bluuebunny/crossref_metadata_2025_split huggingface dataset:
Impact of the COVID-19 pandemic on incidence and severity of acute appendicitis: a comparison between 2019 and 2020
Authors:   the SCOUT Collaboarative Study group, Scheijmans Jochem C. G. , Borgstein Alexander B. J. , Puylaert Carl A. J. , Bom Wouter J. , Bachiri Said , van Bodegraven Eduard A. , Brandsma Amarins T. A. , ter Brugge Floor M. , de Castro Steve M. M. , Couvreur Roy , Franken Lotte C. , Gaspersz Marcia P. , de Graaff Michelle R. , Groenen Hannah , Kleipool Suzanne C. , Kuypers Toon J. L. , Martens Milou H. , Mens David M. , Orsini Ricardo G. , Reneerkens Nando J. M. M. , Schok Thomas , Sedee Wouter J. A. , Tavakoli Rad Shahzad , Volders José H. , Weeder Pepijn D. , Prins Jan M. , Gietema Hester A. , Stoker Jaap , Gisbertz Suzanne S. , Besselink Marc G. H. , Boermeester Marja A. 
Published: May 2021

Abstract
Background
During the COVID-19 pandemic, a decrease in the number of patients presenting with acute appendicitis was observed. It is unclear whether this caused a shift towards more complicated cases of acute appendicitis. We compared a cohort of patients diagnosed with acute appendicitis during the 2020 COVID-19 pandemic with a 2019 control cohort.

Methods
We retrospectively included consecutive adult patients in 21 hospitals presenting with acute appendicitis in a COVID-19 pandemic cohort (March 15 – April 30, 2020) and a control cohort (March 15 – April 30, 2019). Primary outcome was the proportion of complicated appendicitis. Secondary outcomes included prehospital delay, appendicitis severity, and postoperative complication rates.

Results
The COVID-19 pandemic cohort comprised 607 patients vs. 642 patients in the control cohort. During the COVID-19 pandemic, a higher proportion of complicated appendicitis was seen (46.9% vs. 38.5%; p = 0.003). More patients had symptoms exceeding 24 h (61.1% vs. 56.2%, respectively, p = 0.048). After correction for prehospital delay, presentation during the first wave of the COVID-19 pandemic was still associated with a higher rate of complicated appendicitis. Patients presenting > 24 h after onset of symptoms during the COVID-19 pandemic were older (median 45 vs. 37 years; p = 0.001) and had more postoperative complications (15.3% vs. 6.7%; p = 0.002).

Conclusions
Although the incidence of acute appendicitis was slightly lower during the first wave of the 2020 COVID-19 pandemic, more patients presented with a delay and with complicated appendicitis than in a corresponding period in 2019. Spontaneous resolution of mild appendicitis may have contributed to the increased proportion of patients with complicated appendicitis. Late presenting patients were older and experienced more postoperative complications compared to the control cohort.
BRAFnon-V600E more frequently co-occurs with IDH1/2 mutations in adult patients with gliomas than in patients harboring BRAFV600E but without a survival advantage
Authors: Wang Wei , Wang Maode , Jiang Haitao , Wang Tuo , Da Rong 
Published: May 2021

Abstract
Background
The effects of BRAFnon-V600E and BRAFV600E on the outcomes and the molecular characteristics of adult glioma patients are unknown and need to be explored, although BRAFV600E has been extensively studied in pediatric glioma.

Methods
Co-occurring mutations and copy number alterations of associated genes in the MAPK and p53 pathways were investigated using data from The Cancer Genome Atlas (TCGA) public database retrieved by cBioPortal. The prognosis of available adult glioma cohorts with BRAFV600E and BRAFnon-V600E mutations were also investigated.

