bluuebunny/crossref_metadata_2025_split huggingface dataset:
Cross-sectional study on the drug utilization and evaluation indicator of antibiotics used in pediatric population
Authors: Hu Xu , Zhang Xueting , Wang Yao , Xie Xuefeng 
Published: October 2021

Abstract
Background
The lack of medication standards is a serious problem in paediatrics mainly because of age-related differences in organ development and physiological functions in children. Consequently, dosage measurement becomes inaccurate. For this reason, methods for evaluating and monitoring rational paediatric medications should be developed. Drug use indicators, such as those similar to the drug utilisation index (DUI) based on the Anatomical Therapeutic Chemical/Defined Daily Dose (DDD) and widely used for the assessment of appropriate dosage in adults, should be explored in terms of their applicability to children.

Methods
A total of 5,538 prescriptions of antibiotics selected from a general teaching hospital were included. Drug, dose, frequency and treatment duration were obtained from each prescription. The prescription daily dose (PDD) of each antibiotic drug was calculated as the average of the daily doses. Underdose and overdose were determined in terms of the PDD/DDD ratio for each prescription. Children’s DUI (cDUI) was explored in terms of the appropriate dosage for children as follows: the meaning of children’s DDD (cDDD) and the evaluation of paediatric drug dosage.

Results
The top five antibiotics and their utilisation rates were as follows: cefmetazole sodium injection (18.47 %), erythromycin lactobionate injection (15.07 %), amoxicillin/clavulanate potassium injection (10.72 %), ceftriaxone sodium injection (9.50 %) and azithromycin dry suspension (8.02 %). The ratio of cDUI and PDD/cDDD was mostly not close to 1.

Conclusions
The establishment of a cDUI system is an effective means of paediatric dosage evaluation. In addition to DDDs, cDUI and PDD/cDDD should be used to analyse the utilisation of antibiotics in children.
Long-term exposure to air pollution and the risk of developing sudden sensorineural hearing loss
Authors: Tsai Stella Chin-Shaw , Hsu Yi-Chao , Lai Jung-Nien , Chou Ruey-Hwang , Fan Hueng-Chuen , Lin Frank Cheau-Feng , Zhang Ruihong , Lin Cheng-Li , Chang Kuang-Hsi 
Published: October 2021

AbstractBackgroundThe association between exposure to air pollution and sudden sensorineural hearing loss (SSNHL) has not been extensively discussed in the literature. Therefore, we conducted this nationwide study to evaluate the risk of SSNHL in Taiwanese residents with exposure to air pollution.MethodsWe enrolled subjects aged older than 20 years with no history of SSNHL from 1998 to 2010, and followed up until developing SSNHL, withdrawn from the National Health Insurance program, and the end of the database (2011/12/31). The air quality data are managed by Taiwan Environmental Protection Administration. The annual concentrations of PM2.5, SO2, CO, NO, and NO2from 1998 to 2010 were classified into the three levels according to tertiles. We calculated the annual average of pollutants from baseline until the end of the study, and classified into tertiles. The adjusted hazard ratio (aHR) was estimated by using the multivariate Cox proportional hazard model.ResultsWhen considered continuous air pollutants concentration, subjects who exposed with higher concentration of CO (aHR = 2.16, 95% CI 1.50–3.11), NO (aHR = 1.02, 95% CI 1.01–1.03), and NO2(aHR = 1.02, 95% CI 1.01–1.04) developing significant higher risk of SSNHL. When classified air pollutants concentration into low, moderate and high level by tertiles, and selected low level as reference, patients exposed with moderate (aHR = 1.56, 95% CI 1.20–2.04) or high level (aHR = 1.33, 95% CI 1.01–1.75) of PM2.5showed significant higher risk of developing SSNHL.ConclusionThis study indicated an increased risk of SSNHL in residents with long-term exposure to air pollution. Nevertheless, further experimental, and clinical studies are needed to validate the study findings.
Lack of HIV RNA test result is a barrier to breastfeeding among women living with HIV in Botswana
Authors: Mayondi Gloria Katuta , Mussa Aamirah , Zash Rebecca , Moyo Sikhulile , Issacson Arielle , Diseko Modiegi , Mabuta Judith , Mogomotsi Goabaone , Dintwa Eldah , Makhema Joseph , Mmalane Mompati , Lockman Shahin , Morroni Chelsea , Shapiro Roger 
Published: October 2021

Abstract
Background
Botswana updated its antiretroviral treatment (ART) guidelines in May 2016 to support breastfeeding for women living with HIV (WLHIV) on ART who have documented HIV RNA suppression during pregnancy.

