bluuebunny/crossref_metadata_2025_split huggingface dataset:
Improving obstructive sleep apnea competency of primary care clinicians through online education
Authors: Hiebert Cayla 
Published: October 2024

ABSTRACT

Background:
Obstructive sleep apnea (OSA) is an often overlooked, widespread disease and a public health concern. Evidence-based practice guidelines do not exist to guide primary care clinicians' OSA screening practices. Clinicians must be competent in OSA; however, clinicians lack competency about this disease.

Local problem:
Elevated rates of undiagnosed OSA potentially exist in two rural and one suburban counties in Kansas, as indicated by the increased weight and elevated chronic disease prevalence in these counties' populations.

Methods:
A one-cohort, pretest–posttest, quasi-experimental design was used for this quality-improvement project implemented over 11 weeks. Clinicians' competencies on OSA were measured before and after the intervention using the Obstructive Sleep Apnea Knowledge and Attitude Survey.

Intervention:
A brief educational video on OSA was developed for this project. Definition, risk factors and complications, screening methods, definitive diagnosis, and treatment options were covered in this video.

Results:
Participants (N = 14) showed improved OSA competency after watching the educational video. Participants improved OSA competency after watching the interventional video (M = 16.3, SE = 0.194) versus preintervention (M = 14.2, SE = 0.318). Participants also improved OSA attitude scores postintervention.

Conclusion:
Primary care clinician OSA competency scores improved after engaging in a brief educational video intervention when measured using the OSA knowledge and attitude survey. Practicing clinicians can benefit from participating in education about the disease.
GATA1 transcription factor targets the gene expression of B19 virus in HEK293 cell line
Authors: Atashi Amir , Jafaripour Leila , Froughi Kobra , Behzadifard Mahin 
Published: October 2024

Background/Aim:
B19 virus (B19V) is a single-strand DNA virus that has specific tropism to erythroid progenitor cells (EPCs). The virus enters the cells via P antigen and coreceptors and induces infection and cell apoptosis. GATA1 has a high expression in EPC and is a critical transcription factor for the cells development and differentiation. As human EPCs are the main target of the virus infection that have high expression of GATA-1 as the critical transcription factor, the aim of this study was to investigate the effect of GATA1 cotransfection with B19V genome on the expression of the viral mRNAs in HEK293 as nonpermissive cell line to the virus that had no mRNA expression of GATA-1.

Methods:
HEK293 cells were transfected with pHI0 plasmid containing the B19V genome and the plasmid of the GATA1 genome. The quantity of B19V mRNAs (NS1, 7.5 kDa, and 11 kDa) expression was evaluated after 24 h of transfection.

Results:
The results showed a statistically significant increase in fold change expression of (NS1 ∽12.3, VP1 ∽27.6, 11kb protein ∽38) in cotransfected cells with GATA1 and B19 plasmids compare to control group (P<0.05).

Conclusion:
This research showed transfected cells with GATA1 had elevation in the expression of the B19V genes mRNAs in a nonpermissive cell. This result may show the role of GATA1 as a critical transcription factor in support of the virus infection in EPCs. This suggests that GATA1 may potentially sport B19V replication or gene expression.
Hemorrhagic hepatic infarction in a pregnant woman with severe pre-eclampsia: a case report
Authors: Onanga Antoine O. , Narayan Gaurang , Rusho Maher A. , Kalala Brigitte , Bwami Clovis A. , Karanga Edouard K. , Bulondo Daniel , Peter Uggh Innocent H. , Naaz Farheen , Suheb Mahammed K. , Tague Christian , Akilimali Aymar 
Published: October 2024

Introduction and importance:
Severe pre-eclampsia is a medical condition that affects women during the last two trimesters of pregnancy. Hemorrhagic hepatic infarction is a hepatic complication and is rarely encountered in women with severe pre-eclampsia. This case report aims to present the characteristics of hemorrhagic hepatic infarction in a pregnant woman with severe pre-eclampsia.

Case presentation:
A 27-year-old pregnant woman with a 30-week gestation of amenorrhea was admitted with a blood pressure of 160/100 millimeters of Mercury (mmHg), headaches, dizziness, and oedema in the lower limbs.