Results
Ninety patients with BRAFV600E or BRAFnon-V600E were enrolled in this study, and data from 52 nonredundant patients were investigated. Glioblastoma multiform was the most common cancer type, with BRAFnon-V600E and BRAFV600E. TP53 (56.00% vs. 7.41%), IDH1/2 (36.00% vs. 3.70%), and ATRX (32.00% vs. 7.41%) exhibited more mutations in BRAFnon-V600E than in BRAFV600E, and TP53 was an independent risk factor (56.00% vs. 7.41%). Both BRAFnon-V600E and BRAFV600E frequently overlapped with CDKN2A/2B homozygous deletions (HDs), but there was no significant difference. Survival analysis showed no difference between the BRAFnon-V600E and BRAFV600E cohorts, even after excluding the survival benefit of IDH1/2 mutations and considering the BRAFnon-V600E mutations in the glycine-rich loop (G-loop) and in the activation segment. The estimated mean survival of patients with BRAFnon-V600E & IDH1/2WT with mutations in the G-loop groups was the shortest.

Conclusions
BRAFnon-V600E exhibited a stronger association with IDH1/2 mutations than BRAFV600E, but no survival advantage was found.
The association between cognitive impairment and breast and colorectal cancer screening utilization
Authors: Yang Shuang , Bian Jiang , George Thomas J. , Daily Karen , Zhang Dongyu , Braithwaite Dejana , Guo Yi 
Published: May 2021

Abstract
Background
Undergoing cancer screening is a debatable topic in patients with cognitive impairment. In this study, we aimed to examine the utilization and predictors of breast and colorectal cancer screening among screening eligible, cognitively impaired individuals.

Methods
We analyzed the 2018 and 2019 National Health Interview Survey data (n = 12,965 and 24,782, respectively) on individuals eligible for breast or colorectal cancer screening. We calculated the percentage of cancer screening eligible individuals who received mammogram or colonoscopy by cognitive impairment status. We used multivariable logistic regression to examine whether having a recent mammogram or colonoscopy differed by cognitive impairment status, adjusting for covariates.

Results
We observed a significantly lower percentage of mammogram use in the screening eligible, cognitively impaired (mild or severe) versus unimpaired women. Adjusting for the covariates, the cognitively impaired women, mild (odds ratio [OR] = 0.85; p = 0.015) or severe (OR = 0.54; p <  0.001), were less likely to have had a recent mammogram compared to the cognitively unimpaired women. Although statistically non-significant, the percentage of colonoscopy use in the screening eligible, cognitively impaired individuals were slightly higher than that in the cognitively unimpaired individuals. In the regression analysis, we found the cognitively impaired men, mild (OR = 0.79; p <  0.001) or severe (OR = 0.69; p = 0.038), were less likely to have had a recent colonoscopy compared to the cognitively unimpaired men. More studies are needed to examine the multilevel factors that underpin the difference in cancer screening utilization in this vulnerable population.

Conclusion
Our results highlight the need for additional research to address utilization and effectiveness of cancer screening in individuals with cognitive impairment.
Knowledge, attitudes and uptake related to influenza vaccine among healthcare workers during the 2018–2019 influenza season in Tunisia
Authors: Cherif Ines , Kharroubi Ghassen , Bouabid Leila , Gharbi Adel , Boukthir Aicha , Ben Alaya Nissaf , Ben Salah Afif , Bettaieb Jihene 
Published: May 2021

Abstract
Background
The influenza vaccine (IV) is considered the most effective strategy to prevent seasonal influenza infection and annual vaccination of healthcare workers (HCWs) is recommended by the World Health Organization given their high mixing with patients. We assessed IV uptake among HCWs in the 2018–2019 season and explored their knowledge and attitudes regarding influenza immunization.

Methods
A cross-sectional study was conducted in 150 representative Tunisian health facilities from March to May 2019. We recruited 1231 HCWs with direct patient contact using self-weighted multistage sampling. Univariate and multivariate logistic regression analyses permitted to assess the factors associated with IV uptake in the 2018–2019 influenza season.

Results
Among 1231 health professionals enrolled in this study, less than half (36.6, 95% confidence interval [CI]: 33.9–39.4) received the IV at least once in their lives and only 15.3% (CI: 13.3–17.4) were vaccinated against influenza in the 2018–2019 influenza season. High confidence regarding IV efficacy, belief about the mandatory character of influenza vaccination for HCWs, and IV uptake in the 4 years preceding the 2018–2019 influenza season were independently associated with higher IV uptake by multivariate analysis. However, participants with high educational level were less likely to receive the IV than those with the lowest educational level.