Methods
From September 2016 to March 2019, we evaluated feeding method at discharge among WLHIV at eight government maternity wards in Botswana within the Tsepamo Study. We validated the recorded feeding method on the obstetric record using the prevention of mother-to-child transmission of HIV (PMTCT) counsellor report, infant formula dispensing log or through direct observation. Available HIV RNA results were recorded from the obstetric record, and from outpatient HIV records (starting February 2018). In a subset of participants, we used electronic laboratory records to verify whether an HIV RNA test had occurred. Univariable and multivariable logistic regression analyses were performed to identify factors associated with infant feeding choice.

Results
Among 13,354 WLHIV who had a validated feeding method at discharge, 5303 (39.7%) chose to breastfeed and 8051 (60.3%) chose to formula feed. Women who had a documented HIV RNA result in the obstetric record available to healthcare providers at delivery were more likely to breastfeed (50.8%) compared to women who did not have a documented HIV RNA result (35.4%) (aOR 0.59; 95% CI 0.54, 0.65). Among women with documented HIV RNA, 2711 (94.6%) were virally suppressed (< 400 copies/mL). Breastfeeding occurred in a substantial proportion of women who did not meet criteria, including 46 (30.1%) of 153 women with HIV RNA > 400 copies/mL, and 134 (27.4%) of 489 women with no reported ART use. A sub-analysis of electronic laboratory records among 150 women without a recorded result on the obstetric record revealed that 93 (62%) women had an HIV RNA test during pregnancy.

Conclusions
In a setting of long-standing use of suppressive ART, with majority of WLHIV on ART from the time of conception, requiring documentation of HIV RNA suppression in the obstetric record to inform infant feeding decisions is a barrier to breastfeeding but unlikely to prevent a substantial amount of HIV transmission.
Continuing breastfeeding for at least two years after birth in rural Vietnam: prevalence and psychosocial characteristics
Authors: Doma Hemavarni , Tran Thach Duc , Tran Tuan , Hanieh Sarah , Tran Ha , Nguyen Trang , Biggs Beverley-Ann , Fisher Jane 
Published: October 2021

AbstractBackgroundThe World Health Organization recommends breastfeeding for at least two years (24 months or more) after birth. In Vietnam, 22% of women continue breastfeeding for at least two years. The aim of this study was to determine the sociodemographic and psychosocial characteristics of mother-baby dyads associated with breastfeeding for 24 months or more in a rural setting in Vietnam.MethodsA secondary analysis was conducted on existing data obtained from a prospective study in Ha Nam, Vietnam. Women were recruited when they were pregnant and were followed up until 36 months after giving birth. The data were collected between 2009 and 2011. The associations between sociodemographic and psychosocial characteristics and continued breastfeeding for 24 months or more were examined using a multivariable logistic regression model.ResultsOverall, 363 women provided complete data which were included in the analyses. Among those, 20.9% breastfed for 24 months or more. Women who were 31 years old or older were more likely to breastfeed for 24 months or more than women who were 20 years old or younger (adjusted odds ratio, AOR, 9.54 [95% CI 2.25, 40.47]). Women who gave birth to girls were less likely to breastfeed for 24 or more months than women who had boys (AOR 0.44; 95% CI 0.25, 0.80).ConclusionsThis study provides evidence that may be useful for policy-makers to help improve breastfeeding practices for all children in Vietnam by targeting policy towards younger women and women with girls to promote continued breastfeeding for at least 24 months.
Whole-body vibration decreases delayed onset muscle soreness following eccentric exercise in elite hockey players: a randomised controlled trial
Authors: Akehurst Harold , Grice John E. , Angioi Manuela , Morrissey Dylan , Migliorini Filippo , Maffulli Nicola 
Published: October 2021

