bluuebunny/crossref_metadata_2025_split huggingface dataset:
Serotype distribution of invasive, non-invasive and carried Streptococcus pneumoniae in Malaysia: a meta-analysis
Authors: Lister Alex J. J. , Le Cheng Foh , Cheah Eddy Seong Guan , Desa Mohd Nasir Mohd , Cleary David W. , Clarke Stuart C. 
Published: May 2021

Abstract
Background
Pneumococcal pneumonia is the leading cause of under-five mortality globally. The surveillance of pneumococcal serotypes is therefore vital for informing pneumococcal vaccination policy and programmes. Pneumococcal conjugate vaccines (PCVs) have been available as an option in the private healthcare setting and beginning December 2020, PCV10 was incorporated as part of routine national immunisation programme (NIP) in Malaysia. We searched existing literature on pneumococcal serotype distribution across Malaysia to provide an overall view of this distribution before the implementation of PCV10.

Methods
Online databases (PubMed, Ovid MEDLINE and Scopus), reference lists of articles identified, and grey literature (Malaysian Ministry of Health website, WHO website) were systematically searched for relevant literature on pneumococcal serotype distribution across Malaysia up to 10th November 2020. No lower date limit was set to maximise the number of target reports returned. Results of serotypes were split by age categories, including ≤5 years, > 5 years and unreported for those that did not specify.

Results
The search returned 18 relevant results, with a total of 2040 isolates. The most common serotypes across all disease types were 19F (n = 313, 15.3% [95%CI: 13.8–17.0]), 23F (n = 166, 8.1% [95%CI: 7.0–9.4]), 14 (n = 166, 8.1% [95%CI: 7.0–9.4]), 6B (n = 163, 8.0% [95%CI: 6.9–9.2]) and 19A (n = 138, 6.8% [95%CI: 5.8–7.9]).

Conclusion
Four of the most common serotypes across all isolate sources in Malaysia are covered by PCV10, while PCV13 provides greater serotype coverage in comparison to PCV10. There is still a need for surveillance studies, particularly those investigating serotypes in children under 5 years of age, to monitor vaccine effectiveness and pneumococcal population dynamic following implementation of PCV10 into routine immunisation.
A Selective Androgen Receptor Modulator (OPK-88004) in Prostate Cancer Survivors: A Randomized Trial
Authors: Pencina Karol M , Burnett Arthur L , Storer Thomas W , Guo Wen , Li Zhuoying , Kibel Adam S , Huang Grace , Blouin Michelle , Berry Donna L , Basaria Shehzad , Bhasin Shalender 
Published: May 2021

Abstract

Background
Androgen deficiency is common among prostate cancer survivors, but many guidelines consider history of prostate cancer a contraindication for testosterone replacement. We determined the safety and efficacy of a selective androgen receptor modulator (OPK-88004) in symptomatic, testosterone-deficient men who had undergone radical prostatectomy for low-grade, organ-confined prostate cancer.

Methods
In this placebo-controlled, randomized, double-blind trial, 114 men, ≥19 years of age, who had undergone radical prostatectomy for low-grade, organ-localized prostate cancer, undetectable PSA (&lt;0.1 ng/mL) for ≥2 years after radical prostatectomy and testosterone deficiency were randomized in stages to placebo or 1, 5, or 15 mg OPK-88004 daily for 12 weeks. Outcomes included PSA recurrence, sexual activity, sexual desire, erectile function, body composition, muscle strength and physical function measures, mood, fatigue, and bone markers.

Results
Participants were on average 67.5 years of age and had severe sexual dysfunction (mean erectile function and sexual desire domain scores 7.3 and 14.6, respectively). No participant experienced PSA recurrence or erythrocytosis. OPK-88004 was associated with a dose-related increase in whole-body (P &lt; 0.001) and appendicular (P &lt; 0.001) lean mass and a significantly greater decrease in percent body fat (P &lt; 0.001) and serum alkaline phosphatase (P &lt; 0.001) than placebo. Changes in sexual activity, sexual desire, erectile function, mood, fatigue, physical performance, and bone markers did not differ among groups (P = 0.73).