Clinical discussion:
These complaints with clinical and paraclinical examinations led to the diagnosis of severe pre-eclampsia, and she underwent an emergency cesarean section, but 6 h later, she presented with hypovolemic shock, and this led to a new surgery. A surgery that made it possible to develop or discover a diffuse hepatic infarction with hemorrhagic infiltration of the gallbladder and the falciform ligament without active bleeding in the liver. Emergency management of pre-eclampsia was adopted, and the postoperative course was simple, with a good clinical outcome when the patient was discharged.

Conclusion:
Severe pre-eclampsia and hemorrhagic hepatic infarction are complications of pregnancy, which require emergency treatment, and above all, these medical conditions require the termination of the pregnancy.
Cross-sectional study exploring the prevalence and clinical manifestations of acute diarrhea among under-5 children in primary care hospital in Democratic Republic of the Congo
Authors: BAVURHE Rodrigue Fikiri , RUSHO Maher Ali , BALUME Alain , NAAZ Farheen , KIHANDUKA Elie , ALI Babar , FAREED Areeba , RHUGENDABANGA Francois , SUHEB Mahammed Khan , HANGI Samson , RUGENDABANGA Excellent , BYIRINGIRO Elysée , CAKIRWA Hugues , BALAGIZI Fabien , BANTURAKI Davis , MBABAZI Samuel A. , ODUOYE Malik Olatunde , ONESIME Jones , BANGA Styves , AKILIMALI Aymar ,   Medical Research Circle (MedReC) Collaborators
Published: October 2024

Background:
Acute diarrhea (AD), which is defined as frequent passing of liquid stools compared to normal, is a serious and worrying problem and remains a concern for healthcare systems because of its high mortality cause in children under 5 years old. The authors’ study aimed to present the prevalence and to describe the clinical manifestation of AD among under-5 children.

Methods:
From June 2022 to May 2023, the authors conducted a retrospective, descriptive and cross-sectional study including all patients aged 0–5 years hospitalized for AD.

Results:
Out of 512 patients, only 197 (38.5%) children with AD were selected for our study. The average age is 25.5 months, and the sex ratio is 1.11. Some families (75.1%) have clean latrines, and 21.8% use water from the river. Inaccessibility to clean water and intolerance or food poisoning were the causes of acute diarrhea in children. Major signs and symptoms are fever, dehydration and vomiting. Weight loss and malnutrition are the major complications of AD in children. The treatment of AD is provided by oral rehydration solutions and antibiotics.

Conclusion:
The study highlights the significant prevalence of acute diarrhea among under-5 children underscores the importance of preventive measures and government intervention, such as the introduction of rotavirus vaccination. However, conclusions regarding prevalence rates should be interpreted with caution due to the lack of detailed population data.
Radio-protective effects of melatonin therapy against testicular oxidative stress: a systematic review and meta-analysis of rodent models
Authors: Dehdari Ebrahimi Niloofar , Sadeghi Alireza , Falamarzi Kimia , Shahlaee Mohammad Amin , Azarpira Negar 
Published: October 2024

Background:
Radiation exposure is a concern in today’s world, given the widespread use of electronic devices and medical procedures involving ionizing and non-ionizing radiation. Radiations may cause male infertility by inducing oxidative stress in testicular tissue. Melatonin has antioxidant properties.

Methods:
The authors systematically reviewed the literature for the studies that have investigated the effects of melatonin therapy on radiation-induced oxidative stress in rodents’ testicular tissue. PubMed, Scopus, and Web of Science were searched for relevant animal trials. Standardized mean difference and 95% CIs were used to pool the data. Subgroup and sensitivity analyses were done. The risk of bias was assessed using SYRCLE tool.

Results:
Outcomes: histopathology and sperm analyses (testicular apoptotic cells, Johnsen’s testicular biopsy score, seminiferous epithelial height, tubular diameter, sperm motility, viability, count, and morphology, concentration of spermatid, spermatocyte, and spermatogonia), body and testes weights (absolute and relative body and testicular weights), reproductive hormones (serum prolactin, FSH, and testosterone), and oxidative stress tissue markers (TBARS, CAT, GSH, GSH-Px, MDA, SOD, and XO, and total antioxidant capacity). Rats and mice were exposed to electromagnetic radiations (gamma, roentgen, microwave, radiofrequency, and high-power line energy) and particle waves (radioiodine and carbon-ion). Melatonin therapy was significantly associated with improved male reproduction.

