bluuebunny/crossref_metadata_2025_split huggingface dataset:
Using polymerase chain reaction cycle threshold (PCR Ct) values for predicting and managing cholera outbreaks: potential, challenges, and future directions
Authors: Akingbola Adewunmi , Adewole Olajumoke , Soyemi Toluwalashe , Jombo Paul , Ojo Olajide 
Published: November 2024

Abstract
Background
Cholera continues to be a major public health threat, especially in regions with poor sanitation and limited access to clean water. Accurate prediction and management of cholera outbreaks are essential to reduce mortality and morbidity. This review focuses on the potential of polymerase chain reaction (PCR) cycle threshold (Ct) values as an innovative tool for early detection and control of cholera outbreaks, specifically highlighting its utility in predicting outbreaks and guiding public health responses.

Main body of abstract
PCR Ct values offer a significant advantage in the early detection of Vibrio cholerae, the pathogen responsible for cholera, in both clinical and environmental samples. By providing quantitative data on bacterial load, lower Ct values indicate a higher concentration of the pathogen, signaling the potential for increased disease transmission. These values allow for more precise, real-time monitoring of cholera outbreaks and aid in targeting intervention strategies such as water sanitation improvements, vaccination campaigns, and antibiotic treatments. Moreover, the application of Ct values in environmental surveillance, particularly in monitoring water sources, offers a proactive approach to prevent the spread of cholera by identifying contamination risks before human cases arise. However, the implementation of PCR in low-resource settings faces significant challenges, including high costs, the need for advanced laboratory infrastructure, and a lack of technical expertise. Addressing these barriers through cost-effective innovations and capacity building initiatives is crucial for optimizing the use of PCR Ct values in cholera management.

Conclusion
PCR Ct values hold great promise for improving cholera outbreak prediction and control. Despite challenges in adopting this technology in resource-limited settings, the integration of Ct value monitoring into public health frameworks can enhance early detection efforts and contribute to more effective cholera management strategies.
Recent development of integrated design and improving methods of waverider and inlet
Authors: Gong Tianyu , Long Yaosong , Cheng Zhongtao , Li Yiqing 
Published: November 2024

AbstractFor its outstanding aerodynamic capabilities, the integrated design of the waverider and inlet is widely accepted in hypersonic aircraft. Three aspects of the integrated design of the waverider and inlet since 2020 are mainly described in this paper. Firstly, the advantages and shortcomings of the conventional integrated design are examined. Then, different layouts of integrated design are proposed, and the aerodynamic performance optimization methods of the waverider, inlet, and their coupling are introduced. Besides, a series of methods for increasing the calculating accuracy of the waverider and inlet are presented, and the focus of attention is to consider the lateral flow problem.
Breast metastasis from large cell neuroendocrine carcinoma of the lung: a case report
Authors: Alshafeiy Taghreed I. , Hamza Hazwa Karathanathodi , Al-Mazroui Reem , Al-Qassabi Badriya , Al-Aghbari Suad 
Published: November 2024

Abstract
Background
Primary breast carcinoma is far more common than breast metastases. Common breast metastases usually come from lymphoma, leukemia, melanoma, and ovarian cancers. Breast metastases from neuroendocrine carcinomas are considered an exceeding rare entity. It has been reported in the literature that the pathological presentation of this particular metastatic tumor is very challenging as it shares many morphological characteristics with primary breast carcinoma.

Case presentation
We report a case of a patient with large cell neuroendocrine carcinoma of the lung metastasizes to both breasts. The patient was initially presented with brain metastasis of unknown origin. Further radiological imaging workup showed multiple bilateral breast masses and bilateral lymphadenopathy, which raised concern for secondary lymphoma of the breast. The histopathology of this case was challenging, particularly when triple negative invasive ductal carcinoma diagnosis had been made. Multidisciplinary meetings between medical oncologists, radiologists, and pathologists profoundly helped confirming the diagnosis of metastatic large cell neuroendocrine tumor to the breast.