AbstractBackgroundDelayed onset muscle soreness (DOMS) is a common non-structural muscle injury which can disrupt training and impair performance in elite athletes. Vibration therapy reduces inflammation and improves neuromuscular efficiency, leading to reductions in pain and stiffness, and may be effective for the prevention or treatment of DOMS. However, the effect of whole-body vibration (WBV) used after sport in elite athletes has not been reported.MethodsA randomised, controlled trial was performed. Participants were elite (national or international level) hockey players and underwent an eccentric exercise protocol previously shown to produce clinical DOMS. After exercise, one group underwent static stretching with WBV therapy, and the other performed stretching only. Baseline and serial post-exercise pain scores and measurements of quadriceps tightness were obtained.ResultsEleven participants were recruited into each study arm. There were no significant differences in baseline group characteristics. Participants receiving WBV had significant reductions in both pain (p = 0.04) and quadriceps tightness (p = 0.02) compared with stretching only.ConclusionsPost-exercise WBV is effective in elite hockey players to reduce DOMS after eccentric exercise. Elite athletes in multi-sprint sports are at risk of DOMS during training and competition, and its reduction could contribute to reduced injury risk and improved performance. This treatment modality is favourable because it can be incorporated with minimal disruption into the recovery section of existing training regimes. These findings may also be extrapolated to other multi-sprint sports.
Malignant primary pericardial mesothelioma presenting as effusive constrictive pericarditis: a case report study
Authors: Savarrakhsh Amir , Vakilpour Azin , Davani Sam Zeraatian-Nejad , Daskareh Mahyar , Morsaghian Mahdieh , Salari Arsalan , Mirrazeghi Seyedeh Fatemeh 
Published: October 2021

Abstract
Background
Primary pericardial mesothelioma (PPM) is a rare malignancy with a high prevalence of mortality. The diagnosis is usually challenging using a variety of imaging modalities and invasive procedures and is generally performed at the later stages of the disease or in autopsy. This case study points to an unconventional presentation of PPM and the challenges in diagnosing this rare mortal malignancy.

Case presentation
This study presents a 44-year-old woman with no remarkable medical history with an initial diagnosis of effusive constrictive pericarditis at first hospitalization. Imaging evaluations, including transthoracic echocardiography and chest computed tomography scan, demonstrated visible thickened pericardium, pericardial effusion, and mass-like lesions in pericardium and mediastinum. The definite diagnosis of primary pericardial mesothelioma was established after pericardiectomy and histopathology examinations. Chemotherapy with pemetrexed and carboplatin was administrated to the patient, and she has been through four cycles of chemotherapy with no complications to date.

Conclusion
Constrictive pericarditis is an uncommon presentation of PPM. Due to the high mortality rate and late presentation, difficulties and uncertainties in diagnosis, being aware of this rare malignant entity in different cardiac manifestations, particularly when there is no clear explanation or response to treatment in such conditions, is highly important.
Motor function in type 2 and 3 SMA patients treated with Nusinersen: a critical review and meta-analysis
Authors: Coratti Giorgia , Cutrona Costanza , Pera Maria Carmela , Bovis Francesca , Ponzano Marta , Chieppa Fabrizia , Antonaci Laura , Sansone Valeria , Finkel Richard , Pane Marika , Mercuri Eugenio 
Published: October 2021

Abstract
Background
There is an increasing number of papers reporting the real world use of Nusinersen in different cohorts of SMA patients.

Main body
The aim of this paper was to critically review the literature reporting real world data on motor function in type 2 and 3 patients treated with Nusinersen, subdividing the results according to SMA type, age and type of assessment and performing a meta-analysis of the available results. We also report the available data collected in untreated patients using the same measures. Of the 400 papers identified searching for Nusinersen and spinal muscular atrophy, 19 reported motor function in types 2 and 3: 13 in adults, 4 in children and 2 included both. Twelve papers reported untreated patients’ data. All studies reported positive changes on at least one of the functional measures and at every time point while all-untreated cohorts showed negative changes.

Conclusion
Our review suggests that Nusinersen provides a favorable benefit in motor function across a wide range of SMA type 2 and 3 patients over a 10–14 month observation period. Although a direct comparison with studies reporting data from untreated patients cannot be made, the longitudinal changes in the treated cohorts (consistently positive) are divergent from those observed in the untreated cohorts (consistently negative). The difference could be observed both in the global cohorts and in smaller groups subdivided according to age, type or functional status.
Qualitative interviews to improve patient-reported outcome measures in late-onset Pompe disease: the patient perspective
Authors: Hamed Alaa , An Haack Kristina , Gwaltney Chad , Baranowski Eileen , Stewart Andrew , Krupnick Robert , Tyler Margaret , Sparks Susan , Paty Jean 
Published: October 2021

Abstract
Background
Late-onset Pompe Disease (LOPD) is a rare, heterogeneous disease manifested by a range of symptoms varying in severity. Research establishing the frequency of these symptoms and their impact on patients’ daily lives is limited. The objective of this study was to develop a conceptual model that captures the most relevant symptoms and functional limitations experienced by patients with LOPD, to inform the development of new patient-reported outcome (PRO) tools.

