bluuebunny/crossref_metadata_2025_split huggingface dataset:
Trends and predictive factors for treatment failure following artemisinin-based combination therapy among children with uncomplicated malaria in Ghana: 2005–2018
Authors: Abuaku Benjamin , Duah-Quashie Nancy Odurowah , Quashie Neils , Gyasi Akosua , Afriyie Patricia Opoku , Owusu-Antwi Felicia , Ghansah Anita , Malm Keziah Laurencia , Bart-Plange Constance , Koram Kwadwo Ansah 
Published: December 2021

Abstract
Background
Since the introduction of artemisinin-based combination therapy (ACT) in Ghana in 2005 there has been a surveillance system by the National Malaria Control Programme (NMCP) and the University of Ghana Noguchi Memorial Institute for Medical Research (UG-NMIMR) to monitor the therapeutic efficacy of ACTs for the treatment of uncomplicated malaria in the country. We report trends and determinants of failure following treatment of Ghanaian children with artesunate-amodiaquine (ASAQ) and artemether-lumefantrine (AL) combinations.

Methods
Per protocol analyses as well as cumulative incidence of day 28 treatment failure from Kaplan Meier survival analyses were used to describe trends of failure over the surveillance period of 2005–2018. Univariable and multivariable cox regression analyses were used to assess the determinants of treatment failure over the period.

Results
Day 28 PCR-corrected failure, following treatment with ASAQ, significantly increased from 0.0% in 2005 to 2.0% (95% CI: 1.1–3.6) in 2015 (p = 0.013) but significantly decreased to 0.4% (95% CI: 0.1–1.6) in 2018 (p = 0.039). Failure, following treatment with AL, decreased from 4.5% (95% CI: 2.0–9.4) in 2010 to 2.7% (95% CI: 1.4–5.1) in 2018, though not statistically significant (p = 0.426). Risk of treatment failure, from multivariable cox regression analyses, was significantly lower among children receiving ASAQ compared with those receiving AL (HR = 0.24; 95% CI: 0.11–0.53; p < 0.001); lower among children with no parasitaemia on day 3 compared with those with parasitaemia on day 3 (HR = 0.02; 95% CI: 0.01–0.13; p < 0.001); and higher among children who received ASAQ and had axillary temperature ≥ 37.5 °C on day 1 compared with those with axillary temperature < 37.5 °C (HR = 3.96; 95% CI: 1.61–9.75; p = 0.003).

Conclusions
Treatment failures for both ASAQ and AL have remained less than 5% (below WHO’s threshold of 10%) in Ghana since 2005. Predictors of treatment failure that need to be considered in the management of uncomplicated malaria in the country should include type of ACT, day 3 parasitaemia, and day 1 axillary temperature of patients being treated.
Imaging features of sentinel lymph node mapped by multidetector-row computed tomography lymphography in predicting axillary lymph node metastasis
Authors: Ou Xiaochan , Zhu Jianbin , Qu Yaoming , Wang Chengmei , Wang Baiye , Xu Xirui , Wang Yanyu , Wen Haitao , Ma Andong , Liu Xinzi , Zou Xia , Wen Zhibo 
Published: December 2021

Abstract
Introduction
Accurately assessing axillary lymph node (ALN) status in breast cancer is vital for clinical decision making and prognosis. The purpose of this study was to evaluate the predictive value of sentinel lymph node (SLN) mapped by multidetector-row computed tomography lymphography (MDCT-LG) for ALN metastasis in breast cancer patients.

Methods
112 patients with breast cancer who underwent preoperative MDCT-LG examination were included in the study. Long-axis diameter, short-axis diameter, ratio of long-/short-axis and cortical thickness were measured. Logistic regression analysis was performed to evaluate independent predictors associated with ALN metastasis. The prediction of ALN metastasis was determined with related variables of SLN using receiver operating characteristic (ROC) curve analysis.