Conclusions
Administration of OPK-88004 was safe and not associated with PSA recurrence in androgen-deficient men who had undergone radical prostatectomy for organ-confined prostate cancer. OPK-88004 increased lean body mass and decreased fat mass but did not improve sexual symptoms or physical performance.
The Role of HIF1α-PFKFB3 Pathway in Diabetic Retinopathy
Authors: Min Jie , Zeng Tianshu , Roux Margaretha , Lazar David , Chen Lulu , Tudzarova Slavica 
Published: May 2021

Abstract
Diabetic retinopathy (DR) is the leading cause of blindness for adults in developed countries. Both microvasculopathy and neurodegeneration are implicated in mechanisms of DR development, with neuronal impairment preceding microvascular abnormalities, which is often underappreciated in the clinic. Most current therapeutic strategies, including anti-vascular endothelial growth factor (anti-VEGF)-antibodies, aim at treating the advanced stages (diabetic macular edema and proliferative diabetic retinopathy) and fail to target the neuronal deterioration. Hence, new therapeutic approach(es) intended to address both vascular and neuronal impairment are urgently needed.
The hypoxia-inducible factor 1α (HIF1α)–6-phosphofructo-2-kinase/fructose-2,6-bisphosphatase 3 (PFKFB3) pathway is critically implicated in the islet pathology of diabetes. Recent evidence highlighted the pathway relevance for pathologic angiogenesis and neurodegeneration, two key aspects in DR. PFKFB3 is key to the sprouting angiogenesis, along with VEGF, by determining the endothelial tip-cell competition. Also, PFKFB3-driven glycolysis compromises the antioxidative capacity of neurons leading to neuronal loss and reactive gliosis. Therefore, the HIF1α-PFKFB3 signaling pathway is unique as being a pervasive pathological component across multiple cell types in the retina in the early as well as late stages of DR. A metabolic point-of-intervention based on HIF1α-PFKFB3 targeting thus deserves further consideration in DR.
The energetic function of the human foot and its muscles during accelerations and decelerations
Authors: Smith Ross E. , Lichtwark Glen A. , Kelly Luke A. 
Published: May 2021

ABSTRACT
The human foot is known to aid propulsion by storing and returning elastic energy during steady-state locomotion. While its function during other tasks is less clear, recent evidence suggests the foot and its intrinsic muscles can also generate or dissipate energy based on the energetic requirements of the center of mass during non-steady-state locomotion. In order to examine contributions of the foot and its muscles to non-steady-state locomotion, we compared the energetics of the foot and ankle joint while jumping and landing before and after the application of a tibial nerve block. Under normal conditions, energetic contributions of the foot rose as work demands increased, while the relative contributions of the foot to center of mass work remained constant with increasing work demands. Under the nerve block, foot contributions to both jumping and landing decreased. Additionally, ankle contributions were also decreased under the influence of the block for both tasks. Our results reinforce findings that foot and ankle function mirror the energetic requirements of the center of mass and provide novel evidence that foot contributions remain relatively constant under increasing energetic demands. Also, while the intrinsic muscles can modulate the energetic capacity of the foot, their removal accounted for only a 3% decrement in total center of mass work. Therefore, the small size of intrinsic muscles appears to limit their capacity to contribute to center of mass work. However, their role in contributing to ankle work capacity is likely important for the energetics of movement.
Ο ρόλος των διευθυντών σχολείων Δευτεροβάθμιας Εκπαίδευσης στην οργάνωση και υλοποίηση της εξ αποστάσεως εκπαίδευσης
Authors: Τάτσης Ιωάννης 
Published: May 2021

