bluuebunny/crossref_metadata_2025_split huggingface dataset:
The complex relationship between estrogen and migraines: a scoping review
Authors: Reddy Nihaal , Desai Miraj N. , Schoenbrunner Anna , Schneeberger Steven , Janis Jeffrey E. 
Published: March 2021

Abstract
Background
Migraines are a chronic disease for millions worldwide and have been hypothesized to be hormonally mediated due to their higher prevalence in females and menstrual associations. Estrogen has been commonly implicated in migraine pathogenesis, yet its exact role in the pathophysiology of migraines has yet to be fully understood.

Method
We conducted a scoping review of the literature regarding estrogen’s role in migraine pathogenesis and included 19 studies out of an initial 202 in the final review. Two independent reviewers screened and extracted data from included studies based on predetermined inclusions and exclusion criteria.

Results
The estrogen withdrawal hypothesis, discussed by 12 of the reviewed studies, is the most discussed theory about estrogen’s role in migraine physiology and describes the association of migraine onset with natural declines in estrogen levels, particularly when estrogen levels fall below 45–50 pg/mL after an extended period of priming. Additional findings suggest that women with a history of migraine have an increased sensitivity to physiologic fluctuations in estradiol levels. Several studies suggest that migraines are associated with menstruation.

Conclusion
It appears that estrogen is very likely to play a key role in migraine pathogenesis, but seems to affect patients in different ways depending on their past medical history, age, and use of hormonal therapy. Further research is warranted to isolate the effects of estrogen in each unique patient population, and we believe that studies comparing menstruating women to postmenopausal women could help shed light in this area.
Psychosocial rehabilitation experiences of women victims of armed conflict in Montes de María, Colombia
Authors: Sarmiento-Marulanda Laura Camila , Aguilera-Char Amira Ayleen , González-Gil Catalina , López-López Wilson 
Published: March 2021

Abstract
Background
After 9 years of the ground-breaking social policy Law 1448 of 2011 -Victims Law- and its extension until 2030, the Colombian State and other stakeholders have made several efforts towards granting the right of integral reparation for more than 9 million victims that are recognized in the Colombian transitional context. Psychosocial rehabilitation is a Victims Law’s reparation measure whose objective is to re-establish the psychosocial, physical and mental health welfare in the individual, familiar and community levels. This study aims to understand the experiences of psychosocial rehabilitation of women victims of armed conflict in Montes de Maria and the underlying social intervention paradigms that guide the Law’s implementation.

Methods
Based on a qualitative design with a phenomenological approach, narrative tools and thematic network analysis permitted to give voice to the women participants. Individual narrative interviews were conducted with 12 women victims and a focus group with eight of them was used as a triangulation strategy.

Results
Although the Victims Law is oriented by a sociopolitical intervention paradigm, the stories of the women’s victims of Montes de María mainly evidenced non-sociopolitical interventions with humanitarian assistance towards revictimization and State abandonment. As a coping mechanism towards the State negligence encountered, women strive to overcome psychosocial trauma by developing agency and community resources for the resignification of the traumatic experiences and peacebuilding.

Conclusions
For the Victims Law to achieve its integrality aim, the psychosocial approach should be implemented through all its measures but remains absent in Montes de Maria. The diversity of victim’s individual and collective initiatives that were found, can contribute towards transformative and participatory psychosocial intervention with community’s resources. Women victims can perform as advisors and collaborators in the implementation of individual and collective reparation, which remains as an opportunity for psychosocial rehabilitation and peacebuilding. Further monitoring and evaluation of the law with a territorial and differential perspective is required to respond to the victim’s needs.
Characteristics and diversity of mutations in regulatory genes of resistance-nodulation-cell division efflux pumps in association with drug-resistant clinical isolates of Acinetobacter baumannii
Authors: Salehi Bahare , Ghalavand Zohreh , Yadegar Abbas , Eslami Gita 
Published: March 2021