Results
Among the 112 cases, 35 (30.8%) cases had ALN metastasis. The cortical thickness in metastatic ALN group was significantly thicker than that in non-metastatic ALN group (4.0 ± 1.2 mm vs. 2.4 ± 0.7 mm, P < 0.001). Multi-logistic regression analysis indicated that cortical thickness of > 3.3 mm (OR 24.53, 95% CI 6.58–91.48, P < 0.001) had higher risk for ALN metastasis. The best sensitivity, specificity, negative predictive value(NPV) and AUC of MDCT-LG for ALN metastasis prediction based on the single variable of cortical thickness were 76.2%, 88.5%, 90.2% and 0.872 (95% CI 0.773–0.939, P < 0.001), respectively.

Conclusion
ALN status can be predicted using the imaging features of SLN which was mapped on MDCT-LG in breast cancer patients. Besides, it may be helpful to select true negative lymph nodes in patients with early breast cancer, and SLN biopsy can be avoided in clinically and radiographically negative axilla.
Primary extraosseous dural chondrosarcoma: a case report
Authors: Garay Buitron Francis , Pons-Escoda Albert , Vidal Noemí , Torres Alberto , Camins Angels 
Published: December 2021

Abstract
Background
Dural chondrosarcoma is a very rare intracranial tumor, given that meninges do not normally contain cartilaginous tissue from which it can originate. We present a case of primary extraosseous dural chondrosarcoma.

Case presentation
A 48-year-old woman presented to our tertiary center neurosurgery consultation with progressive headache, vomiting, vertigo, and gait instability of 5 months’ duration.
An initial brain CT revealed a large parietal mass with gross calcifications and subtle hyperostosis of the inner table. Subsequent brain MRI showed a heterogeneous expansive lesion with a honey-comb enhancement.
Discussion of intra- or extra-axial location was warranted, and finally, initial presurgical suspicion of meningioma arose although some atypical imaging features were detected. The differential diagnosis included solitary fibrous tumor–hemangiopericytoma and dural metastasis.
Total resection of the lesion was performed, extra-axial origin was confirmed, and pathology resulted in a primary dural chondrosarcoma.

Conclusion
The importance of this case presentation lies in the unusual nature of the final diagnosis, the brief literature review and differential diagnosis with emphasis on imaging pearls, as well as the useful reminder for physicians to consider less frequent diseases when key findings do not unambiguously lead to the usual suspects.
Socio-demographic and environmental risk factors associated with multiple under-five child loss among mothers in Bangladesh
Authors: Kabir Rasel , Farag Marwa , Lim Hyun Ja , Geda Nigatu , Feng Cindy 
Published: December 2021

Abstract
Background
Despite the substantial decline in child mortality globally over the last decade, reducing neonatal and under-five mortality in Bangladesh remains a challenge. Mothers who experienced multiple child losses could have substantial adverse personal and public health consequences. Hence, prevention of child loss would be extremely desirable during women’s reproductive years. The main objective of this study was to determine the risk factors associated with multiple under-five child loss from the same mother in Bangladesh.

Methods
In this study, a total of 15,877 eligible women who had given birth at least once were identified from the 2014 Bangladesh Demographic and Health Survey. A variety of count regression models were considered for identifying socio-demographic and environmental factors associated with multiple child loss measured as the number of lifetime under-five child mortality (U5M) experienced per woman.

Results
Of the total sample, approximately one-fifth (18.9%, n = 3003) of mothers experienced at least one child’s death during their reproductive period. The regression analysis results revealed that women in non-Muslim families, with smaller household sizes, with lower education, who were more advanced in their childbearing years, and from an unhygienic environment were at significantly higher risk of experiencing offspring mortality. This study also identified the J-shaped effect of age at first birth on the risk of U5M.

