bluuebunny/crossref_metadata_2025_split huggingface dataset:
Effect of bitter orange blossom distillate on anxiety and sleep disorder in mothers with infants admitted to neonatal intensive care unit: A Randomized controlled clinical trial
Authors: Dehghan Zahra , Jafarian Amiri Seyedeh Roghaye , Mozaffarpur Seyyed Ali , Shirafkan Hoda , Arzani Afsaneh 
Published: August 2024

Objective
Mothers of neonates admitted to the intensive care unit are prone to sleep disorders due to stress and anxiety. Some herbs have anti-anxiety and sedative properties. This study aimed to investigate the effect of bitter orange blossom distillate on anxiety and sleep disorders in mothers with infants admitted to the neonatal intensive care unit.

Methods
This randomized controlled clinical trial was conducted from 2021 May 15 to 2022 February 2, on 60 mothers with NICU-admitted infants in one of the medical teaching centers affiliated with Babol University of Medical Sciences, Iran. Permuted block randomization was used to assign the mothers to the experimental (bitter orange blossom distillate syrup) and control groups (syrup prepared from water and sugar). Given the impossibility of blinding the participants, allocation concealment was used to prevent the researcher from predicting the future allocation of the samples to the groups. In addition, the statistical consultant received coded data pertaining to the type of intervention in each group. A demographic questionnaire, the Spielberger State and Trait Anxiety Inventory (STAI), and the General Sleep Disorder Scale were employed to collect data. We assessed the level of anxiety and sleep disorder (in both groups before the intervention and again after the last day of the intervention). Data were analyzed using SPSS V22 software. A P-value less than 0.05 were considered significant.

Results
The mean and standard deviation of the sleep disorder score in the intervention group from (50.26±5.81) to (44.70±6.94) and in the control group from (50.46±6.95) to (48.53±8.62) changed. The covariance test showed that bitter orange blossom distillate syrup has a significant effect on the improvement of sleep disorders (P = 0.01, Effect size = 0.09), but there was no significant difference in the State and Trait anxiety level of mothers (P = 0.122, 0.144 and Effect size = 0.04, 0.03) respectively.

Conclusions
Due to the positive effect of bitter orange blossom distillate syrup on sleep disorders of mothers with hospitalized babies, this low-cost and low-risk intervention is recommended.

Trial registration
This study is registered at clinicaltrials.gov as Trial ID = IRCT20201209049666N1.
Pathology students’ perceptions of virtual learning: A case study of students in Saudi Arabia
Authors: Almohammadi Nawal Hamdan 
Published: August 2024

Background
Pathology laboratory classes are traditionally conducted using a conventional light microscope. The Coronavirus Disease 2019 (COVID-19) pandemic and recent technological advances necessitated remote learning through online classes using virtual slides (VS) instead of glass slides (GS).

Aim
The purpose of this study was to gauge the perception of learning pathology using virtual slides (VS) as opposed to glass slides (GS) for medical students in Saudi Arabia. This study would help modify teaching methods with the advancement of the application of newer methods in online teaching.

Methods
This two-phased study evaluated learning outcomes and perceptions in pathology online education for medical students. Using a questionnaire, Phase one analyzed second and third-year students’ perceptions of the teaching methods after an online pathology course. Phase Two assessed the learning outcomes of third-year students during online practical sessions using a pretest and post-test design. Statistical data were collected using a simple additive approach. Statistical tools were used to determine the factors affecting students’ perceptions.

Results
The accessibility of VS at any possible time, location, or device was the most advantageous trait of virtual learning (mean = 2.94±0.9). Students agreed the least with virtual slides as the only optimal method of learning pathology (mean = 2.25±0.9). Most enjoyed the virtual lab experience (51.7%) but still prefer both laboratory-GS and virtual-VS classes (83.5%).

