίας προς την Πρέβεζα θα είναι σταθερό και η τύχη της πόλης, σαν στόχου στα ιταλικά στρατιωτικά σχέδια, θα αλληλοεμπλέκεται συνεχώς με αυτήν των Επτανήσων, σε μια αδιάκοπη αλληλουχία επιβεβαιώσεων και ματαιώσεων σχεδίων απόβασης. Το κείμενο ερευνά το ενδιαφέρον της ιταλικής ηγεσίας προς την Πρέβεζα κατά τον Ελληνοϊταλικό πόλεμο καθώς και τα πολεμικά γεγονότα που διαδραματίστηκαν γύρω από αυτό το θέμα. Βασίζεται κατά μεγάλο μέρος σε δύο πρωτογενείς πηγές, το πολεμικό ημερολόγιο της Ανώτατης Ιταλικής Διοίκησης και τα πρακτικά των συσκέψεων του Αρχηγού Γενικού Επιτελείου.
Έκθεση αρχειακού υλικού "1912-2012:100 χρόνια ελεύθερη Πρέβεζα"
Authors: Σκλαβενίτης Σπύρος 
Published: December 2021

Παρουσίαση της έκθεσης του αρχειακού υλικού "1912-2012:100 χρόνια ελεύθερη Πρέβεζα" στο πλαίσιο εορτασμού για τη συμπλήρωση 100 χρόνων απόο την απελευθέρωση της Πρέβεζας
Ο Διγενής στην κορφή του ρολογιού. Μια εις Άδου κάθοδος στην ιστορία της πόλης
Authors: Παπαδημητρίου Απόστολος Σπ. 
Published: December 2021

Διήγημα. Ο βασικός πυρήνας της ιστορίας του διηγήματος βασίζεται σε πραγματικά γεγονότα που συντηρήθηκαν από προφορικές διηγήσεις παλαιότερων συγγενών του συγγραφέα
A Randomized controlled trial of the Effect of intraVenous iron on Anaemia in Malawian Pregnant women (REVAMP): Statistical analysis plan
Authors: Harding Rebecca , Ataide Ricardo , Mwangi Martin N , Simpson Julie A , Mzembe Glory , Moya Ernest , Truwah Zinenani , Nkhwazi Brains Changaya , Mwabinga Mphatso , Nkhono William , Phiri Kamija S , Pasricha Sant-Rayn , Braat Sabine 
Published: December 2021

Background: Anaemia affects more than half of Africa’s pregnancies. Standard care, with oral iron tablets, often fails to achieve results, with compliance and gastrointestinal side-effects being a significant issue. In recent years, intravenous iron formulations have become safe, effective, and quick to administer, allowing the complete iron requirements of pregnancy to be provided in one 15-minute infusion. The Randomized controlled trial of the Effect of intraVenous iron on Anaemia in Malawian Pregnant women (REVAMP) will evaluate whether a modern intravenous iron formulation, ferric carboxymaltose (FCM), given once during the second trimester is effective and safe in improving maternal and neonatal outcomes for treatment of moderate to severe anaemia in sub-Saharan Africa. The objective was to publish the detailed statistical analysis plan for the REVAMP trial prior to unblinding the allocated treatments and performing the analysis. Methods: REVAMP is a multicentre, two-arm, open-label, parallel-group randomized control trial (RCT) in 862 pregnant women in their second trimester. The trial statistician developed the statistical analysis plan in consultation with the trial management team based on the protocol, data collection forms, and study outcomes available in the blinded study database. Results: The detailed statistical analysis plan will support the statistical analyses and reporting of the REVAMP trial after unblinding the treatment allocations. Conclusions: A statistical analysis plan allows for transparency as well as reproducibility of reporting and statistical analyses.
Traits of transformational leaders in nursing: emotional intelligence counts?
Authors: Khrais Huthaifah , Alsadi Mohammad 
Published: December 2021

Background/Aims In the complex healthcare industry, transformational leadership and emotional intelligence in managers can achieve better outcomes. However, there is a lack of knowledge about the interaction between these two features. This study explored the traits of transformational leadership among the nurse managers in Jordan, focusing on the trait of emotional intelligence in critically-selected demographics. Methods A descriptive correlational research design was conducted. A total of 57 nurse managers from an acute referral hospital in Jordan completed the Multifactor Leadership Questionnaire and the 30-item Trait Emotional Intelligence Questionnaire to measure transformational leadership and emotional intelligence respectively. Demographic data were also collected on participants' age, gender, years of clinical experience and years of managerial experience. Results There was a strong direct relationship between transformational leadership style and emotional intelligence. Male nurses with more than 15 years of clinical experience showed more transformational leadership practices and the highest levels of emotional intelligence among this cohort. Conclusions Emotional intelligence is a vital component of effective transformational leadership, which promotes a healthy work environment and better healthcare outcomes.
Beyond STEMI: paramedics' views on how to improve their ability to interpret ECGs
Authors: Devergie Julien , O'Regan Andrew , Hayes Peter 
Published: December 2021

Background: Internationally, the paramedic scope of practice is developing. Bypassing emergency departments in favour of direct access to primary percutaneous coronary intervention laboratories has been limited largely to cases of ST-elevation myocardial infarction and new-onset left bundle branch block, but updates to international guidelines suggest that enhancing paramedics' skills in interpreting electrocardiograms (ECGs) and widening the bypass criteria could be beneficial. Aim: The aim of the study is to explore paramedics' views on ways to improve their ECG interpretation abilities. Method: A two-arm design was used with an online questionnaire (quantitative) and one-to-one interviews (qualitative). The questionnaire results were used to inform the interview guide. Findings: One hundred and eighteen paramedics completed the survey, and 11 took part in interviews. The major themes identified from the template analysis of the interviews were ‘a profession in transition’, ‘lagging professional development’ and ‘supporting the frontline’. Self-directed learning resources before, during and after action were proposed. Conclusion: Paramedicine is evolving in Ireland and practitioners have reported undertaking self-directed learning activities. The resulting heterogeneity in skills such as ECG interpretation, and perceived barriers to education, can cause feelings of vulnerability within the profession. Supporting the frontline by introducing some Group-Orchestrated Self-Directed Learning resources could empower practitioners and contribute to the evolution of prehospital care in Ireland.