AbstractBackgroundThis study was aimed to characterize the genetic diversity and expression of three putative resistance-nodulation-cell division (RND)-type efflux systems and their contribution to multidrug efflux in clinical isolates ofAcinetobacter baumannii.MethodsAntimicrobial susceptibility testing of 95A. baumanniiisolates was determined by Kirby-Bauer disk diffusion for 18 antibiotics and minimum inhibitory concentration (MIC) of colistin was determined by the broth microdilution method. Moreover, the MIC of five classes of antibiotics was assessed using E-test strips in the presence and absence of phenylalanine-arginine beta-naphthylamide (PAβN). Regulatory genes of the RND efflux pumps (adeRS,adeL,adeNandbaeSR) were subjected to sequencing. The relative expression ofadeB,adeGandadeJgenes was determined by quantitative real-time PCR (qRT-PCR).ResultsOverall, the majority of isolates (94%) were extensively drug-resistant (XDR). In the phenotypic assay, efflux pump activity was observed in 40% of the isolates against multiple antibiotics mainly tigecycline. However, we found no efflux activity against imipenem. Several amino acid substitutions were detected in the products of regulatory genes; except in AdeN. Of note, G186V mutation in AdeS was found to be associated with overexpression of its efflux pump. No insertion sequences were detected.ConclusionsOur findings outlined the role of RND efflux pumps in resistance ofA. baumanniito multiple antibiotics particularly tigecycline, and pointed out the importance of a variety of single mutations in the corresponding regulatory systems. Further studies are required to decipher the precise role of RND efflux pumps in multidrug-resistant clinical isolates ofA. baumannii.
Characterisitcs of Saccharomyces boulardii for reducing ammonia emission from livestock manure
Authors: Kim Sun Il , Heo Wan , Lee So Jung , Han Bok Kyung , Lee Hong Gu , Kim Young Jun 
Published: March 2021

AbstractAmmonia from livestock manure acts as a precursor to produce particulate matter (PM) by reacting with atmospheric chemical components volatilized from various sources. Ammonia itself acts as a toxic substance to human health, and thus has direct or indirect adverse effects on human health. This study aimed to verify the effectiveness and mechanism of action of Saccharomyces boulardii (SB) in reducing the ammonia emission from livestock manure. The specific ability of SB was confirmed through comparative verification with S. cerevisiae (SC) belonging to the same genus. SB and SC could use 50% of ammonia–nitrogen as inorganic nitrogen source in minimal medium. In the control group, the pH level of manure was significantly increased compared to the pH level at 0 h, and the DNA concentration of Proteus mirabilis, which increase the manure pH through ammonia production, was found to increase by 2.7-fold. Significant decrease in pH and proliferation of P. mirabilis was found in SB group compared to control (p < 0.05). The SB group also reduced the amount of ammonia emitted from manure by 25% for 35 days. These results suggested that SB contributed to reducing ammonia emission from manure by reducing pH and inhibiting HAB as well as removing ammonia–nitrogen. Accordingly, SB as a microbiological agent is expected to contribute not only to reduce ammonia emission but also to improve manure quality as a fertilizer.
Multi-source financing for tuberculosis treatment in China: key issues and challenges
Authors: Long Qian , Jiang Wei-Xi , Zhang Hui , Cheng Jun , Tang Sheng-Lan , Wang Wei-Bing 
Published: March 2021

Abstract
Background
The End Tuberculosis (TB) Strategy of the World Health Organization highlights the need for patient-centered care and social protection measures that alleviate the financial hardships faced by many TB patients. In China, TB treatments are paid for by earmarked government funds, social health insurance, medical assistance for the poor, and out-of-pocket payments from patients. As part of Phase III of the China-Gates TB project, this paper introduces multi-source financing of TB treatment in the three provinces of China and analyzes the challenges of moving towards universal coverage and its implications of multi-sectoral engagement for TB care.

