bluuebunny/crossref_metadata_2025_split huggingface dataset:
High risk of early sub-therapeutic penicillin concentrations after intramuscular benzathine penicillin G injections in Ethiopian children and adults with rheumatic heart disease
Authors: Ketema Ezra B. , Gishen Nigus Z. , Hailu Abraha , Leul Abadi , Hadgu Abera , Hagos Kiflom , Berhane Samual , Tsega Temesgen , Page-Sharp Madhu , Davis Timothy ME , Moore Brioni , Batty Kevin T. , Carapetis Jonathan , Salman Sam , Manning Laurens 
Published: June 2021

IntroductionIntramuscular benzathine penicillin G (BPG) injections are a cornerstone of secondary prophylaxis to prevent acute rheumatic fever (ARF) and rheumatic heart disease (RHD). Uncertainties regarding inter-ethnic and preparation variability, and target exposure profiles of BPG injection are key knowledge gaps for RHD control.MethodsTo evaluate BPG pharmacokinetics (PK) in patients receiving 4-weekly doses in Ethiopia, we conducted a prospective cohort study of ARF/RHD patients attending cardiology outpatient clinics. Serum samples were collected weekly for one month after injection and assayed with a liquid chromatography-mass spectroscopy assay. Concentration-time datasets for BPG were analyzed by nonlinear mixed effects modelling using NONMEM.ResultsA total of 190 penicillin concentration samples from 74 patients were included in the final PK model. The median age, weight, BMI was 21 years, 47 kg and 18 kg/m2, respectively. When compared with estimates derived from Indigenous Australian patients, the estimate for median (95% confidence interval) volume of distribution (V/F) was lower (54.8 [43.9–66.3] l.70kg-1) whilst the absorption half-life (t1/2-abs2) was longer (12.0 [8.75–17.7] days). The median (IQR) percentage of time where the concentrations remained above 20 ng/mL and 10 ng/mL within the 28-day treatment cycle was 42.5% (27.5–60) and 73% (58.5–99), respectively.ConclusionsThe majority of Ethiopian patients receiving BPG as secondary prophylaxis to prevent RHD do not attain target concentrations for more than two weeks during each 4-weekly injection cycle, highlighting the limitations of current BPG strategies. Between-population variation, together with PK differences between different preparations may be important considerations for ARF/RHD control programs.
Evidence of Zika virus circulation in asymptomatic pregnant women in Northeast, Brazil
Authors: Branco Rebeca Costa Castelo , Brasil Patrícia , Araújo Josélio Maria Galvão , Cardoso Flávia Oliveira , Batista Zulmira Silva , Leitão Valéria Maria Souza , da Silva Marcos Antonio Custódio Neto , de Castro Lailson Oliveira , Valverde Joanna Gardel , Jeronimo Selma Maria Bezerra , Lima Josélia Alencar , Ribeiro da Silva Raimunda , Barbosa Maria do Carmo Lacerda , Brito Luciane Maria Oliveira , Xavier Marcelo Antônio Pascoal , Nascimento Maria do Desterro Soares Brandão 
Published: June 2021

Background
Zika virus (ZIKV) is a flavivirus associated with microcephaly and other fetal anormalities. However, evidence of asymptomatic ZIKV infection in pregnant women is still scarce. This study investigated the prevalence of Zika infection in asymptomatic pregnant women attending two public maternities in Maranhão state, Northeast Brazil.

Methods
A total of 196 women were recruited at the time of delivery by convenience sampling from two maternity clinics in São Luís, Maranhão, Brazil, between April 2017 and June 2018. Venous blood, umbilical cord blood and placental fragments from maternal and fetal sides were collected from each subject. ZIKV infection was determined by reverse transcription polymerase chain reaction (RT-qPCR) for ZIKV and by serology (IgM and IgG). Nonspecific laboratory profiles (TORCH screen) were obtained from medical records.

Results
The participants were mostly from São Luís and were of 19–35 years of age. They had 10–15 years of schooling and they were of mixed race, married, and Catholic. ZIKV was identified in three umbilical cord samples and in nine placental fragments. Mothers with positive ZIKV RT-qPCR were in the age group older than 19 years. Of the 196 women tested by ZIKV rapid test, 6 and 117 women were positive for anti-ZIKV IgM and anti-ZIKV IgG antibodies, respectively. Placental Immunohistochemistry study detected ZIKV in all samples positive by RT-PCR. The newborns did not show any morphological and/or psychomotor abnormalities at birth.