Conclusions
This study documented that low education, poor socio-economic status, extremely young or old age at first birth, and an unhygienic environment significantly contributed to U5M per mother. Therefore, improving women’s educational attainment and socio-economic status, prompting appropriate timing of pregnancy during reproductive life span, and increasing access to healthy sanitation are recommended as possible interventions for reducing under-five child mortality from a mother. Our findings point to the need for health policy decision-makers to target interventions for socio-economically vulnerable women in Bangladesh.
An exploratory study of two-dimensional shear-wave elastography in the diagnosis of acute compartment syndrome
Authors: Zhang Jun , Zhang Wanfu , Zhou Huihui , Sang Lin , Liu Lina , Sun Yuanyuan , Gong Xue , Guan Hao , Yu Ming 
Published: December 2021

Abstract
Background
Two-dimensional shear-wave elastography (2D-SWE) is an ultrasound elastography technique that uses shear waves to quantitatively measure tissue stiffness and it has recently been developed as a safe, real-time, and noninvasive imaging technique. The purpose of this study was to investigate the value of 2D-SWE in the diagnosis and treatment of acute compartment syndrome (ACS).

Methods
2D-SWE was used to measure the elasticity values of the main muscles in the superficial compartments of the calf in 212 healthy volunteers, and the difference in the muscle elasticity values between different gender and age groups were analyzed. Nine patients with clinical suspicion of ACS were included in this study and 2D-SWE was used to measure the elasticity values of the muscles on the affected and unaffected sides, and a comparative analysis was performed.

Results
The mean elasticity values of the tibialis anterior (TA), peroneus longus (PL), and gastrocnemius medialis (GA) muscles in the relaxed state of the 212 healthy volunteers were 25.4 ± 3.2 kPa, 15.7 ± 1.5 kPa, and 12.1 ± 2.1 kPa, respectively. No statistically significant differences was observed in the elasticity values of the same muscle under the state of relaxation in different gender and age groups (p > 0.05). A statistically significant difference in the elasticity values of the muscle between the affected and unaffected sides in the fasciotomy group (p < 0.05, n = 5) was observed. In contrast, no difference in the elasticity values of the muscle between the affected and unaffected sides in the conservative group (p > 0.05, n = 4) was observed. There was a statistically significant difference in the elasticity values of the muscle on the affected side in the two treatment groups (p < 0.05).

Conclusions
When the ACS occurs, the muscle elasticity of the affected limb increases significantly. 2D-SWE is expected to be a new noninvasive technique for the assessment of ACS and may provide a potential basis for clinical diagnosis and treatment.
What is the impact of the COVID-19 pandemic on residency training: a systematic review and analysis
Authors: Chen Shou-Yen , Lo Hsiang-Yun , Hung Shang-Kai 
Published: December 2021

AbstractBackgroundThe coronavirus disease 2019 (COVID-19) pandemic has greatly affected medical education in addition to clinical systems. Residency training has probably been the most affected aspect of medical education during the pandemic, and research on this topic is crucial for educators and clinical teachers. The aim of this study was to understand the effect of the COVID-19 pandemic comprehensively through a systematic review and analysis of related published articles.MethodsA systematic review was conducted based on a predesigned protocol. We searched MEDLINE and EMBASE databases until November 30, 2020, for eligible articles. Two independent reviewers extracted data by using a customized form to record crucial information, and any conflicts between the two reviewers were resolved through discussion with another independent reviewer. The aggregated data were summarized and analyzed.ResultsIn total, 53 original articles that investigated the effect of the COVID-19 pandemic on residency training were included. Studies from various regions were included in the research, with the largest percentage from the United States (n = 25, 47.2%). Most of these original articles were questionnaire-based studies (n = 44, 83%), and the research target groups included residents (79.55%), program directors (13.64%), or both (6.82%). The majority of the articles (n = 37, 84.0%) were published in countries severely affected by the pandemic. Surgery (n = 36, 67.92%) was the most commonly studied field.ConclusionsThe COVID-19 pandemic has greatly affected residency training globally, particularly surgical and interventional medical fields. Decreased clinical experience, reduced case volume, and disrupted education activities are major concerns. Further studies should be conducted with a focus on the learning outcomes of residency training during the pandemic and the effectiveness of assisted teaching methods.
Oral GLP-1 analogue: perspectives and impact on atherosclerosis in type 2 diabetic patients
Authors: Saraiva José Francisco Kerr , Franco Denise 
Published: December 2021