Conclusions
VS had the benefit of accessibility and efficiency. The acceptance of VS was significantly affected by the orientation prior to the online class. Findings showed that VS cannot completely replace GS and more aspects such as technical difficulties and prior VS experience should be explored.
Post-marketing quality surveillance of selected antibacterial agents marketed in porous borders; the case of Ethiopia-Sudan-Eritrea border
Authors: Denekew Tewodros , Eticha Tadele , Teshome Yehualashet , Endeshaw Siyalkalem , Ashenef Ayenew 
Published: August 2024

Background
The presence of poor-quality medicines is becoming a public health threat in many parts of the world, particularly in developing countries. Antibiotics are among the most common anti-infective medicines that are highly prone to this problem.

Objectives
The purpose of this study was to assess the quality of selected antibacterials that are marketed in Setit Humera and West Gondar Zones, North West Ethiopia, which are located on the Ethiopian side of the Ethiopia-Sudan-Eritrea border.

Methods
Seventy-one samples of the four antibacterial medicines (Ciprofloxacin, Norfloxacin, Amoxycillin, and Amoxycillin clavullanate combination) were collected from six sites in Setit Humera and West Gondar Zones, North West Ethiopia. A mystery shopping system was used for sample collection. Visual inspections and confirmation of the registration status were carried out using the joint WHO/FIP/USP checklist and the Ethiopian Food and Drug Authority’s (EFDA’s) Electronic Regulatory Information System (eRIS), respectively. Then Pharmacopeial methods (USP, BP) were employed to assess the physicochemical quality parameters.

Results
During the period of our data collection, the application status for registration in the eRIS system was checked. From 71 samples, 25.35% (18/71) were not registered, and 15.49% (11/71) were registered, but the license period had expired. Some samples (12.06% (17/71)) did not meet the visual inspection criteria. The physicochemical evaluation showed that all the samples studied met the quality specifications for the identification and hardness tests. However, concerning assay, dissolution, uniformity of dosage units, disintegration, and friability test parameters, 27.49% (23/71), 16.9% (12/71), and 14.08% (10/71), 2.82% (2/71) and 8.57% (3/35) of samples were found to be substandard, respectively. Overall, 56.33% (40/71) of the samples tested were of poor quality, failing to meet any one or more of the assessed parameters in this study.

Conclusion
The study indicated that poor-quality antibacterial medicines are circulating in the study sites. Therefore, even if the area was affected by conflict at the time of the study, the regulatory bodies should focus on enforcing the necessary measures by collaborating with the regional and national regulatory medicine agencies to ensure that the antibacterial medicines available meet the required mandatory minimum standards.
Recruiting transgender men in the Southeastern United States for genital microbiome research: Lessons learned
Authors: Van Gerwen Olivia T. , Sherman Z. Alex , Kay Emma Sophia , Wall Jay , Lewis Joy , Eastlund Isaac , Graves Keonte J. , Richter Saralyn , Pontius Angela , Aaron Kristal J. , Siwakoti Krishmita , Rogers Ben , Toh Evelyn , Elnaggar Jacob H. , Taylor Christopher M. , Van Wagoner Nicholas J. , Muzny Christina A. 
Published: August 2024

Background
Transgender men (TGM) are underrepresented in genital microbiome research. Our prospective study in Birmingham, AL investigated genital microbiota changes over time in TGM initiating testosterone, including the development of incident bacterial vaginosis (iBV). Here, we present lessons learned from recruitment challenges encountered during the conduct of this study.

Methods
Inclusion criteria were assigned female sex at birth, TGM or non-binary identity, age ≥18 years, interested in injectable testosterone but willing to wait 7 days after enrollment before starting, and engaged with a testosterone-prescribing provider. Exclusion criteria were recent antibiotic use, HIV/STI infection, current vaginal infection, pregnancy, or past 6 months testosterone use. Recruitment initiatives included community advertisements via flyers, social media posts, and referrals from local gender health clinics.

Results
Between February 2022 and October 2023, 61 individuals contacted the study, 17 (27.9%) completed an in-person screening visit, and 10 (58.8%) of those screened were enrolled. The primary reasons for individuals failing study screening were having limited access to testosterone-prescribing providers, already being on testosterone, being unwilling to wait 7 days to initiate testosterone therapy, or desiring the use of topical testosterone. Engagement of non-White TGM was also minimal.