Conclusions
Our study revealed a low vaccination rate among Tunisian HCWs confirming the importance of tailored education programs targeting this population.
How combining different caries lesions characteristics may be helpful in short-term caries progression prediction: model development on occlusal surfaces of primary teeth
Authors: Floriano Isabela , Souza Rocha Elizabeth , Matos Ronilza , Mattos-Silveira Juliana , Ekstrand Kim Rud , Mendes Fausto Medeiros , Braga Mariana Minatel 
Published: May 2021

Abstract
Background
Few studies have addressed the clinical parameters' predictive power related to caries lesion associated with their progression. This study assessed the predictive validity and proposed simplified models to predict short-term caries progression using clinical parameters related to caries lesion activity status.

Methods
The occlusal surfaces of primary molars, presenting no frank cavitation, were examined according to the following clinical predictors: colour, luster, cavitation, texture, and clinical depth. After one year, children were re-evaluated using the International Caries Detection and Assessment System to assess caries lesion progression. Progression was set as the outcome to be predicted. Univariate multilevel Poisson models were fitted to test each of the independent variables (clinical features) as predictors of short-term caries progression. The multimodel inference was made based on the Akaike Information Criteria and C statistic. Afterwards, plausible interactions among some of the variables were tested in the models to evaluate the benefit of combining these variables when assessing caries lesions.

Results
205 children (750 surfaces) presented no frank cavitations at the baseline. After one year, 147 children were reassessed (70%). Finally, 128 children (733 surfaces) presented complete baseline data and had included primary teeth to be reassessed. Approximately 9% of the reassessed surfaces showed caries progression. Among the univariate models created with each one of these variables, the model containing the surface integrity as a predictor had the lowest AIC (364.5). Univariate predictive models tended to present better goodness-of-fit (AICs < 388) and discrimination (C:0.959–0.966) than those combining parameters (AIC:365–393, C:0.958–0.961). When only non-cavitated surfaces were considered, roughness compounded the model that better predicted the lesions' progression (AIC = 217.7, C:0.91).

Conclusions
Univariate model fitted considering the presence of cavitation show the best predictive goodness-of-fit and discrimination. For non-cavitated lesions, the simplest way to predict those lesions that tend to progress is by assessing enamel roughness. In general, the evaluation of other conjoint parameters seems unnecessary for all non-frankly cavitated lesions.
The inhibitory effect of silencing CDCA3 on migration and proliferation in bladder urothelial carcinoma
Authors: Shen Dexin , Fang Yayun , Zhou Fenfang , Deng Zhao , Qian Kaiyu , Wang Gang , Xiao Yu , Ju Lingao , Wang Xinghuan 
Published: May 2021

Abstract
Background
CDCA3 is an important component of the E3 ligase complex with SKP1 and CUL1, which could regulate the progress of cell mitosis. CDCA3 has been widely identified as a proto-oncogene in multiple human cancers, however, its role in promoting human bladder urothelial carcinoma has not been fully elucidated.

Methods
Bioinformatic methods were used to analyze the expression level of CDCA3 in human bladder urothelial carcinoma tissues and the relationship between its expression level and key clinical characteristics. In vitro studies were performed to validate the specific functions of CDCA3 in regulating cell proliferation, cell migration and cell cycle process. Alterations of related proteins was investigated by western blot assays. In vivo studies were constructed to validate whether silencing CDCA3 could inhibit the proliferation rate in mice model.

Results
Bioinformatic analysis revealed that CDCA3 was significantly up-regulated in bladder urothelial carcinoma samples and was related to key clinical characteristics, such as tumor grade and metastasis. Moreover, patients who had higher expression level of CDCA3 tend to show a shorter life span. In vitro studies revealed that silencing CDCA3 could impair the migration ability of tumor cells via down-regulating EMT-related proteins such as MMP9 and Vimentin and inhibit tumor cell growth via arresting cells in the G1 cell cycle phase through regulating cell cycle related proteins like p21. In vivo study confirmed that silencing CDCA3 could inhibit the proliferation of bladder urothelial carcinoma cells.