AbstractCardiovascular events related to atherosclerosis are responsible for high morbidity and mortality among patients with type 2 diabetes. Improvement in care, especially in early stages, is crucial. Oral semaglutide, a glucagon-like peptide 1 analogue, controls blood glucose and results in significant body weight loss in patients with type 2 diabetes. Beyond these well-known effects, an interesting aspect of this drug is its antiatherogenic activity, which should be further explored in clinical practice. This paper reviews the evidence related to oral semaglutide decreasing cardiovascular risk in patients with type 2 diabetes, focusing on the drug’s antiatherosclerotic properties. The glucagon-like peptide 1 analogue restores endothelial dysfunction, induces vasodilatation, and reduces plasma lipids. Oral semaglutide showed cardiovascular safety profile, with significant reduced risk of death from cardiovascular events. Based on current data, clinicians should consider oral semaglutide for type 2 diabetes management.
Reprogramming of RNA silencing triggered by cucumber mosaic virus infection in Arabidopsis
Authors: Annacondia Maria Luz , Martinez German 
Published: December 2021

AbstractBackgroundRNA silencing has an important role mediating sequence-specific virus resistance in plants. The complex interaction of viruses with RNA silencing involves the loading of viral small interfering RNAs (vsiRNAs) into its host ARGONAUTE (AGO) proteins. As a side effect of their antiviral activity, vsiRNAs loading into AGO proteins can also mediate the silencing of endogenous genes. Here, we analyze at the genome-wide level both aspects of the interference of cucumber mosaic virus (CMV) with the RNA silencing machinery of Arabidopsis thaliana.ResultsWe observe CMV-derived vsiRNAs affect the levels of endogenous sRNA classes. Furthermore, we analyze the incorporation of vsiRNAs into AGO proteins with a described antiviral role and the viral suppressor of RNA silencing (VSR) 2b, by combining protein immunoprecipitation with sRNA high-throughput sequencing. Interestingly, vsiRNAs represent a substantial percentage of AGO-loaded sRNAs and displace other endogenous sRNAs. As a countermeasure, the VSR 2b loaded vsiRNAs and mRNA-derived siRNAs, which affect the expression of the genes they derive from. Additionally, we analyze how vsiRNAs incorporate into the endogenous RNA silencing pathways by exploring their target mRNAs using parallel analysis of RNA end (PARE) sequencing, which allow us to identify vsiRNA-targeted genes genome-wide.ConclusionsThis work exemplifies the complex relationship of RNA viruses with the endogenous RNA silencing machinery and the multiple aspects of virus resistance and virulence that this interaction induces.
Intravenous albumin for the prevention of hemodynamic instability during sustained low-efficiency dialysis: a randomized controlled feasibility trial (The SAFER-SLED Study)
Authors: Clark Edward G. , McIntyre Lauralyn , Watpool Irene , Kong Jennifer W. Y. , Ramsay Tim , Sabri Elham , Canney Mark , Hundemer Gregory L. , Brown Pierre-Antoine , Sood Manish M. , Hiremath Swapnil 
Published: December 2021

Abstract
Background
Hemodynamic instability is a frequent complication of sustained low-efficiency dialysis (SLED) treatments in the ICU. Intravenous hyperoncotic albumin may prevent hypotension and facilitate ultrafiltration. In this feasibility trial, we sought to determine if a future trial, powered to evaluate clinically relevant outcomes, is feasible.

Methods
This single-center, blinded, placebo-controlled, randomized feasibility trial included patients with acute kidney injury who started SLED in the ICU. Patients were randomized to receive 25% albumin versus 0.9% saline (control) as 100 mL boluses at the start and midway through SLED, for up to 10 sessions. The recruitment rate and other feasibility outcomes were determined. Secondary exploratory outcomes included ultrafiltration volumes and metrics of hemodynamic instability.