Conclusions
Asymptomatic ZIKV infection is frequent, but it was not associated to morphological and/or psychomotor abnormalities in the newborns up to 6 months post-birth. Although pathological abnormalities were not observed at birth, we cannot rule out the long term impact of apparent asymptomatic congenital ZIKV infection.
How does onchocerciasis-related skin and eye disease in Africa depend on cumulative exposure to infection and mass treatment?
Authors: Vinkeles Melchers Natalie V. S. , Stolk Wilma A. , Murdoch Michele E. , Pedrique Belén , Kloek Marielle , Bakker Roel , de Vlas Sake J. , Coffeng Luc E. 
Published: June 2021

Background
Onchocerciasis (river-blindness) in Africa is targeted for elimination through mass drug administration (MDA) with ivermectin. Onchocerciasis may cause various types of skin and eye disease. Predicting the impact of MDA on onchocercal morbidity is useful for future policy development. Here, we introduce a new disease module within the established ONCHOSIM model to predict trends over time in prevalence of onchocercal morbidity.

Methods
We developed novel generic model concepts for development of symptoms due to cumulative exposure to dead microfilariae, accommodating both reversible (acute) and irreversible (chronic) symptoms. The model was calibrated to reproduce pre-control age patterns and associations between prevalences of infection, eye disease, and various types of skin disease as observed in a large set of population-based studies. We then used the new disease module to predict the impact of MDA on morbidity prevalence over a 30-year time frame for various scenarios.

Results
ONCHOSIM reproduced observed age-patterns in disease and community-level associations between infection and disease reasonably well. For highly endemic settings with 30 years of annual MDA at 60% coverage, the model predicted a 70% to 89% reduction in prevalence of chronic morbidity. This relative decline was similar with higher MDA coverage and only somewhat higher for settings with lower pre-control endemicity. The decline in prevalence was lowest for mild depigmentation and visual impairment. The prevalence of acute clinical manifestations (severe itch, reactive skin disease) declined by 95% to 100% after 30 years of annual MDA, regardless of pre-control endemicity.

Conclusion
We present generic model concepts for predicting trends in acute and chronic symptoms due to history of exposure to parasitic worm infections, and apply this to onchocerciasis. Our predictions suggest that onchocercal morbidity, in particular chronic manifestations, will remain a public health concern in many epidemiological settings in Africa, even after 30 years of MDA.
Predictors of underachieved and overachieved fertility among women with completed fertility in Ghana
Authors: Yeboah Isaac , Kwankye Stephen Owusu , Frempong-Ainguah Faustina 
Published: June 2021

Background
A woman’s ability to achieve her preferred family size is critical in addressing issues of high fertility in sub-Saharan Africa. The socio-cultural context in sub-Saharan Africa presents some difficulty for the attainment of preferred fertility for many women. Few studies in sub-Saharan Africa have examined the extent to which women are unable to achieve their preferred family sizes. This study, therefore, examines the factors that are associated with the non-attainment of women’s preferred fertility by the end of their reproductive years.

Data and methods
The study analyzed pooled cross-sectional data with a sub-sample of 1,888 currently married women aged 45–49 years from five rounds of the Ghana Demographic and Health Survey, 1993 to 2014. Test of associations and multinomial logistic regression analysis were used to examine the predictors of underachieved and overachieved fertility relative to achieved fertility.

Results
The results indicate that 44 per cent of the women recorded overachieved fertility while about 36 per cent underachieved their fertility. Partner wants more, experiencing child loss and married more than once were significantly associated with overachieved fertility. Nonetheless, increased years of a woman’s education and delaying her at first birth were negatively associated with overachieved fertility. On the other hand, underachieved fertility was significantly associated with having a partner with fewer fertility preference, being of the Islamic faith and ever use of modern contraception.

Conclusion
Partner’s fertility preference, child loss experience, marrying more than once and ever use of modern contraception were important predictors of a woman’s inability to achieve her fertility preference. Policies to regulate men’s fertility behaviour, delaying age at first birth, use of modern contraception, encouraging longer years of education, and reducing infant and child mortality are important strategies to achieve fertility preference in Ghana.
Longitudinal changes in IgG levels among COVID-19 recovered patients: A prospective cohort study
Authors: Alzaabi Ashraf Hassan , Ahmed Luai A. , Rabooy Abdulla E. , Zaabi Ali Al , Alkaabi Mohammed , AlMahmoud Falah , Hamed Mai Farouk , Bashaeb Khalid Omar , Bakhsh Abdul Rahim , Adil Suha , Elmajed Nadeen , Abousalha Ahmed Nigm , Uwaydah Ahmad Kanaan , Mazrouei Khulood Al 
Published: June 2021