Conclusion
Large cell neuroendocrine carcinoma of the lung is a relatively uncommon diagnosis with generally poor prognosis. Large cell neuroendocrine carcinoma that metastasizes to the breast is even scarcer. Correlation between clinical assessment, radiological imaging, and pathological evaluation is the key in making such an unusual and complex diagnosis. Additionally, radiologists should be aware of metastatic presentations of the breast and avoid confusion with mimicking benign entities or primary breast carcinomas.
Knowledge and perception of physiotherapy students and lecturers about the involvement of simulated patients in clinical examinations at physiotherapy training institutions in South-West, Nigeria
Authors: Odole Adesola C. , Odunaiya Nse A. , Ojo Omoniyi S. , Fatoye Francis , Mbada Chidozie E. , Fatoye Clara F. , Fafolahan Abiola O. , Akinpelu Aderonke O. 
Published: November 2024

Abstract
Background
Medical educators in Nigeria are beginning to incorporate the use of simulated patients (SPs) in clinical examinations. This study was designed to investigate and compare the knowledge and perception of physiotherapy students and lecturers about the involvement of SPs in clinical examinations at physiotherapy training institutions in South-West, Nigeria.

Methods
This study used a mixed-method approach, combining cross-sectional analysis and focus group discussions. A validated questionnaire assessed the knowledge and perception of physiotherapy students and lecturers regarding SP involvement in clinical exams. Quantitative data were analyzed with descriptive statistics, chi-square, and Mann–Whitney U tests (p < 0.05). Qualitative data were analyzed using thematic analysis.

Results
Two hundred and seven clinical students (83 males, 124 females, average age 22.02 ± 1.65 years) and 37 physiotherapy lecturers (25 males, 12 females, average age 48.27 ± 7.49 years) participated in this study. Among the students, 151 were aware of SP involvement in clinical exams: 35.1% had poor knowledge, 53.0% had fair knowledge, and 11.9% had good knowledge. The majority of lecturers (70.3%) demonstrated good knowledge. Most students (147, 71.0%) and lecturers (32, 86.5%) had positive perceptions of SP involvement in exams. Qualitative analysis indicated insufficient training for SPs in clinical examinations at physiotherapy training institutions in South-West Nigeria. Reported drawbacks included a preference for using models, familiarity with SPs, and limitations in the conditions that SPs can simulate.

Conclusion
Physiotherapy students at physiotherapy training institutions in South-West Nigeria had fair knowledge about the involvement of SPs in clinical examinations while lecturers had good knowledge about the involvement of SPs in clinical examinations. However, both students and lecturers had a positive perception about the involvement of SPs in clinical examinations though the concept of SPs should be differentiated from the use of models.
Visual grading of valvular regurgitation is inferior to measurement – results from the VIAVA-study (VIsual Assessment of VAlvular Regurgitation)
Authors: Demirel Ozan , Di Stefano Paolo , Boxhammer Elke , Wuppinger Thomas , Granitz Christina , Goebel Björn , Hoppe Uta C. , Lichtenauer Michael , Mirna Moritz 
Published: November 2024

AbstractWhile the visual estimation of systolic left ventricular function by experienced examiners closely aligns with quantitative methodologies, the accuracy of visual estimation in determining the severity of valvular regurgitation using colour flow Doppler assessment of native heart valves remains largely unexplored. This study analysed the ability of 262 physicians to visually estimate the severity of 12 native valve regurgitations by grading colour Doppler transthoracic echocardiography loops in an online questionnaire. The assessments of the participants were compared to standardized quantitative evaluations conducted by certified echocardiography experts. Of the three valves to assess, evaluations by the participants showed the best correlation (Rs = 0.75, p < 0.0001) and agreement (percent agreement: 66.4%) with those of the experts in mitral valve regurgitation (MR). High agreement was observed for mild regurgitation across all valves (MR 94.5%, AR 80.3% and TR 88.7%), while consensus diminished in moderate (MR 55.9%, AR 49.5% and TR 55.0%) and severe regurgitation (MR 57.6%, AR 67.4%, TR 14.6%). The study underscores the potential utility of visual estimation of valvular regurgitation in clinical settings for identifying clinically relevant regurgitations. However, our findings also highlight the importance of integrating visual estimation with quantitative methods, particularly in moderate and severe cases of regurgitation.
Exploring the long-term impact of a nurse-midwife mentorship intervention in Neno district, Malawi: a secondary data analysis of maternal and neonatal complications
Authors: Rouse Miranda , Mphande Isaac , Mwale Nelson , Kapira Sitalire , Sayenda Mphatso , Mvula Mc Geofrey , Openshaw Maria , Kapito Esnath , Kutsamba Martha , Maweu Daniel , Mitchell Ashley , Dandu Madhavi , Muller Anna , Blair Alden Hooper , Baltzell Kimberly 
Published: November 2024