Main text
The new financing policies for TB treatment in the three provinces include increased reimbursement for TB outpatient care, linkage of TB treatment with local poverty alleviation programs, and use of local government funds to cover some costs to reduce out-of-pocket expenses. However, there are several challenges in reducing the financial burdens faced by TB patients. First, medical costs must be contained by reducing the profit-maximizing behaviors of hospitals. Second, treatment for TB and multi-drug resistant TB (MDR-TB) is only available at county hospitals and city or provincial hospitals, respectively, and these hospitals have low reimbursement rates and high co-payments. Third, many patients with TB and MDR-TB are at the edge of poverty, and therefore ineligible for medical assistance, which targets extremely poor individuals. In addition, the local governments of less developed provinces often face fiscal difficulties, making it challenging to use of local government funds to provide financial support for TB patients. We suggest that stakeholders at multiple sectors should engage in transparent and responsive communications, coordinate policy developments, and integrate resources to improve the integration of social protection schemes.

Conclusions
The Chinese government is examining the establishment of multi-source financing for TB treatment by mobilization of funds from the government and social protection schemes. These efforts require strengthening the cooperation of multiple sectors and improving the accountability of different government agencies. All key stakeholders must take concrete actions in the near future to assure significant progress toward the goal of alleviating the financial burden faced by TB and MDR-TB patients.

Graphic abstract
Pre-arrest diversion to addiction treatment by law enforcement: protocol for the community-level policing initiative to reduce addiction-related harm, including crime
Authors: Zgierska Aleksandra E. , White Veronica M. , Balles Joseph , Nelson Cory , Freedman Jason , Nguyen Thao H. , Johnson Sarah C. 
Published: March 2021

Abstract
Background
Despite evidence that treatment reduces addiction-related harms, including crime and overdose, only a minority of addiction-affected individuals receive it. Linking individuals who committed an addiction-related crime to addiction treatment could improve outcomes.

Methods
The aim of this city-wide, pre-arrest diversion program, Madison Addiction Recovery Initiative (MARI) is to reduce crime and improve health (i.e., reduce the overdose deaths) among adults who committed a minor, non-violent, drug use-related offense by offering them a referral to treatment in lieu of arrest and prosecution of criminal charges. This manuscript outlines the protocol and methods for the MARI program development and implementation. MARI requires its participants to engage in the recommended treatment, without reoffending, during the six-month program, after which the initial criminal charges are “voided” by the law enforcement agency. The project, implemented in a mid-size U.S. city, has involved numerous partners, including law enforcement, criminal justice, public health, and academia. It includes training of the police officer workforce and collaboration with clinical partners for treatment need assessment, treatment placement, and peer support. Program evaluation includes formative, process, outcome (participant-level) and exploratory impact (community-level) assessments. For outcome evaluation, we will compare crime (primary outcome), overdose-related offenses, and incarceration-related data 12 months before and 12 months after the index crime between participants who completed (Group 1), started but not completed (Group 2), and were offered but did not start (Group 3) the program, and adults who would have been eligible should MARI existed (Historical Comparison, Group 4). Clinical characteristics will be compared at baseline between Groups 1–2, and pre-post the program within Group 1. Participant baseline data will be assessed as potential covariates. Surveys of police officers and program completers, and community-level indicators of crime and overdose pre- versus post-program will provide additional data on the program impact.

Discussion
By offering addiction treatment in lieu of arrest and prosecution of criminal charges, this pre-arrest diversion program has the potential to disrupt the cycle of crime, reduce the likelihood of future offenses, and promote public health and safety.
Advances in the automated synthesis of 6-[18F]Fluoro-L-DOPA
Authors: Neves Ângela C. B. , Hrynchak Ivanna , Fonseca Inês , Alves Vítor H. P. , Pereira Mariette M. , Falcão Amílcar , Abrunhosa Antero J. 
Published: March 2021