Conclusion
Despite robust study inquiry by TGM, screening and enrollment challenges were faced including engagement by TGM not yet in care and specific study eligibility criteria. Excitement among TGM for research representation should be leveraged in future work by engaging transgender community stakeholders at the inception of study development, particularly regarding feasibility of study inclusion and exclusion criteria, as well as recruitment of TGM of color. These results also highlight the need for more clinical resources for prescribing gender-affirming hormone therapy, especially in the Southeastern US.
Anti-Müllerian hormone and fertility in women after childhood cancer treatment: Association with current infertility risk classifications
Authors: Nyström Anna , Mörse Helena , Øra Ingrid , Henic Emir , Engellau Jacob , Wieslander Elinore , Tomaszewicz Andrzej , Elfving Maria 
Published: August 2024

Background
To identify childhood cancer survivors (CCSs) at risk of premature ovarian insufficiency (POI) and impaired fertility is important given its impact on quality of life. The aim of this study was to assess ovarian markers and fertility outcomes in adult female CCSs. We used the Swedish and the PanCareLIFE classifications for infertility risk grouping.

Methods
167 CCSs, at median age 34.6 years (19.3–57.8) with a median follow-up time of 25.4 years (11.6–41.3), and 164 healthy matched controls were included in this cross-sectional study. We assessed anti-Müllerian hormone (AMH) levels, antral follicle count (AFC), ovarian volume (OV), and fertility outcomes. Based on gonadotoxic treatments given, CCSs were categorized into infertility risk groups.

Results
The median levels of AMH, AFC and OV were lower in CCSs (1.9 vs. 2.1 ng/ml, 12.0 vs. 13.0, 6.8 vs. 8.0 cm3) compared with controls, although statistically significant only for OV (p = 0.021). AMH levels in CCSs <40 years were lower for those classified as high-risk (p = 0.034) and very high-risk (p<0.001) for infertility, based on the Swedish risk classification. Similarly, AFC was reduced in the high-risk (p<0.001) and the very high-risk groups (p = 0.003). CCSs of all ages showed a trend towards impaired fertility, especially in the very high-risk group. POI was diagnosed in 22/167 CCSs, of whom 14 were in the high- and very high-risk groups. The results according to the PanCareLIFE classification were similar.

Conclusion
Both the Swedish and the PanCareLIFE infertility risk classifications are reliable tools for identifying those at risk of reduced ovarian markers and fertility, as well as POI. We recommend fertility preservation counselling for patients receiving highly gonadotoxic treatments (i.e., Cyclophosphamide Equivalent Dose ≥6 g/m2, radiotherapy exposure to ovaries or stem cell transplantation) with follow-up at a young reproductive age due to the risk of a shortened reproductive window.
Dynamic changes in proresolving lipid mediators and their receptors following acute vascular injury in male rats
Authors: Kagaya Hideo , Kim Alexander S. , Chen Mian , Lin Pei‐Yu , Yin Xuanzhi , Spite Matthew , Conte Michael S. 
Published: August 2024

AbstractAcute vascular injury provokes an inflammatory response, resulting in neointimal hyperplasia (NIH) and downstream pathologies. The resolution of inflammation is an active process in which specialized proresolving lipid mediators (SPM) and their receptors play a central role. We sought to examine the acute phase response of SPM and their receptors in both circulating blood and the arterial wall in a rat angioplasty model. We found that the ratio of proresolving to pro‐inflammatory lipid mediators (LM) in plasma decreased sharply 1 day after vascular injury, then increased slightly by day 7, while that in arteries remained depressed. Granulocyte expression of SPM receptors ALX/FPR2 and DRV2/GPR18, and a leukotriene B4 receptor BLT1 increased postinjury, while ERV1/ChemR23 expression was reduced early and then recovered by day 7. Importantly, we show unique arterial expression patterns of SPM receptors in the acute setting, with generally low levels through day 7 that contrasted sharply with that of the pro‐inflammatory CCR2 receptor. Overall, these data document acute, time‐dependent changes of LM biosynthesis and SPM receptor expression in plasma, leukocytes, and artery walls following acute vascular injury. A biochemical imbalance between inflammation and resolution LM pathways appears persistent 7 days after angioplasty in this model. These findings may help guide therapeutic approaches to accelerate vascular healing and improve the outcomes of vascular interventions for patients with advanced atherosclerosis.
From the Syrian to Ukrainian refugee crisis: Tracing the changes in the Italian Twitter discussions through network analysis
Authors: Kiyak Sercan , De Coninck David , Mertens Stefan , d’Haenens Leen 
Published: August 2024