Η αναστολή της λειτουργίας των σχολείων στο πλαίσιο των μέτρων που έλαβε η ελληνική πολιτεία για την αντιμετώπιση της πανδημίας του κορονοϊού, την άνοιξη του 2020 και η εφαρμογή της εξ αποστάσεως εκπαίδευσης για όσο καιρό τα σχολεία παρέμειναν κλειστά, αποτέλεσε μία πρωτόγνωρη πρόκληση για ολόκληρη την εκπαιδευτική κοινότητα. Η παρούσα εργασία αναδεικνύει τον κομβικό ρόλο που κλήθηκαν να διαδραματίσουν οι διευθυντές των σχολείων της δευτεροβάθμιας εκπαίδευσης με συγκεκριμένες αποφάσεις και ενέργειες. Μελετάται ιδιαίτερα ο τρόπος συντονισμού των εκπαιδευτικών και των μαθητών στην υλοποίηση της εξ αποστάσεως εκπαίδευσης, η λειτουργία της Ομάδας υποστήριξης και η διασφάλιση της προστασίας των Προσωπικών Δεδομένων των μαθητών. Επιπλέον εξετάζεται η εξ αποστάσεως συνεδρίαση του συλλόγου διδασκόντων, η καταγραφή των ελλείψεων σε τεχνικά μέσα και άλλα πρακτικά ζητήματα. Κεντρικός στόχος της μελέτης είναι η ανάδειξη των αδυναμιών αλλά και των δυνατοτήτων της εξ αποστάσεως εκπαίδευσης αλλά και του καίριου ρόλου της εκπαιδευτικής ηγεσίας στην εφαρμογή της στην ελληνική εκπαιδευτική πραγματικότητα.
Εξ Αποστάσεως Εκπαίδευση: Διοικητικά - Οργανωτικά - Θεσμικά Προβλήματα στην Πρωτοβάθμια Εκπαίδευση
Authors: Παπαδόπουλος Σταύρος 
Published: May 2021

Η παρούσα εισήγηση έχει κεντρικό θέμα της την εξ αποστάσεως εκπαίδευση και τις δύο μορφές, την ασύγχρονη και τη σύγχρονη. Έχοντας ως σημείο αναφοράς την πρόσφατη αναστολή λειτουργίας των σχολείων λόγω της πανδημίας παρουσιάζουμε μια μελέτη περίπτωσης εφαρμογής εξ αποστάσεως εκπαίδευσης. Αναλύουμε και παρουσιάζουμε πώς εφαρμόστηκε τόσο η ασύγχρονη όσο και η σύγχρονη εξ αποστάσεως εκπαίδευση σε ένα σχολείο της Ρόδου, το 1ο Δημοτικό Σχολείο Ιαλυσού. Αναφέρουμε τις πρακτικές που εφαρμόστηκαν στο σχολείο, πώς οδηγηθήκαμε σε αυτές, το ωρολόγιο πρόγραμμα, το πρόγραμμα του τμήματος ένταξης και το πρόγραμμα των μαθητών/τριων της παράλληλης στήριξης. Εστιάζουμε στα διοικητικά, οργανωτικά και θεσμικά προβλήματα που προέκυψαν στην εφαρμογή τους το διάστημα αυτό. Η εισήγηση ολοκληρώνεται με συμπεράσματα και προτάσεις για την εξ αποστάσεως εκπαίδευση στη χώρα μας.
Ένας εναλλακτικός τρόπος αξιοποίησης της έρευνας σε μαθητές Λυκείου
Authors: Ντάκουλα Αικατερίνη 
Published: May 2021

Η εφαρμογή εναλλακτικών διδακτικών προσεγγίσεων στο σύγχρονο σχολείο προϋποθέτει δημιουργικότητα και φαντασία από τον εκπαιδευτικό, συνδυαζόμενη με τις αρχές της Παιδαγωγικής και του Αναλυτικού Προγράμματος Σπουδών. Στόχος της παρούσας εισήγησης είναι να συμβάλλει σε μια διαφορετική προσέγγιση της Βυζαντινής Ιστορίας για τους μαθητές της Β΄ Λυκείου και συγκεκριμένα πτυχών της καθημερινής ζωής των Βυζαντινών, μέσα από την ανίχνευση διαδικτυακών ιστορικών πηγών, την αναζήτηση πληροφοριών σε εγκεκριμένους διδακτικούς ιστότοπους και τη σύνθεση σε μια ευρετική πορεία προς τη γνώση. Αυτό που επιδιώκεται είναι η διανοητική και συναισθηματική κινητοποίηση του μαθητή, στηριγμένη στα βασικά σημεία του θεωρητικού σχεδιασμού της βιωματικής προσέγγισης με την αξιοποίηση της συνεργασίας των μαθητών και των προσωπικών τους βιωμάτων. Στην εισήγηση παρουσιάζονται ο σχεδιασμός των φάσεων, η εφαρμογή και η υλοποίηση τους με τη χρήση πολυμεσικού/πολυτροπικού υλικού μέσω σύγχρονης και ασύγχρονης εξ αποστάσεως διδασκαλίας. Επιπλέον, αναφέρονται οι προβληματισμοί, οι δυσκολίες και τα εμπόδια που αναστέλλουν τη διάχυση των γνώσεων και δυσχεραίνουν τη μαθησιακή διεργασία σε περιβάλλοντα εξΑΕ.
Association of subgingival Epstein–Barr virus and periodontitis
Authors: Maulani Chaerita , C. Masulili Sri Lelyati , Santoso Widayat Djoko , Soedarsono Nurtami , Kusdhany Lindawati , Auerkari Elza Ibrahim 
Published: May 2021