Conclusion:
Radiation exposure harms male fertility, but melatonin, as an antioxidant, is potentially associated with improved male reproductive function in rodents. Inconsistencies in research require further investigations.
Efficacy and safety of the FGF19 analog aldafermin for the treatment of nonalcoholic steatohepatitis: a GRADE assessed systematic review and meta-analysis
Authors: Ali Mohammad Haris , Rehman Obaid Ur , Talha Muhammad , Fatima Eeshal , Fatima Laveeza , Zain Ahmad , Haisbuzzaman Md Al 
Published: October 2024

Background:
Nonalcoholic fatty liver disease (NAFLD) is increasingly concerning due to its rising prevalence. It encompasses conditions from simple steatosis to severe nonalcoholic steatohepatitis (NASH), posing risks such as fibrosis, cirrhosis, or hepatocellular carcinoma if untreated. This systematic review and meta-analysis aims to assess aldafermin, an FGF19 analog, for efficacy and safety in NASH patients.

Methods:
Eligible studies were identified by searching PubMed, Cochrane Library, and Google Scholar, resulting in 1115 studies. Three RCTs were included. The risk of bias was assessed using the Cochrane Risk of Bias tool, and data synthesis utilized Review Manager software. The certainty of evidence was evaluated with the GRADE approach.

Results:
In the 3 mg dose group, aldafermin significantly improved various parameters. The ELF score decreased notably (pooled MD: −0.46, 95% CI: −0.64 to −0.28; P<0.00001). Additionally, fibrosis improvement without NASH worsening showed a pooled MD of 8.15 (95% CI: −3.62 to 19.93; P<0.17), and fibrosis improvement with NASH resolution displayed a pooled MD of 10.16 (95% CI: 1.68–18.64; P=0.02). Furthermore, significant reductions were noted in absolute AST levels (pooled MD: −13.40, 95% CI: −18.66 to −8.14; P<0.00001) and absolute ALT levels (pooled MD: −19.92, 95% CI: −27.08 to −12.75; P<0.00001), suggesting improved liver function.

Conclusion:
The meta-analysis indicates that aldafermin, particularly, the 3 mg dose, shows significant efficacy in improving liver histology and biochemical markers in NASH patients compared to placebo, along with a satisfactory safety profile.
Management of high-dose olanzapine poisoning in a young child under limited resource setting: a case report from Nepal
Authors: Yadav Pramodman Singh , Pokhrel Popular , Bhattarai Sashank , Adhikari Pratik , Dev Abinash , Upadhaya Aishworya , Chaudhary Shipra 
Published: October 2024

Introduction:
Olanzapine, an atypical antipsychotic, is widely used for treating psychiatric conditions such as schizophrenia and bipolar disorder. Accidental overdose in children is rare but can lead to severe clinical effects. This case report discusses the management of a 5-year-old male who accidently ingested 180 mg of olanzapine, the highest reported dose in a child around 5 year.

Case presentation:
A 5-year-old boy accidentally ingested 180 mg of Olanzapine, resulting in loss of consciousness and central nervous system depression. He exhibited hyperglycemia, elevated lactate, and prolonged prothrombin time, but no significant cardiovascular issues. Following intubation and supportive care, including intravenous medications and mechanical ventilation, the child gradually improved. He was discharged in stable condition with follow-up instructions.

Discussion:
Olanzapine toxicity in children presents with a variety of symptoms, including somnolence, hypotension, and neurological impairments, which are dose-dependent. Even in case of an exceptionally high overdose, the absence of cardiovascular toxicity supports safety profile of olanzapine. Common laboratory findings include hyperglycemia, elevated liver enzymes, and metabolic disturbances. Management involves airway protection, supportive care, and monitoring, as no specific antidote exists. Prompt and appropriate care, even in severe cases under limited resource settings, can lead to favorable outcomes.