AbstractThe neurotracer 6-[18F]FDOPA has been, for many years, a powerful tool in PET imaging of neuropsychiatric diseases, movement disorders and brain malignancies. More recently, it also demonstrated good results in the diagnosis of other malignancies such as neuroendocrine tumours, pheochromocytoma or pancreatic adenocarcinoma.The multiple clinical applications of this tracer fostered a very strong interest in the development of new and improved methods for its radiosynthesis. The no-carrier-added nucleophilic 18F-fluorination process has gained increasing attention, in recent years, due to the high molar activities obtained, when compared with the other methods although the radiochemical yield remains low (17–30%). This led to the development of several nucleophilic synthetic processes in order to obtain the product with molar activity, radiochemical yield and enantiomeric purity suitable for human PET studies.Automation of the synthetic processes is crucial for routine clinical use and compliance with GMP requirements. Nevertheless, the complexity of the synthesis makes the production challenging, increasing the chance of failure in routine production. Thus, for large-scale clinical application and wider use of this radiopharmaceutical, progress in the automation of this complex radiosynthesis is of critical importance.This review summarizes the most recent developments of 6-[18F]FDOPA radiosynthesis and discusses the key issues regarding its automation for routine clinical use.
Accuracy and diagnostic value of diffusion-weighted whole body imaging with background body signal suppression (DWIBS) in metastatic breast cancer
Authors: Eissawy Mohamed Gaber , Saadawy Amr M. Ismaeel , Farag Kamel , Akl Tamer , Kamr Wael Hamza 
Published: March 2021

Abstract
Background
Breast cancer is the most common malignant tumor among women. The mortality of the patients could be mainly attributed to metastasis and spread of breast cancer to distant sites. The objective of the current study is to evaluate and express the role of diffusion-weighted whole body imaging with background body signal suppression (DWIBS) in detection of osseous and soft tissue metastatic lesions in patients with cancer breast.

Results
The current prospective study included 50 female patients with pathologically proven breast cancer. The overall sensitivity of DWIBS and STIR were 97.5% and 92.5%, respectively. DWIBS was the most sensitive sequence with highest negative predictive values. DWIBS and STIR were the most sensitive with the highest negative predictive value. Both DWIBS and STIR detected more vertebral metastatic deposits (100% and 97.8%, respectively) and more soft tissue lesions (94.4% for both) than WB DWI and T1WI.

Conclusion
DWIBS MRI sequence is an effective method for detection of solid organ, bone and lymph node metastasis but not specific for characterization of lesions.
Predictive values of Alvarado score, serum C-reactive protein, and white blood cell count in the diagnosis of acute appendicitis: a prospective study
Authors: Talabi Ademola Olusegun , Adedeji Tewogbade Adeoye , Sowande Oludayo Adedapo , Adejuyigbe Olusanya 
Published: March 2021

Abstract
Background
The diagnosis of acute appendicitis in children is quite challenging as the rate of negative appendectomy varies between 15 and 57%. Increased utilization of imaging diagnostic facilities in advanced countries seems to have reduced the incidence of operating on normal appendix to a single digit. In low- and middle-income countries, the incidence remains unacceptably high (double digits). Inflammatory markers and scoring systems may be a suitable adjunct to increase diagnostic yield in most third world countries. Thus, the aim of this study was to evaluate the diagnostic value of Alvarado score, white blood cell count, and serum C-reactive protein in children with acute appendicitis.

Results
The ages of patients ranged between 4 and 15 years with a mean of 11.2 ± 2.8 years. The male to female ratio was 1.4 to 1.0. Nineteen percent of patients had negative appendiceal findings on histological examination. The sensitivity and specificity of Alvarado score, C-reactive protein estimation, total white blood cell count in diagnosing acute appendicitis were 86.4% and 63.2%, 98.8% and 36.8%, and 51.9% and 89.5% respectively. Alvarado score has the highest area under ROC curve analysis 0.824, 95% CI of 0.724 to 0.924 compared with CRP, 0.769. 95% CI of = 0.647 to 0.891 and WBC count, 0.765, 95% CI of 0.643 to 0.887. Both CRP and WBC count showed higher discriminatory values between complicated and uncomplicated appendicitis, p < 0.001.