Methods
A preliminary conceptual model was constructed following a literature review and revised through interviews with expert clinicians to identify important and relevant concepts regarding symptoms and impacts of LOPD. This preliminary model informed the development of a qualitative patient interview guide, which was used to gather the patient perspective on symptoms and impacts relating to LOPD or its treatment (including symptom/impact frequency and levels of disturbance). Patient interviews aided further refinement of the conceptual model. The findings from the patient interviews were triangulated with the literature review and clinician interviews to identify the most relevant and significant effects of LOPD from the patient perspective.

Results
Muscle weakness, fatigue, pain, and breathing difficulties (especially while lying down) were the most common and highly disturbing symptoms experienced by patients. Limitations associated with mobility (e.g., difficulty rising from a sitting position, getting up after bending) and activities of daily living, (e.g., reduced ability to participate in social/family activities or work/study) were the most frequently reported impacts with the highest levels of disturbance on the patient’s daily life. These identified symptoms and impacts were included in the new conceptual model of disease.

Conclusions
This qualitative patient interview study, also informed by a literature review and clinician interviews, identified the most frequent and relevant symptoms and the functional impact of LOPD on patients. The study interviews also captured the patient-preferred language to describe symptoms and impacts of LOPD. The results from this study can be used to develop future PRO instruments that are tailored to the specific symptoms and impacts experienced by patients with LOPD.
Selectively increasing GHS-R1a expression in dCA1 excitatory/inhibitory neurons have opposite effects on memory encoding
Authors: Li Nan , Li Na , Xu Fenghua , Yu Ming , Qiao Zichen , Zhou Yu 
Published: October 2021

Abstract
Aim
Growth hormone secretagogue receptor 1a (GHS-R1a) is widely distributed in brain including the hippocampus. Studies have demonstrated the critical role of hippocampal ghrelin/GHS-R1a signaling in synaptic physiology, memory and cognitive dysfunction associated with Alzheimer’s disease (AD). However, current reports are inconsistent, and the mechanism underlying memory modulation of GHS-R1a signaling is uncertain. In this study, we aim to investigate the direct impact of selective increase of GHS-R1a expression in dCA1 excitatory/inhibitory neurons on learning and memory.

Methods
Endogenous GHS-R1a distribution in dCA1 excitatory/inhibitory neurons was assessed by fluorescence in situ hybridization. Cre-dependent GHS-R1a overexpression in excitatory or inhibitory neurons was done by stereotaxic injection of aav-hSyn-DIO-hGhsr1a-2A-eGFP virus in dCA1 region of vGlut1-Cre or Dlx5/6-Cre mice respectively. Virus-mediated GHS-R1a upregulation in dCA1 neurons was confirmed by quantitative RT-PCR. Different behavioral paradigms were used to evaluate long-term memory performance.

Results
GHS-R1a is distributed both in dCA1 excitatory pyramidal neurons (αCaMKII+) and in inhibitory interneurons (GAD67+). Selective increase of GHS-R1a expression in dCA1 pyramidal neurons impaired spatial memory and object-place recognition memory. In contrast, selective increase of GHS-R1a expression in dCA1 interneurons enhanced long-term memory performance. Our findings reveal, for the first time, a neuronal type-specific role that hippocampal GHS-R1a signaling plays in regulating memory. Therefore, manipulating GHS-R1a expression/activity in different subpopulation of neurons may help to clarify current contradictory findings and to elucidate mechanism of memory control by ghrelin/GHS-R1a signaling, under both physiological and pathological conditions such as AD.
Response to COVID-19 mRNA vaccination in multiple myeloma is conserved but impaired compared to controls
Authors: Bitoun Samuel , Henry Julien , Vauloup-Fellous Christelle , Dib Nicolas , Belkhir Rakiba , Mouna Lina , Joly Candie , Desjardins Delphine , Bitu Marie , Le Grand Roger , Seror Raphaèle , Roque Afonso Anne-Marie , Mariette Xavier 
Published: October 2021