Abstract
This study examines the Italian Twitter landscape during the 2015 Syrian and 2022 Ukrainian refugee crises, with a focus on the evolution of anti-refugee discourse. Through the analysis of 400,000 tweets, we sought to identify attitudinal communities, track changes in user positions, and evaluate the trending potential of the communities. Our findings indicate a shift in opinion leaders within the anti-refugee community from 2015, alongside a persistent ability to influence public discourse. Additionally, while the pro-Ukrainian refugee community has grown, incorporating previously neutral users, it remains loosely connected. Finally, the shifts in attitudes of Italian populist leaders regarding Syrian and Ukrainian refugees are interpreted in light of the changes in user attitudes as observed in the communication networks. This research highlights the importance of computational communication methods for investigating fringe groups absent from mainstream discourse, and underscores the necessity of content moderation and proactive digital activism to counter anti-refugee sentiment online.
History-restricted marginal structural model and latent class growth analysis of treatment trajectories for a time-dependent outcome
Authors: Diop Awa , Sirois Caroline , Guertin Jason R. , Schnitzer Mireille E. , Brophy James M. , Blais Claudia , Talbot Denis 
Published: August 2024

Abstract
In previous work, we introduced a framework that combines latent class growth analysis (LCGA) with marginal structural models (LCGA-MSM). LCGA-MSM first summarizes the numerous time-varying treatment patterns into a few trajectory groups and then allows for a population-level causal interpretation of the group differences. However, the LCGA-MSM framework is not suitable when the outcome is time-dependent. In this study, we propose combining a nonparametric history-restricted marginal structural model (HRMSM) with LCGA. HRMSMs can be seen as an application of standard MSMs on multiple time intervals. To the best of our knowledge, we also present the first application of HRMSMs with a time-to-event outcome. It was previously noted that HRMSMs could pose interpretation problems in survival analysis when either targeting a hazard ratio or a survival curve. We propose a causal parameter that bypasses these interpretation challenges. We consider three different estimators of the parameters: inverse probability of treatment weighting (IPTW), g-computation, and a pooled longitudinal targeted maximum likelihood estimator (pooled LTMLE). We conduct simulation studies to measure the performance of the proposed LCGA-HRMSM. For all scenarios, we obtain unbiased estimates when using either g-computation or pooled LTMLE. IPTW produced estimates with slightly larger bias in some scenarios. Overall, all approaches have good coverage of the 95 % confidence interval. We applied our approach to a population of older Quebecers composed of 57,211 statin initiators and found that a greater adherence to statins was associated with a lower combined risk of cardiovascular disease or all-cause mortality.
Pronounced neonatal breast enlargement beyond the first week of life and its regression correlates with serum prolactin levels – a case series
Authors: Bartos Hilda-Brigitta , Weise Linnéa , Schock Alexandra , Diez Sonja , Weiss Christel , Drommelschmidt Karla , Mahnken Andreas H. , Hummler Helmut , Müller Hanna 
Published: August 2024

Abstract

Objectives
Mild breast swelling is frequently observed in newborns during the first postnatal week. Breast enlargement is also observed in a minor proportion of infants beyond the first postnatal week, leading to discussions how to deal with it. Our objective was to review a case series of infants with prolonged breast swelling.