Conclusion
Alvarado score outperformed other tests in setting the diagnosis of acute appendicitis. However, none of the tests can be relied on wholly for operative decision. Clinical judgement remains the bedrock for diagnosis and operative management.
Real-World Outcomes With Generic Pomalidomide in Relapsed Refractory Multiple Myeloma—Experience From a Tertiary Care Cancer Center
Authors: Bondili Suresh Kumar , Bagal Bhausaheb , Zawar Abhinav , Ventrapati Pradeep , Thorat Jayashree , Gokarn Anant , Punatar Sachin , Nayak Lingaraj , Bonda Avinash , Jain Hashmukh , Sengar Manju , Khattry Navin 
Published: March 2021

PURPOSE The prognosis of relapsed and refractory multiple myeloma (RRMM) that is refractory to bortezomib and lenalidomide is very poor wherein the median survival is between 3 and 9 months. We did this retrospective analysis to study the pattern of utilization, tolerance, and outcomes with pomalidomide in these patients having RRMM. MATERIALS AND METHODS Retrospective analysis of all the patients who were treated with generic pomalidomide at Tata Memorial Centre, Mumbai, during the period of May 2017 to March 2019 was done. Patients with secretory disease and who had completed at least one cycle of pomalidomide were analyzed for response rates, toxicity, and survival outcomes. RESULTS A total of 81 patients received pomalidomide-based therapy during this study period, out of which 75 were included in the survival analysis. Forty-eight patients (59.3%) were refractory to both lenalidomide and bortezomib. Overall response rate was 58.7%. Five patients (6.7%) achieved complete response, very good partial response was seen in 13 patients (17.3%), and partial response was seen in 26 patients (34.7%). After a median follow-up of 11 months (range 2-27 months), median progression-free survival was 9.1 months (95% CI, 5.4 to 12.9 months). Median progression-free survival for patients who were refractory to both lenalidomide and bortezomib versus nonrefractory was 5.5 and 12.6 months, respectively, which was significant statistically ( P = .04, hazard ratio, 0.35, 95% CI, 0.28 to 0.97). The median overall survival was not reached. Important toxicities included anemia (28%), neutropenia (16%), pneumonia (16%), and venous thrombosis (5%). CONCLUSION Generic pomalidomide-based therapy is an effective option and is well tolerated in patients with RRMM. Higher response rates and longer survival seen in our study are possibly because of heterogeneity of the study population.
Impact of COVID-19 on Cancer Care Delivery in Africa: A Cross-Sectional Survey of Oncology Providers in Africa
Authors: Martei Yehoda M. , Rick Tara J. , Fadelu Temidayo , Ezzi Mohammed S. , Hammad Nazik , Quadri Nasreen S. , Rodrigues Belmira , Simonds Hannah , Grover Surbhi , Incrocci Luca , Vanderpuye Verna 
Published: March 2021

PURPOSE The COVID-19 pandemic has disrupted cancer care globally. There are limited data of its impact in Africa. This study aims to characterize COVID-19 response strategies and impact of COVID-19 on cancer care and explore misconceptions in Africa. METHODS We conducted a web-based cross-sectional survey of oncology providers in Africa between June and August 2020. Descriptive statistics and comparative analysis by income groups were performed. RESULTS One hundred twenty-two participants initiated the survey, of which 79 respondents from 18 African countries contributed data. Ninety-four percent (66 of 70) reported country mitigation and suppression strategies, similar across income groups. Unique strategies included courier service and drones for delivery of cancer medications (9 of 70 and 6 of 70, respectively). Most cancer centers remained open, but > 75% providers reported a decrease in patient volume. Not previously reported is the fear of infectivity leading to staff shortages and decrease in patient volumes. Approximately one third reported modifications of all cancer treatment modalities, resulting in treatment delays. A majority of participants reported ≤ 25 confirmed cases (44 of 68, 64%) and ≤ 5 deaths because of COVID-19 (26 of 45, 58%) among patients with cancer. Common misconceptions were that Africans were less susceptible to the virus (53 of 70, 75.7%) and decreased transmission of the virus in the African heat (44 of 70, 62.9%). CONCLUSION Few COVID-19 cases and deaths were reported among patients with cancer. However, disruptions and delays in cancer care because of the pandemic were noted. The pandemic has inspired tailored innovative solutions in clinical care delivery for patients with cancer, which may serve as a blueprint for expanding care and preparing for future pandemics. Ongoing public education should address COVID-19 misconceptions. The results may not be generalizable to the entire African continent because of the small sample size.