Conclusion:
In cases of high-dose accidental olanzapine poisoning in children, it is essential to begin quick intervention and comprehensive supportive care to achieve successful outcomes and can be managed even in limited resource settings. Preventive measures are crucial to avoid such incidents, and careful monitoring is essential in managing pediatric olanzapine overdose.
Two-stage surgical approach for type III odontoid fracture with C1–C2 fracture dislocation: a case report and management overview
Authors: Haq Khitamul , Akhter Saleem , Waqas Muhammad A. , Alao Adedoyin E. , Halder Abhik , Chaurasia Bipin 
Published: October 2024

Introduction and importance:
Odontoid fractures of the second cervical vertebra (C2) are categorized into three types, with type III extending into the body of the axis. These fractures, often resulting from high-energy trauma, can cause significant instability and neurological issues. This case report discusses a 43-year-old male with a type III odontoid fracture and C1–C2 fracture dislocation, demonstrating the effectiveness of traditional neurosurgical techniques in managing such complex injuries.

Case presentation:
A 43-year-old male presented with upper cervical pain and right upper limb weakness following a road traffic accident. Imaging revealed a type III odontoid fracture with posterior displacement and atlanto-axial (C1–C2) joint dislocation. The patient underwent a two-stage surgical procedure. The first stage involved transoral decompression to address the retropulsed odontoid fragment and relieve spinal cord compression. The second stage involved posterior craniocervical fixation using an autologous iliac bone graft for stabilization. The patient showed postoperative improvement and was discharged on the third day, with a stable condition at a one-month follow-up.

Clinical discussion:
Managing type III odontoid fractures with C1–C2 dislocation is challenging, requiring a strategic approach to ensure spinal stability and neurological recovery. Transoral decompression provides direct access for effective decompression, while posterior fixation ensures robust stabilization. The use of an autologous iliac bone graft enhances fusion and long-term stability. This case illustrates the successful integration of traditional neurosurgical techniques with modern surgical principles.

Conclusion:
This case underscores the importance of traditional neurosurgical techniques in managing complex odontoid fractures. The two-stage approach of transoral decompression followed by posterior craniocervical fixation proved effective, highlighting the relevance of these techniques in achieving positive outcomes in contemporary neurosurgical practice.
Cardioprotective strategies in the management of chemotherapy-induced cardiotoxicity: current approaches and future directions
Authors: Al-Hasnawi Zeineb , Hasan Hawraa Mohammed , Abdul Azeez Jaafar Mohammed , Kadhim Naam , Shimal Aya Ahmed , Sadeq Maryam Hussein , Mahood Noor Al-Huda Ali Motashar , Al-Qara Ghuli Abdulmelik A. N. , Hussein Ahmed Safaa , Prajjwal Priyadarshi , Jain Hritvik , Goyal Aman , Amir Omniat 
Published: October 2024

Background:
Chemotherapy-induced cardiotoxicity (CIC) is a significant challenge in cancer treatment, leading to heart failure and myocardial infarction. With rising cancer survival rates, the long-term cardiovascular health of survivors has gained importance. While several cardioprotective medications have been studied to mitigate chemotherapy’s harmful effects on the heart, more research is needed to confirm their effectiveness and optimal use.

Methodology:
This review synthesizes evidence on cardioprotective drugs in managing CIC. The authors conducted a comprehensive literature search of peer-reviewed articles, clinical trials, and meta-analyses published between January 2000 and May 2024. Studies were selected based on relevance, quality, and focus on mechanisms, efficacy, and clinical outcomes of cardioprotective agents such as beta-blockers, ACE inhibitors, ARBs, statins, and dexrazoxane.

Results and discussion:
Cardioprotective medications show potential in alleviating the impact of chemotherapy on heart function. Beta-blockers and ACE inhibitors effectively reduce heart failure incidence and improve cardiac outcomes. Statins, with their anti-inflammatory and antioxidative properties, and dexrazoxane, which reduces anthracycline-induced cardiotoxicity, also show promise. However, variability in study designs, patient groups, and chemotherapy treatments complicates the establishment of standardized treatment protocols.