Abstract
Background
There is critical need to strengthen the global nursing and midwifery workforce. This is especially true in Malawi where they are the primary providers of obstetric and neonatal care. In Neno district, Malawi, in 2017, we implemented an intensive training and longitudinal bedside mentorship intervention for nurses and midwives. From inception, there was a pre-planned project target completion after 5 years, including a staged handover to local ownership after 3 years. The objective of this study was to assess differences in reported maternal and neonatal complications following project completion and handover to local leadership.

Methods
The project was a partnership between an academic institution and local nongovernmental organization. In October 2020, the intervention was handed over and maintained by the local organization with limited support from the academic institution. Data from January 2019 to May 2023 were extracted from the Malawi District Health Information Software 2. Bivariate analyses explored differences in the pre- and post-handover periods for all government-collected, birth-related variables. The “pre-handover” period encompassed January 2019 to September 2020 and “post-handover” from October 2020 to May 2023. Multivariate linear regression explored outcomes while controlling for health facility.

Results
Data were collected from 10 health facilities in the district and included a total of 23,259 births. Overall, there were few significant changes between periods. Exceptions were in reporting of antepartum hemorrhage (p < 0.01), maternal sepsis (p = 0.01), and manual removal of the placenta (p < 0.01), where we observed decreases in reporting. There was a significant decrease in the reporting of neonatal sepsis (p = 0.01) in the bivariate analysis, which remained only borderline significant in the multivariate model (p = 0.05). Where differences occurred, they were associated with improvements in reported identification of complications and provision of associated emergency care.

Conclusions
Few differences in reported maternal and neonatal complications between the periods suggest positive impact of the intervention was sustained following project handover and transition of activities to local leadership. These findings strengthen support for longitudinal mentorship as a pivotal component for skill retention after training. Transparent partnerships which include pre-determined end points and time for handover of activities to local ownership are crucial components for sustainability.
Impaired Bone Tissue Quality Associated With Inflammation in HIV-immunological Nonresponders: A Cross-sectional Analysis
Authors: Rins-Lozano Oriol , Rodríguez-Morera Jaime , Arrieta-Aldea Itziar , González-Mena Alicia , Rodríguez-Mercader Sergi , Suaya Lucía , Pascual-Aranda Mariano , Cañas-Ruano Esperanza , Fernandez-Quiroga María José , Canepa Cecilia , Du Juan , Marcos Agustín , Knobel Hernando , García-Giralt Natalia , Güerri-Fernández Robert 
Published: November 2024

Abstract

Introduction
People with HIV (PWH) with poor immune response despite adequate antiretroviral treatment (ART) are susceptible to non-AIDS-related health issues. This study seeks to evaluate bone quality in immunological nonresponders (INRs) in comparison to those with proper immune response (IRs) using in vivo microindentation to quantify bone quality, in addition to conventional bone mineral density (BMD) evaluations.

Methods
A cross-sectional study was conducted at Hospital del Mar in Barcelona from January 2019 to June 2023. Participants were matched in a 1:2 ratio (INRs:IR) based on age, sex, body mass index, and antiretroviral treatment. Participants underwent bone quality assessment using in vivo microindentation, BMD, and analysis of bone turnover and inflammation markers. Statistical analyses involved multivariable regression to adjust for potential confounding variables.

Results
A total of 159 PWH were included, 53 INRs and 106 IRs. INRs had worse bone quality, with lower median bone material strength index compared to IRs (79 [76-87] vs 86 [82-89]; P &lt; .001), and similar BMD. INRs shown increased high-sensitive C-reactive protein levels with lower 25-(OH)-vitamin D3. A significant negative correlation between inflammation and bone quality was found, especially in INRs. Multivariable linear regression shown that INR status is a major predictor of decreased bone quality, regardless of conventional risk factors.