Background: The Epstein–Barr virus (EBV) is gaining interest as a possible agent in the etiology of periodontitis. Previous studies have shown controversy on whether EBV DNA in the subgingival periodontal pockets is associated with periodontitis. The aim of the present study was to seek the potential relationship between EBV and periodontitis. Methods: Data on socio-demographics, oral health, and periodontal health were recorded, and samples were collected from gingival crevicular fluid, using sterile paper point. This case–control study of 118 participants included 59 subjects with severe periodontitis and 59 control subjects with mild periodontitis. The EBV load was determined by quantitative real-time PCR. Results: EBV DNA was detected in 37.3% of the case samples and in 18.6% of the control samples. There was no significant difference in the load of EBV DNA between severe and mild periodontitis (p>0.05). The observed load of EBV DNA was up to 4.55x105 copies/mL. The detected EBV DNA was significantly associated with the plaque index and the oral hygiene index (all p<0.05). Conclusions: A significant association was not found, but EBV might contribute to periodontitis. Gingival crevicular fluid is useful for monitoring the EBV load by the real-time PCR technique.
EPISTEMOLOGIA FEMINISTA - NAOMI SCHEMAN
Authors: Missaggia Vaccari Rafaela , Dalva Secco Gisele 
Published: May 2021

Este texto é uma tradução de “Feminist epistemology”, artigo de Naomi Scheman originalmente publicado em Metaphilosophy (v. 26, n.3, de julho de 1995) e republicado na coletânea Shifting Ground - Knowledge and Reality, Transgression and Trustworthiness (como parte da Studies in feminist philosophy, da Oxford University Press, 2011). No artigo, Scheman elucida de diferentes maneiras como “feminista” é um qualificativo legítimo para qualquer epistemologia que conceda relevância às experiências de mulheres como sujeitos de conhecimento, sem, no entanto, abrir espaço para relativismos. Ao argumentar em favor da pertinência de uma epistemologia aberta à diversidade que a perspectiva feminista proporciona, Scheman acaba por propor também um alargamento da noção de objetividade, revelando prolíficas conexões entre epistemologia e política por meio de uma reflexão sobre normas epistêmicas. Palavras-chave: sujeitos de conhecimento, objetividade, mulheres, normas epistêmicas.
LITERATURA, MULHERES, DISCURSO FILOSÓFICO. SOBRE HELENA
Authors: Gagnebin Jeanne Marie 
Published: May 2021

RESUMO: Este artigo pretende estabelecer, a partir da figura de Helena na tradição poética e filosófica (platônica) grega, como o discurso filosófico se constitui por uma recusa semelhante da beleza da ficção e da sedução das mulheres. Ficção e “feminino” apresentariam uma valorização da ambiguidade e da pluralidade de possíveis que coloca em risco a definição unívoca do conceito filosófico clássico de “verdade”. PALAVRAS-CHAVE: Ficção, Feminino, Filosofia.ABSTRACT: This paper aims to establish, based on the figure of Helen in the Greek poetic and philosophical (Platonic) tradition, how the philosophical discourse is constituted by a similar refusal of the beauty of fiction and the seduction of women. Fiction and “feminine” would present an appreciation of ambiguity and the plurality of possible ones that put at risk the univocal definition of the classic philosophical concept of “truth”.KEYWORDS: Fiction. Feminine. Philosophy.
PEDAGÓGICA DE LA LIBERACIÓN: UNA PUESTA EM PRÁCTICA
Authors: Salazar Gabriel Herrera 
Published: May 2021