ObjectivesTo quantify SARS-CoV2 IgG antibody titers over time and assess the longevity of the immune response in a multi-ethnic population setting.SettingThis prospective study was conducted in a tertiary hospital in Abu Dhabi city, UAE, among COVID-19 confirmed patients. The virus-specific IgG were measured quantitatively in serum samples from the patients during three visits over a period of 6 months. Serum IgG levels ≥15 AU/ml was used to define a positive response.Participants113 patients were analyzed at first visit, with a mean (SD) age of participants of 45.9 (11.8) years 87.5% of the patients were men. 63 and 27 participants had data available for visits 2 and 3, respectively.Primary outcomeChange in SARS-CoV2 IgG antibody titers over the visits.ResultsNo mortality or re-infection were reported. 69% of the patients developed positive IgG response within the first month after the onset of symptoms. The levels of IgG showed a consistent increase during the first three months with a peak level during the third month. Increasing trend in the levels of IgG were observed in 82.5%, 55.6% and 70.4% of patients between visit 1 to visit 2, visit 2 to visit 3, and from visit 1 to visit 3, respectively. Furthermore, about 64.3% of the patients showed sustained increase in IgG response for more than 120 days.ConclusionsOur study indicates a sustained and prolonged positive immune response in COVID-19 recovered patients. The consistent rise in antibody and positive levels of IgG titers within the first 5 months suggest that immunization is possible, and the chances of reinfection minimal.
Integrated bioinformatics analysis and screening of hub genes in papillary thyroid carcinoma
Authors: Fan Rong , Dong Lijin , Li Ping , Wang Xiaoming , Chen Xuewei 
Published: June 2021

Background
With the increasing incidence of papillary thyroid carcinoma (PTC), PTC continues to garner attention worldwide; however its pathogenesis remains to be elucidated. The purpose of this study was to explore key biomarkers and potential new therapeutic targets for, PTC.

Methods
GEO2R and Venn online software were used for screening of differentially expressed genes. Hub genes were screened via STRING and Cytoscape, followed by Gene Ontology and KEGG enrichment analysis. Finally, survival analysis and expression validation were performed using the UALCAN online software and immunohistochemistry.

Results
We identified 334 consistently differentially expressed genes (DEGs) comprising 136 upregulated and 198 downregulated genes. Gene Ontology enrichment analysis results suggested that the DEGs were mainly enriched in cancer-related pathways and functions. PPI network visualization was performed and 17 upregulated and 13 downregulated DEGs were selected. Finally, the expression verification and overall survival analysis conducted using the Gene Expression Profiling Interactive Analysis Tool (GEPIA) and UALCAN showed that LPAR5, TFPI, and ENTPD1 were associated with the development of PTC and the prognosis of PTC patients, and the expression of LPAR5, TFPI and ENTPD1 was verified using a tissue chip.

Conclusions
In summary, the hub genes and pathways identified in the present study not only provide information for the development of new biomarkers for PTC but will also be useful for elucidation of the pathogenesis of PTC.
Usefulness of postoperative surveillance MR for women after breast-conservation therapy: Focusing on MR features of early and late recurrent breast cancer
Authors: Lee Jeongmin , Kang Bong Joo , Kim Sung Hun 
Published: June 2021

PurposeTo investigate the imaging characteristics of early and late recurrent breast cancer and the detectability of mammography, ultrasonography, and breast magnetic resonance imaging (MRI) in patients who underwent breast-conservation therapy (BCT).Materials and methodsTotal of 1312 women with 2026 surveillance breast MRI after BCT between January 2014 and September 2018 were studied. Early recurrence was defined as newly diagnosed breast cancer and/or axillary metastasis within 12 months of surgery. Late recurrence was defined as recurrence after 12months of surgery. We assessed the detectability of recurrent lesions in each postoperative imaging modality and evaluated characteristics of recurrent lesions on postoperative MRI by comparing early and late recurrence groups.ResultOf the 2026 cases, 103 were confirmed as recurrent breast cancer by biopsy or surgery. Thirty-one cases were early recurrence, and 72 cases were late recurrence. MRI showed significantly higher detectability for recurrent lesions (102 cases, 99%) than mammography (59.4%,p< 0.001) or ultrasound (68.9%,p< 0.001), or both mammography and ultrasound (81.6%,p< 0.001). The recurrent lesions did not have typical malignant morphologic features, but variable features on MRI. However, early recurrent lesions showed fast enhancement in early dynamic phase regardless of the kinetic pattern of delayed dynamic phase; and late recurrence lesions showed early fast enhancement and delayed washout pattern. There were 19 cases which were not detected on mammography or ultrasound but could only be detected with MRI.ConclusionPostoperative breast MRI showed significantly higher detectability for recurrent lesions than mammography and ultrasound. Early fast enhancement is the most important feature of recurrent lesions on postoperative breast MRI for both early and late recurrence groups. Due to its high possibility of recurrence, further work-up should be considered regardless of their morphologic features.
Investigating difficult to detect pancreatic lesions: Characterization of benign pancreatic islet cell tumors using multiparametric pancreatic 3-T MRI
Authors: Antwi Kwadwo , Wiesner Patricia , Merkle Elmar M. , Zech Christoph J. , Boll Daniel T. , Wild Damian , Christ Emanuel , Heye Tobias 
Published: June 2021