Conclusions
CDCA3 is an important oncogene that could strengthen the migration ability of bladder urothelial carcinoma cells and accelerate tumor cell growth via regulating cell cycle progress and is a potential biomarker of bladder urothelial carcinoma.
High prevalence of asymptomatic Plasmodium infection in Bandafassi, South-East Senegal
Authors: Badiane Aida Sadikh , Ndiaye Tolla , Thiaw Alphonse Birane , Binta Deme Awa , Diallo Mamadou Alpha , Seck Mame Cheikh , Diongue Khadim , Garba Mamane Nassirou , Ndiaye Mouhamadou , Ndiaye Daouda 
Published: May 2021

Abstract
Background
Malaria control and elimination strategies are based on levels of transmission that are usually determined by data collected from health facilities. In endemic areas, asymptomatic Plasmodium infection is thought to represent the majority of infections, though they are not diagnosed nor treated. Therefore, there might be an underestimation of the malaria reservoir, resulting in inadequate control strategies. In addition, these untreated asymptomatic Plasmodium infections maintain transmission, making it difficult or impossible to reach malaria elimination goals. Thus, the aim of this study was to determine the prevalence of asymptomatic Plasmodium infections in southeastern Senegal.

Methods
A cross sectional study was conducted among asymptomatic individuals (N = 122) living in the village of Andiel located in Bandafassi, Kédougou, which consisted of about 200 inhabitants during the malaria transmission season in late October 2019. For each individual without malaria-related symptoms and who consented to participate, a rapid diagnostic test (RDT) was performed in the field. Results were confirmed in the laboratory with photo-induced electron transfer (PET-PCR).

Results
Malaria prevalence was 70.3% by PET-PCR and 41.8% by RDT. During the same period, the health post of the area reported 49. 1% test positivity rate by RDT. The majority of the infected study population, 92.9%, was infected with a single species and 7.1% had two or three species of Plasmodium. Plasmodium falciparum was predominant and represented 90.2% of the infections, while 6.5% were due to Plasmodium ovale and 3.3% to Plasmodium malariae. 59.4% of children targeted for SMC (zero to ten years old) were infected.

Conclusion
In southeastern Senegal, where the transmission is the highest, malaria control strategies should address asymptomatic Plasmodium infections at the community level. The results suggest that this area could be eligible for mass drug administration. Moreover, non-falciparum species could be more common and its prevalence should be determined countrywide.
Characterizing environmental geographic inequalities using an integrated exposure assessment
Authors: CAUDEVILLE Julien , REGRAIN Corentin , TOGNET Frederic , BONNARD Roseline , GUEDDA Mohammed , BROCHOT Celine , BEAUCHAMP Maxime , LETINOIS Laurent , MALHERBE Laure , MARLIERE Fabrice , LESTREMAU Francois , CHARDON Karen , BACH Veronique , ZEMAN Florence Anna 
Published: May 2021

AbstractBackgroundAt a regional or continental scale, the characterization of environmental health inequities (EHI) expresses the idea that populations are not equal in the face of pollution. It implies an analysis be conducted in order to identify and manage the areas at risk of overexposure where an increasing risk to human health is suspected. The development of methods is a prerequisite for implementing public health activities aimed at protecting populations.MethodsThis paper presents the methodological framework developed by INERIS (French National Institute for Industrial Environment and Risks) to identify a common framework for a structured and operationalized assessment of human exposure. An integrated exposure assessment approach has been developed to integrate the multiplicity of exposure pathways from various sources, through a series of models enabling the final exposure of a population to be defined.ResultsMeasured data from environmental networks reflecting the actual contamination of the environment are used to gauge the population’s exposure. Sophisticated methods of spatial analysis are applied to include additional information and take benefit of spatial and inter-variable correlation to improve data representativeness and characterize the associated uncertainty. Integrated approaches bring together all the information available for assessing the source-to-human-dose continuum using a Geographic Information System, multimedia exposure and toxicokinetic model.DiscussionOne of the objectives of the integrated approach was to demonstrate the feasibility of building complex realistic exposure scenarios satisfying the needs of stakeholders and the accuracy of the modelling predictions at a fine spatial-temporal resolution. A case study is presented to provide a specific application of the proposed framework and how the results could be used to identify an overexposed population.ConclusionThis framework could be used for many purposes, such as mapping EHI, identifying vulnerable populations and providing determinants of exposure to manage and plan remedial actions and to assess the spatial relationships between health and the environment to identify factors that influence the variability of disease patterns.
Nahua biocultural richness: an ethnoherpetological perspective
Authors: Linares-Rosas Miriam Itzel , Gómez Benigno , Aldasoro-Maya Elda Miriam , Casas Alejandro 
Published: May 2021