Conclusion
INRs’ condition is significantly associated with higher inflammatory levels, which may contribute to a deleterious effect on bone quality as measured by in vivo microindentation. Further studies are needed to confirm these results and to focus on non-AIDS comorbidities in this subgroup of PWH.
Subclinical Hypothyroidism as an Independent Predictor of Cardiovascular Prognosis in Left Ventricular Thrombus Patients
Authors: Shi Boqun , Liu Zechen , Zhang Rui , Tiemuerniyazi Xieraili , Feng Wei , Song Weihua , Dou Kefei 
Published: November 2024

Abstract

Objectives
Left ventricular thrombus (LVT) is associated with an increased risk of adverse cardiovascular events, and thyroid hormones are known to affect the cardiovascular system in various ways. However, subclinical thyroid dysfunction still deserves to be emphasized, and its impact on the prognosis of patients with LVT is rare but needs to be investigated.

Methods
We used retrospective data from patients diagnosed with LVT at Fuwai Hospital over the past 10 years to assess the relationship between thyroid functional status and prognosis of LVT using multivariate Cox proportional hazards models and validated the improved predictive effect of including thyroid function in the prognostic assessment of LVT using receiver operating characteristic curves.

Results
Subclinical hypothyroidism was significantly associated with a higher incidence of major adverse cardiovascular and cerebrovascular events (MACCEs) [hazard ratio (HR) 1.774, 95% confidence interval (CI): 1.053-2.989; P = .031] and cardiovascular death (HR 1.986, 95% CI: 1.110-3.553; P = .021) in LVT patients, whereas no significant correlation was observed in the subclinical hyperthyroidism group. In addition, including thyroid function in the prognostic consideration of LVT patients would contribute to the predictive effect of MACCEs [area under the curve (AUC) for 1 year: 0.715; AUC for 2 years: 0.745; AUC for 3 years: 0.684].

Conclusion
Subclinical hypothyroidism can be used as an independent predictor of MACCEs in patients with LVT, and there is a clinical value in using subclinical hypothyroidism as an important factor suggesting a poor prognosis in patients with LVT.
Outcomes of Radiosurgery for WHO Grade 2 Meningiomas: The Role of Ki-67 Index in Guiding the Tumor Margin Dose
Authors: Meng Ying , Bernstein Kenneth , Mashiach Elad , Santhumayor Brandon , Kannapadi Nivedha , Gurewitz Jason , Snuderl Matija , Pacione Donato , Sen Chandra , Donahue Bernadine , Silverman Joshua S. , Sulman Erik , Golfinos John , Kondziolka Douglas 
Published: November 2024

BACKGROUND AND OBJECTIVES:
The management of World Health Organization (WHO) grade 2 meningiomas is complicated by their diverse clinical behaviors. Stereotactic radiosurgery (SRS) can be an effective management option. Literature on SRS dose selection is limited but suggests that a higher dose is better for tumor control. We characterize the predictors of post-SRS outcomes that can help guide planning and management.

METHODS:
We reviewed a cohort of consecutive patients with pathologically-proven WHO grade 2 meningiomas who underwent SRS at a single institution between 2011 and 2023.

RESULTS:
Ninety-nine patients (median age 62 years) underwent SRS, 11 of whom received hypofractionated SRS in 5 fractions. Twenty-two patients had received previous irradiation. The median follow-up was 49 months. The median overall survival was 119 months (95% CI 92-NA) with estimated 5- and 10-year survival of 83% and 27%, respectively. The median progression-free survival (PFS) was 40 months (95% CI 32-62), with 3- and 5-year rates at 54% and 35%, respectively. The median locomarginal PFS was 63 months (95% CI 51.8-NA) with 3- and 5-year rates at 65% and 52%. Nine (9%) patients experienced adverse events, 2 Common Terminology Criteria for Adverse Events grade 3 and 7 grade 2, consisting of worsening neurologic deficit from edema. In the single-session cohort, Ki-67 significantly predicted both overall survival and intracranial PFS. Tumors with Ki-67 >10% had 2.17 times the risk of locomarginal progression compared with Ki-67 ≤10% (P = .018) adjusting for covariates. Sex, prescription dose, tumor volume, and location also predicted tumor control. In tumors with Ki-67 >10%, margin dose ≥14 Gy was associated with significantly better tumor control but not for tumors with Ki-67 ≤10%.