Introduction
Pancreatic islet-cell tumors (PICT) often present with atypical signal-characteristics and are often missed on preoperative imaging. The aim of this study is to provide a multiparametric PICT characterization and investigate factors impeding PICT detection.

Material and methods
This is a detailed MRI analysis of a prospective, monocenter study, including 49 consecutive patients (37 female, 12 male; median age 50) with symptoms due to endogenous hyperinsulinemic hypoglycemia (EHH) and mostly negative prior-imaging. All patients received a 3-T MRI and a 68Ga-DOTA-exendin-4-PET/CT. Pooled accuracy, sensitivity, specificity and inter-reader agreement were calculated. Reference-standard was histopathology and 68Ga-DOTA-Exendin-4-PET/CT in one patient who refused surgery. For PICT analyses, 34 patients with 49 PICTs (48 histologically proven; one 68Ga-DOTA-exendin-4-PET/CT positive) were assessed. Dynamic contrast-enhanced (DCE) Magnetic Resonance Images (MRI) with Golden-Angle-Radial-Sparse-Parallel (GRASP) reconstruction, enabling imaging at high spatial and temporal resolution, was used to assess enhancement-patterns of PICTs. Tumor-to-background (T2B) ratio for each sequence and the employed quantitative threshold for conspicuity of PICTs were analyzed in regard to prediction of true-positive PICTs.

Results
Evaluation of 49 patients revealed a pooled lesion-based accuracy, sensitivity and specificity of 70.3%, 72.9% and 62.5%, respectively. Mean PICT size was 12.9±5.3mm for detected, 9.0±2.9mm for undetected PICTs (p-value 0.0112). In-phase T1w detected the most PICT (67.3%). Depending on the sequence, PICTs were isointense and poorly visible in 29–68%. Only 2/41(4.9%) PICTs showed typical signal-characteristics across T1w, T2w, DWI and ceT1w combined. 66.6% of PICTs enhanced simultaneously to the parenchyma, 17.8% early and 15.6% late. Predictor screening analysis showed number of sequences detecting a PICT, lesion size and in-phase T1w T2B ratio had the highest contribution for detecting a true-positive PICT.

Conclusion
The majority of PICTs enhance simultaneously to surrounding parenchyma, present with atypical signal-characteristics and thus are poorly visible. In non-enhancing PICTs, radiologists should search for small lesions most likely conspicuous on unenhanced T1w or DWI.
La libertad de expresión y discurso del odio
Authors: Grau-Alvarez Jaime 
Published: June 2021

El objetivo de este trabajo es ofrecer una comparativa sobre la delimitación de la libertad de expresión bajo el concepto de discurso del odio, en dos de los contextos jurídicos más importantes del mundo como son los de Estados Unidos y Europa.
Es interesante entender cómo se ha configurado el discurso del odio en los dos sistemas. A simple vista, el desarrollo de la libertad y, por ende, el desarrollo de la libertad de expresión se ha configurado de manera similar en ambos órdenes, siendo uno de los derechos más protegidos y salvaguardados por la Primera Enmienda o en los derechos fundamentales de las constituciones europeas. Sin embargo, para su delimitación, el camino parece haberse bifurcado, siendo el delito de odio un agravante en Estados Unidos mientras que en Europa se recoge como un delito adicional.
Se realizará un análisis de las bases de la libertad de expresión para cada ordenamiento, destacando las sentencias más relevantes que han sentado jurisprudencia y que sirven como punto de partida para el análisis comparado. Por otro lado, es necesario comparar como resuelven los Tribunales Supremos de ambos ordenamientos para casos que versan sobre asuntos similares como discursos de componente racista o discursos homófobos. Para ello, se van a contrastar las sentencias más relevantes sobre estos discursos, para ver como Estados Unidos ampara este tipo de discursos dentro de la libertad de expresión, mientras que Europa prioriza la dignidad humana.
Por último, se analizará cómo se configura este tipo de discursos en España, para ver cómo el Tribunal Constitucional en ciertos casos, permitió discursos que a ojos del TEDH posiblemente vulnerasen la dignidad humana.
Personalistyczne ujęcie chrześcijańskiej nauki moralnej w magisterium Soboru Watykańskiego II
Authors: Gryz Krzysztof 
Published: June 2021