Conclusion:
Cardioprotective drugs hold significant promise in managing CIC and improving cardiac outcomes for cancer patients. Current evidence supports the efficacy of beta-blockers, ACE inhibitors, statins, and dexrazoxane. Further research is needed to establish standardized protocols, evaluate long-term safety, and optimize treatment timing. Integrating cardioprotective strategies into oncological care can enhance the quality of life and prognosis for cancer survivors.
Prevalence of bacteriuria and treatment outcomes in patients with symptomatic benign prostatic hyperplasia: a prospective observational study
Authors: Ramdam Niroj , Upadhya Pawan Sapkota , Luitel Prajjwol , Thapaliya Ishwor , Paudel Sujan , Kashyap Shiwangi , Karkee Rikesh Jung , Gupta Rakesh Kumar 
Published: October 2024

Introduction:
The global incidence of benign prostatic hyperplasia (BPH) is rising, with bacterial causes of lower urinary tract symptoms (LUTS) being a common factor contributing to complications in these patients.

Aim:
To identify the prevalence of bacteriuria and treatment response in patients with symptomatic BPH.

Materials and methods:
This 1-year prospective study included all patients presenting with LUTS due to BPH who met the inclusion criteria. Urine samples were collected and analyzed for microscopy, culture, and sensitivity following standard protocols. Bacterial growth in urine specimens and International Prostate Symptom Score (IPSS) of LUTS were recorded before and after antibiotic therapy.

Results:
A total of 131 patients with symptomatic BPH were studied. Escherichia coli (47.6%) was the most commonly isolated bacteria, followed by Klebsiella pneumoniae and Pseudomonas species. E. coli and Klebsiella showed the highest sensitivity to nitrofurantoin. After 1 week of antibiotic therapy, 69% of patients had sterile urine cultures, while 31% remained E. coli positive. Significant improvement in IPSS scores was observed after 1 week of therapy (P<0.05), and there was no significant change in urine culture (P=0.854).

Conclusion:
Bacteriuria is a common finding in patients with symptomatic BPH in our setting. Escherichia coli and Klebsiella pneumoniae were the most frequently isolated organisms, with sensitivity to nitrofurantoin and cefixime. A week of antibiotic therapy significantly reduced IPSS scores but did not reduce bacteriuria.
Imaging the translocator protein 18 kDa within cognitive control and declarative memory circuits in virally suppressed people with HIV
Authors: Rubin Leah H. , Maki Pauline M. , Du Yong , Sweeney Shannon Eileen , O’Toole Riley , Nam Hwanhee , Lee Hannah , Soule Ana R. , Rowe Steven P. , Lesniak Wojciech G. , Minn Il , Dastgheyb Raha , Shorer Eran F. , Wugalter Katrina A. , Severson Joan , Wu Yunkou , Hall Andrew W. , Mathews William B. , Kassiou Michael , Dannals Robert F. , Kassaye Seble G. , Brown Todd T. , Bakker Arnold , Pomper Martin G. , Coughlin Jennifer M. 
Published: October 2024

Objectives:
Virally suppressed people with HIV (VS-PWH) show heterogeneity in patterns of cognitive dysfunction. To better understand the relationship between the neuroimmune response and cognition, we used PET to image the translocator protein 18 kDa (TSPO). The study examined HIV-serostatus differences in TSPO as well as associations between regional TSPO and select cognitive processes defined using the Research Domain Criteria (RDoC) framework.

Design:
Cross-sectional investigation in VS-PWH (n = 25) versus HIV-uninfected individuals (n = 18) of cognitive control and declarative memory, as well as [11C]DPA-713 PET measures of TSPO within cognitive control and declarative memory regions of interest (ROI).

Methods:
Group differences in [11C]DPA-713 binding (V
T) in cognitive control or declarative memory regions were examined using linear mixed models. Tests of associations between factor-derived cognitive system measures and PET measures were performed, controlling for TSPO genotype.

Results:
There were no group differences in any of the four factor-derived cognitive system measures. VS-PWH had higher log [11C]DPA-713 V
T across cognitive control regions [unstandardized beta coefficient reflecting mean difference [B] = 0.23, SE = 0.11, 95% confidence interval (CI) 0.01–0.45, P = 0.04] and declarative memory regions (B
= 0.24, SE = 0.11, 95% CI 0.02–0.45, P = 0.03). Higher log [11C]DPA-713 V
T in cognitive control regions related to poorer cognitive control in each group, and to worse self-reported cognitive performance in VS-PWH. Log [11C]DPA-713 V
T in each declarative memory region did not associate with measured declarative memory.

Conclusion:
A localized neuroimmune response marked by high TSPO in brain regions that subserve cognitive control may contribute to poorer cognitive control in VS-PWH.