AbstractPatients with multiple myeloma are at high risk of severe forms of COVID-19. Despite data showing diminished response to vaccine, the era of highly efficient mRNA vaccine might be a gamechanger. We sought to examine response to mRNA vaccine between healthy controls (n = 28) and multiple myeloma (MM) patients (n = 27). Response was analyzed 1 month after the second dose of anti-SARS-CoV-2 BNT162b2 vaccine. Multiple myeloma patients showed diminished levels of Anti-Spike IgG levels compared to controls, but with a high proportion of patients achieving a humoral response (89% vs. 97% in controls). Neutralizing antibodies were present in 74% of patients versus 96% of controls. Patients under current daratumumab treatment had neutralizing activity of anti-SARS-CoV-2 antibodies. Multiple myeloma patients show diminished response to SARS-COV-2 vaccine but with still high response rate. The main potential risk factor of non-response to COVID-19 vaccine was uncontrolled disease under treatment.
Sentinel lymph node identification in early stage ovarian cancer: is it still possible after prior tumor resection?
Authors: Laven Pim , Kruitwagen Roy , Zusterzeel Petra , Slangen Brigitte , van Gorp Toon , van der Pol Jochem , Lambrechts Sandrina 
Published: October 2021

Abstract
Objective
Sentinel lymph node (SLN) detection in ovarian cancer is feasible when tracers are injected before the pathological ovary is resected. This study aims to investigate whether the SLN identification is also feasible in patients whose ovarian tumor has already been resected with injection of the tracer into the ovarian ligaments stumps, i.e. in the event that a frozen section confirms malignancy.

Methods
Patients who underwent laparotomy with frozen section confirming an ovarian malignancy, and those who underwent a second staging laparotomy after prior resection of a malignant ovarian mass, were included. Blue dye and a radioactive isotope were injected in the stumps of the ligamentum ovarium proprium and the ligamentum infundibulo-pelvicum. After an interval of at least 15-min, the sentinel node(s) were identified using either the gamma-probe and / or blue dye.

Results
A total of 11 patients were included in the study, the sentinel node (SLN) procedure was completed in all 11 patients. At least one SLN was identified in 3 patients, resulting in a rather low detection rate of 27,3%.

Conclusion
In this study we showed that SLN procedure after (previous) resection of the tumor seems inferior to detect sentinel nodes when compared to injection of the tracer in the ovarian ligaments before tumor resection.

Trial registration
NCT02540551
Association between the food security status and dietary patterns with polycystic ovary syndrome (PCOS) in overweight and obese Iranian women: a case-control study
Authors: Badri-Fariman Mahtab , Naeini Amirmansour Alavi , Mirzaei Khadijeh , Moeini Ashraf , Hosseini Mostafa , Bagheri Seyedeh Elaheh , Daneshi-Maskooni Milad 
Published: October 2021

AbstractBackgroundPolycystic ovary syndrome (PCOS), as one of the significant endocrine disorders, is common among women worldwide. Food insecurity (FI) and unhealthy dietary patterns can negatively affect reproductive health. The effects of the lifestyle modifications, especially dietary components, on PCOS are contradictory. The aim was the assessment of association between PCOS with food security status and dietary patterns among overweight or obese women.MethodsThis case-control study was performed on 240 overweight and obese women with and without PCOS (ratio 1:1) referred to the infertility clinic of Arash Hospital, Tehran, Iran. The general and socioeconomic characteristics, anthropometrics (weight, height, body mass index (BMI), waist circumference, hip circumference), physical activity, food security status, and dietary intakes (or patterns) were assessed using valid questionnaires, scales, stadiometer, and tape meter. The significantp-value was < 0.05.ResultsThe prevalence of FI was 60% in women with PCOS and 30% in healthy women. PCOS risk was positively related to FI, quasi-western dietary patterns, low economic levels, waist circumference, and menstrual age and negatively with physical activity and healthy dietary patterns, even after controlling the potential confounders (P <  0.05). PCOS women had a higher intake of saturated fats, monounsaturated fats, oleic acid, fluorine, sucrose, and caffeine and a lower intake of vitamins A, B5, B6, B12, C, and D, potassium, proteins, carbohydrates, cholesterols, docosahexaenoic acid, potassium, carotenes, lutein, beta-cryptoxanthin, lycopene, calcium, iron, thiamine, riboflavin, niacin, tetra- and dihydrofolate, biotin, phosphorus, magnesium, zinc, copper, fiber (total, insoluble, and crude), glucose, galactose, fructose, and lactose compared to the healthy women (P <  0.05).ConclusionsFI, quasi-western dietary patterns, low economic levels, and waist circumference were significantly associated with the higher risk of PCOS. The lifestyle changes, especially dietary patterns, may be an essential strategy for reducing PCOS. Further studies are warranted to confirm these findings and to identify the underlying mechanisms.