Results
Sixty patients (271 SLED sessions) were recruited over 10 months. Age and severity of illness were similar between study groups. Most had septic shock and required vasopressor support at baseline. Protocol adherence occurred for 244 sessions (90%); no patients were lost to follow-up; no study-related adverse events were observed; open label albumin use was 9% and 15% in the albumin and saline arms, respectively. Ultrafiltration volumes were not significantly different. Compared to the saline group, the albumin group experienced less hemodynamic instability across all definitions assessed including a smaller absolute decrease in systolic blood pressure (mean difference 10.0 mmHg, 95% confidence interval 5.2–14.8); however, there were significant baseline differences in the groups with respect to vasopressor use prior to SLED sessions (80% vs 61% for albumin and saline groups, respectively).

Conclusions
The efficacy of using hyperoncotic albumin to prevent hemodynamic instability in critically ill patients receiving SLED remains unclear. A larger trial to evaluate its impact in this setting, including evaluating clinically relevant outcomes, is feasible.
Trial registration ClinicalTrials.gov (NCT03665311); First Posted: Sept 11th, 2018. https://clinicaltrials.gov/ct2/show/NCT03665311?term=NCT03665311&draw=2&rank=1
The CT assessment of uncovertebral joints degeneration in a healthy population
Authors: Huang Tianji , Qin Jie , Zhong Weiyang , Tang Ke , Quan Zhengxue 
Published: December 2021

Abstract
Background
A retrospective study investigated the degeneration trend of uncovertebral joints in a healthy population based on CT assessment.

Methods
A total of 200 males and 160 females, aged 21–79 years old (50.82 ± 17.06), who underwent CT examination in our hospital from September 2020 to March 2021 were enrolled. Sixty patients were included in each age group. According to the Kellgren and Lawrence classification and CT was used to evaluate the uncovertebral joints degeneration in different groups.

Results
With the increase of age, the degeneration of each segment was gradually aggravated. The uncovertebral joints started degenerating in the 20 s, and the C5–6 is the most degenerative segment, followed by the C4–5 and C6–7. Significant degeneration occurred in each segment between the 40 s and 60 s and became more severe after the 70 s.

Conclusions
The modified Kellgren and Lawrence classification based on CT scan could provide a quantitative assessment of uncovertebral joints degeneration in a healthy population and could provide more details for artificial cervical arthroplasty.
Trends in Breast Cancer Mortality Between 2001 and 2017: An Observational Study in the European Union and the United Kingdom
Authors: Jani Chinmay , Salciccioli Ingrid , Rupal Arashdeep , Al Omari Omar , Goodall Richard , Salciccioli Justin D. , Marshall Dominic C. , Hanbury Georgina , Singh Harpreet , Weissmann Lisa , Shalhoub Joseph 
Published: December 2021

PURPOSE Breast cancer is the most common cancer in women worldwide, representing 25.4% of the newly diagnosed cases in 2018. The past two decades have seen advancements in screening technologies, guidelines, and newer modalities of treatment. Our study reports and compares trends in breast cancer mortality in the European Union and the United Kingdom. MATERIALS AND METHODS We used the WHO Mortality Database. We extracted breast cancer mortality data from 2001 to 2017 on the basis of the International Classification of Diseases, 10th revision system. Crude mortality rates were dichotomized by sex and reported by year. We computed age-standardized death rates (ASDRs) per 100,000 population using the world standard population. Breast cancer mortality trends were compared using joinpoint regression analysis. RESULTS We analyzed data from 24 EU countries, including the United Kingdom. For women, breast cancer mortality was observed to be downtrending in all countries except Croatia, France, and Poland. For the most recent female data, the highest ASDR for breast cancer was identified in Croatia (19.29 per 100,000), and the lowest ASDR was noted in Spain (12.8 per 100,000). Denmark had the highest change in ASDR and the highest estimated annual percentage change of −3.2%. For men, breast cancer mortality decreased in 18 countries, with the largest relative reduction observed in Denmark with an estimated annual percentage change of −27.5%. For the most recent male data, the highest ASDR for breast cancer was identified in Latvia (0.54 per 100,000). CONCLUSION Breast cancer mortality rates have down trended in most EU countries between 2001 and 2017 for both men and women. Given the observational nature of this study, causality to the observed trends cannot be reliably ascribed. However, possible contributing factors should be considered and subject to further study.