CONCLUSION:
The management of WHO grade 2 meningiomas requires a multimodality approach. This study demonstrates the value of a targeted SRS approach in patients with limited disease and further establishes predictive biomarkers that can guide planning through a personalized approach.
Haemorrhagic shock in a pregnant patient and the unsuspicious subclavian catheter
Authors: Silva Nuno , Rebolo Diogo , Santos Pedro , Sousa Nuno , Lopes Luísa 
Published: November 2024

Introduction: Central venous catheterisation (CVC) is a commonly performed procedure in clinical practice. Although usually safe, complications can arise such inadvertent vascular lesion. This report is of a case of left brachiocephalic vascular lesion due to a subclavian catheter, thus raising awareness about this potential complication, which is not always immediately recognised. Case report: We report the case of a 31-year-old healthy woman, 42 weeks pregnant, who presented with complications during an elective caesarean section. The patient experienced haemorrhagic shock due to the incomplete rupture of the left ovarian pedicle, further complicated by the accidental lesion of the left brachiocephalic vein caused by the tip of a right subclavian catheter, aggravated by the late discovery only after extubation. This case highlights the importance of patient selection, proper technique and the careful monitoring pre- and post-procedure. Conclusion: Brachiocephalic vein lesions arising from CVC insertions are rare but significant complications that require timely recognition and intervention.
Water Quality Sampling Provides Insight into Nutrient Sources and Pathways in an Agricultural Watershed in the Midwestern USA
Authors: Rudko Noah , McMillan Sara K. W. , Frankenberger Jane , Lay Danielle Winter , Limiac Amanda 
Published: November 2024

HighlightsHysteresis and flushing indices were calculated for 23 storm events.Wetter conditions led to a dilution effect for nitrate during storm events.Travel times were faster for all nutrients during the winter, likely due to lack of vegetative cover.Results can be used to choose practices that effectively target specific nutrient sources and pathways.Abstract. Understanding where agricultural nutrients originate in the landscape can help mitigate downstream transport by selecting and installing best management practices that target nutrient sources. We collected flow and water quality data from 2017–2021 at two similar HUC-12 watersheds in northeastern Indiana, which provided an opportunity to link nutrient sources with transport processes in intensively managed agricultural watersheds. We calculated metrics to represent changes in nutrients during a storm event, including hysteresis (the change in concentration on the rising limb of the hydrograph compared to the recession limb) and the flushing index (the difference between concentrations at peak discharge and baseflow). We compared storm-based and annualized concentration-discharge (C-Q) relationships for NO3-N, soluble reactive phosphorus (SRP), total P (TP), and dissolved organic carbon (DOC) to land use and climate variables. Together, these provide insight into nutrient storage zones and transport pathways at the small watershed scale. Our results suggest these landscapes have plentiful and widely distributed sources of nitrogen (N) that are activated in the spring, which we observed as chemostatic behavior (i.e., concentration remained relatively constant during different flows). While this has been shown at larger scales in agricultural watersheds, these patterns are challenging to parse at the small watershed scale. We saw concentrating effects (i.e., increased concentrations as flow increased) for DOC, TP, and SRP during storms, suggesting activation of flow-paths connecting land-based sources to receiving streams. We also noted faster travel times in the winter for all four constituents when subsurface tile drains are most active and plant uptake is negligible. Our results differentiate nutrient delivery mechanisms and can aid management decisions by identifying environmental factors that most influence transport and selecting conservation practices that target these nutrient pathways. Keywords: Agriculture, Carbon, Concentration-discharge, Hysteresis, Nitrogen, Phosphorus, Watershed management.
Development of an optical method to align a high-flux solar furnace
Authors: Martínez-Manuel Leopoldo , Arreola-Ramos Carlos Ernesto , Balbuena-Ortega Argelia , Arancibia-Bulnes Camilo A. 
Published: November 2024

High-flux solar furnaces are valuable tools for applied research and development in solar energy. However, misalignment of concentrator facets can produce optical losses and lower the concentration ratio of these systems. This study proposes a practical method to align a faceted solar furnace. The optical method uses a computer projector that illuminates the facets with a well-defined light pattern to quantitatively and qualitatively determine any misalignment associated with the mirrors. Through the Monte Carlo ray-tracing technique, the complete solar furnace, projector, and observation plane are optically modeled for the development of the methodology. A theoretical sensitivity analysis of the technique is reported, along with the experimental validation of the determined mirror misalignments, which results in a detection accuracy of 0.32 mrad.