RESUMEN: La meta-física del cara-a-cara permite descubrir el horizonte de la pedagógica de la liberación. En la lógica de la Alteridad, la pulsión meta-física de Otro que sí, es deseo radical de amor-de-justicia. La erótica de la liberación nos lleva a trazar de manera original la teoría del antiedipo, la cual plantea un nuevo y alternativo modelo de familia; este esquema va a servir como base de otras relaciones meta-físicas cara-a-cara en otros niveles concretos como son la pedagógica, política, económica o arqueológica. El proyecto de liberación produce la reflexión sobre la construcción de un orden nuevo con amor-de-justicia, un mundo “muy otro”, es por esto que el discurso adquiere una dramatización específica donde lo estratégico y táctico son determinados desde la praxis de liberación. PALABRAS CLAVE: Pedagógica, Erótica, Alteridad, Liberación, Justicia.ABSTRACT: The face-to-face meta-physics allows us to discover the horizon of liberation pedagogy. In the logic of the Alterity, the meta-physical drive of Other beyond yes is a radical desire for love-of-justice. The erotic of liberation leads us to trace in an original way the theory of anti-Oedipus, which raises a new and alternative family model; This scheme will serve as the basis of other face-to-face meta-physical relationships at other concrete levels such as pedagogical, political, economic or archaeological. The project of liberation produces the reflection on the construction of a new order with love-of-justice, a "very other" world, that is why the discourse acquires a specific dramatization where the strategic and tactical are determined from the praxis of liberation.KEYWORDS: Pedagogical, Erotic, Alterity, Liberation and Justice.
Adherence at 2 years with distribution of essential medicines at no charge: The CLEAN Meds randomized clinical trial
Authors: Persaud Nav , Bedard Michael , Boozary Andrew , Glazier Richard H. , Gomes Tara , Hwang Stephen W. , Juni Peter , Law Michael R. , Mamdani Muhammad , Manns Braden , Martin Danielle , Morgan Steven G. , Oh Paul , Pinto Andrew D. , Shah Baiju R. , Sullivan Frank , Umali Norman , Thorpe Kevin E. , Tu Karen , Laupacis Andreas ,   for the Carefully seLected and Easily Accessible at No Charge Medications (CLEAN Meds) study team
Published: May 2021

Background
Adherence to medicines is low for a variety of reasons, including the cost borne by patients. Some jurisdictions publicly fund medicines for the general population, but many jurisdictions do not, and such policies are contentious. To our knowledge, no trials studying free access to a wide range of medicines have been conducted.

Methods and findings
We randomly assigned 786 primary care patients who reported not taking medicines due to cost between June 1, 2016 and April 28, 2017 to either free distribution of essential medicines (n = 395) or to usual medicine access (n = 391). The trial was conducted in Ontario, Canada, where hospital care and physician services are publicly funded for the general population but medicines are not. The trial population was mostly female (56%), younger than 65 years (83%), white (66%), and had a low income from wages as the primary source (56%). The primary outcome was medicine adherence after 2 years. Secondary outcomes included control of diabetes, blood pressure, and low-density lipoprotein (LDL) cholesterol in patients taking relevant treatments and healthcare costs over 2 years. Adherence to all appropriate prescribed medicines was 38.7% in the free distribution group and 28.6% in the usual access group after 2 years (absolute difference 10.1%; 95% confidence interval (CI) 3.3 to 16.9, p = 0.004). There were no statistically significant differences in control of diabetes (hemoglobin A1c 0.27; 95% CI −0.25 to 0.79, p = 0.302), systolic blood pressure (−3.9; 95% CI −9.9 to 2.2, p = 0.210), or LDL cholesterol (0.26; 95% CI −0.08 to 0.60, p = 0.130) based on available data. Total healthcare costs over 2 years were lower with free distribution (difference in median CAN$1,117; 95% CI CAN$445 to CAN$1,778, p = 0.006). In the free distribution group, 51 participants experienced a serious adverse event, while 68 participants in the usual access group experienced a serious adverse event (p = 0.091). Participants were not blinded, and some outcomes depended on participant reports.