Case presentation
We examined five infants with pronounced breast enlargement beyond the first postnatal week and measured human chorionic gonadotropin (HCG), estradiol (E2), follicle-stimulating hormone (FSH), luteinizing hormone (LH), prolactin (PRL), and progesterone (P4) in blood samples and analyzed breast volume by sonographic volume determination in all infants initially and across time. The regression of breast enlargement positively correlated with serum prolactin levels in infants with breast enlargement beyond the first week of life. Complete regression occurred after several weeks and was characterized by normalization of serum prolactin levels.

Conclusions
The present study emphasizes the role of prolactin in neonates with pronounced breast enlargement beyond the first week of life.
Using machine learning techniques for exploration and classification of laboratory data
Authors: Trulson Inga , Holdenrieder Stefan , Hoffmann Georg 
Published: August 2024

Abstract

Objectives
The study aims to acquaint readers with six widely used machine learning (ML) techniques (Principal Component Analysis (PCA), Uniform Manifold Approximation and Projection (UMAP), k-means, hierarchical clustering and the decision tree models (rpart and random forest)) that might be useful for the analysis of laboratory data.

Methods
Utilizing a recently validated data set from lung cancer diagnostics, we investigate how ML can support the search for a suitable tumor marker panel for the differentiation of small cell (SCLC) and non-small cell lung cancer (NSCLC).

Results
The ML techniques used here effectively helped to gain a quick overview of the data structures and provide initial answers to the clinical questions. Dimensionality reduction techniques such as PCA and UMAP offered insightful visualization and impression of the data structure, suggesting the existence of two tumor groups with a large overlap of largely inconspicuous values. This impression was confirmed by a cluster analysis with the k-means algorithm, indicative of unsupervised learning. For supervised learning, decision tree models like rpart or random forest demonstrated their utility in differential diagnosis of the two tumor types. The rpart model, which constructs binary decision trees based on the recursive partitioning algorithm, suggests a tree involving four serum tumor markers (STMs), which were confirmed by the random forest approach. Both highlighted pro-gastrin-releasing peptide (ProGRP), neuron specific enolase (NSE), cytokeratin-19 fragment (CYFRA 21-1) and cancer antigen (CA) 72-4 as key tumor markers, aligning with the outcomes of the initial statistical analysis. Cross-validation of the two proposals showed a higher area under the receiver operating characteristic (AUROC) curve of 0.95 with a 95 % confidence interval (CI) of 0.92–0.97 for the random forest model compared to an AUROC curve of 0.88 (95 % CI: 0.83–0.93).

Conclusions
ML can provide a useful overview of inherent medical data structures and distinguish significant from less pertinent features. While by no means replacing human medical and statistical expertise, ML can significantly accelerate the evaluation of medical data, supporting a more informed diagnostic dialogue between physicians and statisticians.
Mechanical force modulates inflammation and immunomodulation in periodontal ligament cells
Authors: Chansaenroj Jira , Suwittayarak Ravipha , Egusa Hiroshi , Samaranayake Lakshman P. , Osathanon Thanaphum 
Published: August 2024

Abstract
Mechanical forces control a multitude of biological responses in various cells and tissues. The periodontal ligament, located between the tooth’s root and alveolar bone, is a major tissue compartment that is incessantly subjected to such mechanical stimulation through either normal or abnormal oral functionality. It is now known that mechanical stimulation activates periodontal ligament stem cells (PDLSCs) to modulate periodontal immunity and regulate inflammation – a basic feature of periodontal disease that affects virtually every human during their lifetime. For instance, shear stress induces the expression of immunomodulatory-related gene, indoleamine 2,3-dioxygenase (IDO). IDO cleaves l-tryptophan, resulting in increased l-kynurenine levels that, in turn, further promote regulatory T-cell differentiation and inhibit T cell proliferation. These and other related data reinforce the notion that mechanical stimulation plays a crucial role in controlling inflammation and immunomodulation of periodontal tissues. Further investigations, however, are warranted to evaluate the immunomodulatory features of PDLSCs so as to understand the pathological basis of periodontal disease and translate these into clinical interventions.