Abstract
Background
Mexico harbours one of the greatest biocultural diversities of the world, where multiple social and natural elements and systems form complex networks of interactions in which both culture and nature are mutually influenced. Biocultural states and processes are studied by ethnosciences, among them ethnoherpetology, which seeks understanding material and non-material expressions of the interactions between humans, amphibians, and reptiles. Herpetofauna has been part of the magic–religious world and source of goods for Mesoamerican cultures. This study aims to document and analyse the complex body of knowledge, beliefs, and practices on these vertebrates in the Nahua culture, the factors that have influenced progressive risk and loss of culture, habitat, and species, and the potential contribution of contemporary Nahua knowledge to biocultural conservation.

Methods
Through 15 workshops with children and young people, and 16 semi-structured interviews to people 27 to 74 years old, we documented the contemporary Nahua knowledge in the communities of Aticpac and Xaltepec in the Sierra Negra, Puebla, central Mexico. Biological and ecological knowledge, use, management practices, legends, and perceptions on herpetofauna were emphasised in the study.

Results
We obtained an ethnoherpetological checklist, grouping species into four general classificatory categories: kohuatl (serpents), kalatl (frogs and toads), ayotsi (turtles), and ketzo (lizards and salamanders), which included 21, 10, 1, and 11 ethnocategories respectively, based on the local Nahua knowledge of herpetofauna. Serpents, used as medicine, are the most culturally relevant. Due to perceptions of danger, beliefs, and actual snake bites, the main interaction with serpents is their elimination; however, some snakes are tolerated and maintained in captivity. The remaining species of local herpetofauna recorded are tolerated. Cultural aspects of reptiles and amphibians in the Nahua worldview were documented to influence the regulation of interactions of people with these vertebrates, but for younger generations, such aspects are less frequent or absent.

Conclusions
Interactions and cultural relationships between the Nahua people, amphibians and reptiles are complex, maintaining some aspects of the local worldview but also influenced by external factors and being constantly recreated and re-signified. Documenting and understanding the contemporary relations is essential to generate strategies in biocultural conservation of herpetofauna.
Implementation fidelity of the Systems for Person-Centered Elder Care (SPEC): a process evaluation study
Authors: Choi Hyoungshim , Jung Young-il , Kim Hongsoo 
Published: May 2021

Abstract
Background
The Systems for Person-Centered Elder Care (SPEC), a complex intervention, was conducted to examine its effectiveness as a technology-enhanced, multidisciplinary, and integrated care model for frail older persons among ten nursing homes (NHs) in South Korea where formal long-term care has recently been introduced. The purpose of this study was to evaluate the implementation fidelity of the SPEC intervention and to identify moderating factors that influence the implementation fidelity.

Methods
This study was a process evaluation based on an evidence-based framework for implementation fidelity using a mixed-methods design. Quantitative data from consultant logbooks, NH documentations, an information and communications technology (ICT) system, and a standardized questionnaire were collected from April 2015 to December 2016 and analyzed by calculating the descriptive statistics. Semi-structured focus group interviews were held with multidisciplinary teams from the participating NHs. Qualitative data from a semi-structured questionnaire and the focus group interviews were analyzed using content analysis.

Results
The SPEC program demonstrated good implementation fidelity, and adherence to the SPEC program was strong in all aspects, such as content, coverage, frequency, and duration. Of the participating on-site coordinators, 60% reported that the SPEC model positively impacted needs assessment and the reporting system for resident care. The important facilitating factors were tailored facilitating strategies, assurance of the quality of delivery, and recruitment strategies.

Conclusion
The effectiveness of the SPEC program was driven by good implementation fidelity. The key factors of good implementation fidelity were tailored delivery of evidence-based interventions over process evaluation work, facilitating strategies, and ICT support. Larger implementation studies with a more user-friendly ICT system are recommended.

Trial registration
ISRCTN registry, ISRCTN11972147. Registered on 16 March 2015