W okresie poprzedzającym Sobór Watykański II przygotowano kilka projektów, które miały stanowić podstawę dla ojców Soboru do dyskusji na sesjach plenarnych. Obejmowały one fundamentalne problemy teologiczne i duszpasterskie, które Komisja Przygotowawcza (Commissio antepreparatoria) uznała za najważniejsze. Wśród nadesłanych propozycji znalazły się również projekty dotyczące zagadnień moralnych: De ordine morali christiano i De castitate, matrimonio, familia et virginitate. Choć od strony merytorycznej były dobrze przygotowane, spotkały się ze znaczną krytyką ze strony członków Komisji Teologicznej i niektórych biskupów, gdyż – ich zdaniem – nie odpowiadały oczekiwanemu przez papieża Jana XXIII duszpasterskiemu charakterowi soboru. Projekty te były wielokrotnie redagowane, aż ostatecznie zdecydowano, że kwestie te zostaną poruszone w szerszym dokumencie omawiającym relacje Kościoła ze światem, który ostatecznie przybrał kształt Konstytucji duszpasterskiej o Kościele we współczesnym świecie Gaudium et spes.
Osią nauczania tej Konstytucji jest integralna wizja osoby ludzkiej, stworzonej przez Boga jako istota rozumna i wolna, odkupiona przez Chrystusa i powołana do wiecznej wspólnoty w Bogu. Po latach kard. Karol Wojtyła, komentując Konstytucję, zsyntetyzował jej nauczanie, zwłaszcza w sprawach moralnych, na dwie kategorie personalistyczne: „uczestnictwo” i „solidarność”. Pierwsza odnosi się do osobistej relacji człowieka z Bogiem, druga dotyczy relacji człowieka ze światem, który tworzą inni ludzie i wspólnoty, w których żyją. Obie kategorie wyrażają osobiste zaangażowanie człowieka jako odpowiedź na dar i wezwanie zawarte w objawieniu się Boga dla człowieka.
The Power of Human Speech in Hittite Anatolia
Authors: Casa Romina Della 
Published: June 2021

Abstract
With the aim of improving our understanding of how Hittite practitioners in ancient Anatolia used human speech to achieve a desired efficacy or performativity (and therefore change a current situation), this paper explores the ritual character of Telipinu’s mugawar (CTH 324) and its historiola. Along these lines, it examines what traces of human agency are present in the text, and under which circumstances its performance would have been most valuable. Considered from a broader perspective, this study also aims to link Hittite texts to the lives of Anatolia’s inhabitants and to the many ways they did things with words.
Presents in the Palace during the Middle Assyrian Period (1500–1000 BC)
Authors: Llop-Raduà Jaume 
Published: June 2021

AbstractThis paper analyses the terminology for “present” and “giving a present” in the context of Middle Assyrian documents related to the palace. This terminology is specific to the genres of these texts and to the languages (Babylonian and Assyrian) used in them.
English for university admin staff: it’s all in the mix
Authors: Westbrook Pete 
Published: June 2021

Abstract
As a result of increasing internationalisation, the University of Copenhagen established the Centre for Internationalisation and Parallel Language Use (CIP) in 2008 as a research, competence development and resource centre. Part of CIP’s remit is to provide language training (mainly in Danish and English) for students and staff at the University. While there has been a lot of focus on teaching and learning through the medium of English, the language needs of administrative staff seem to have been neglected. They are expected to communicate with international students, teachers and researchers who do not necessarily speak the local language. This activity report looks at how CIP has set about meeting these needs by developing specific terminology-based language courses in English for university administrative staff, including HR, finance and study administrative staff. The terminology taught on the courses is tailored to the specific group of participants; however, a basic framework of activities is used as the starting point for all the terminology courses. As participants’ course evaluations have been overwhelmingly positive about the blend of activities, this paper reports on the design of the framework and how it is applied to the courses in practice.