Conclusions
In this study, we observed that free distribution of essential medicines to patients with cost-related nonadherence substantially increased adherence, did not affect surrogate health outcomes, and reduced total healthcare costs over 2 years.

Trial registration
ClinicalTrials.gov NCT02744963.
Outcomes of retained and disengaged pregnant women living with HIV in Uganda
Authors: Kiragga Agnes N. , Twinomuhwezi Ellon , Banturaki Grace , Achieng Marion , Nampala Juliet , Bagaya Irene , Kigozi Joanita , Castelnuovo Barbara , Musick Beverly S. , Hazra Rohan , Yiannoutsos Constantin T. , Wools-Kaloustian Kara K. 
Published: May 2021

Introduction
Loss-to-follow-up among women living with HIV (WLWHIV) may lead to unfavorable outcomes for both mother and exposed infant. This study traced WLWHIV disengaged from care and their infants and compared their outcomes with those retained in care.

Methods
The study included WLWHIV who initiated ART during pregnancy at six public clinics in Uganda. A woman was defined as disengaged (DW) if she had not attended her 6-week post-partum visit by 10 weeks after her estimated date of delivery. DW were matched with retained women (RW) by age and duration on ART. Nurse counselors traced all selected DW via telephone and community visits to assess vital status, infant HIV sero-status and maternal HIV viral load through blood draws.

Results
Between July 2017 and July 2018, 734 women (359 DW and 375 RW) were identified for the study. Tracing was attempted on 349 DW and 160 (44.6%) were successfully located and enrolled in the study. They were matched with 162 RW. Among DW, 52 (32.5%) transferred to another health facility. Very few DW, 39.0% were HIV virally suppressed (<1000 copies/ml) compared to RW 89.5%, P<0.001). Among 138 babies born to DW, 4.3% tested positive for HIV compared to 1.4% among babies born to RW (P = 0.163).

Conclusion
Pregnant and breastfeeding WLWHIV who disengage from care are difficult to find in urban environments. Many have detectable viral loads, leading to the potential for an increased risk of MTCT. Efforts to reduce disengagement from care are critical for the successful elimination of MTCT in resource-limited settings.
A practical individualized radiation precaution based on the dose rate at release time after inpatient 131I ablation therapy
Authors: Han Sangwon , Jin Soyoung , Yoo Seon Hee , Lee Hyo Sang , Lee Suk Hyun , Jeon Min Ji , Ryu Jin-Sook 
Published: May 2021

Introduction
Retained radioactivity of 131I after ablation therapy largely differs in each patient according to factors including the amount of remnant thyroid tissue, renal function, and use of recombinant human thyroid-stimulating hormone. To reduce unnecessary restriction of patient’s daily life after inpatient 131I ablation therapy, we propose a practical individualized method for radiation precaution based on dose rate at release time.

Methods
We evaluated 215 patients with differentiated thyroid cancer who underwent inpatient 131I ablation therapy following total thyroidectomy. Effective dose equivalent rates at 1-m distance were measured upon release (EDRR) on day 2 and during delayed whole-body scan (EDRD) visits on day 6‒8 after 131I administration. The biexponential model was designed to estimate total effective dose equivalent to others. To assess conservativeness of our model, EDRD estimated by our model was compared with measured EDRD. EDRR-based periods of precaution not to receiving 1 mSv of radiation exposure were estimated and compared with those based on administered radioactivities on American Thyroid Association (ATA) recommendations.

Results
The EDRR ranged from 1.0–48.9 μSv/hr. The measured EDRD were equal to or lower than estimated EDRD in all patients, except for one, indicating that our model is sufficiently conservative. According to our model, no subjects needed additional daytime restriction after release. The maximum permissible times for public transportation use were longer in all patients compared with those based on administered radioactivities. Nighttime restriction periods were significantly shorter than those based on administered radioactivity; median periods requiring sleeping apart were 0 (range, 0‒5), 4 (range, 1‒14), and 3 (range, 2‒13) days after release in patients treated with radioactivity doses of 2.96, 5.50, and 7.40 GBq, respectively, needing 8, 16, and 19 additional days, respectively, based on administered radioactivity.

Conclusions
Radiation safety instructions using proposed method based on EDRR of individual patient could safely reduce the burden of radiation precaution.