bluuebunny/crossref_metadata_2025_split huggingface dataset:
Cutting Edge: LAG3 Dimerization Is Required for TCR/CD3 Interaction and Inhibition of Antitumor Immunity
Authors: Adam Kieran , Lipatova Zhanna , Abdul Ghafoor Raja Maria , Mishra Arjun K , Mariuzza Roy A , Workman Creg J , Vignali Dario A A 
Published: May 2024

Abstract
Lymphocyte activation gene 3 (LAG3) is an inhibitory receptor that plays a critical role in controlling T cell tolerance and autoimmunity and is a major immunotherapeutic target. LAG3 is expressed on the cell surface as a homodimer but the functional relevance of this is unknown. In this study, we show that the association between the TCR/CD3 complex and a murine LAG3 mutant that cannot dimerize is perturbed in CD8+ T cells. We also show that LAG3 dimerization is required for optimal inhibitory function in a B16-gp100 tumor model. Finally, we demonstrate that a therapeutic LAG3 Ab, C9B7W, which does not block LAG3 interaction with its cognate ligand MHC class II, disrupts LAG3 dimerization and its association with the TCR/CD3 complex. These studies highlight the functional importance of LAG3 dimerization and offer additional approaches to therapeutically target LAG3.
Clinical Profile of Patients with Diabetes Mellitus in Gusau, Northwestern, Nigeria
Authors: Sada Kabiru Bello , Sabir A. A. , Sakajiki A. M. , Umar M. T. , Abdullahi U. , Sikiru Y. A. 
Published: May 2024

Background:
There are variable reports of glycemic control and complications among patients living with diabetes mellitus (DM).

Aim:
The aim of this study was to determine the glycemic control and complications among patients with DM seen at the medical outpatient department of a tertiary health institution in Northwestern Nigeria.

Methodology:
This was a descriptive cross-sectional study of 236 patients attending DM Clinic at Federal Medical Centre Gusau. A questionnaire was administered that contains sociodemographic characteristics of the patients, duration of DM, adherence to management, and complications. Anthropometry, blood pressures, and fasting plasma glucose (FPG) were recorded. Data were analyzed using SPSS version 20.0.

Results:
Eighty-six (36%) males and 150 (64%) females patients with DM were evaluated. Their mean (standard deviation [SD]) age was 53.5 ± 12.3 years with mean (SD) duration of DM of 7.9 ± 6.2 years. The mean FPG was 8.85 ± 3.8 mmol/L (males 8.21 ± 3.6, females 9.49 ± 3.8). Forty-seven (20%), 75 (32%), 113 (48%) of the patients had good, fair, and poor glycemic control, respectively. The major complications observed were peripheral neuropathy (61%) and visual impairment (51%). Glycemic control was significantly better among males and those with good adherence to medications. There was a positive association between the longer duration of DM with complications.

Conclusion:
Only 20% of our patients achieved good glycemic control and many have complications. Majority of the patients adhered more with medications as compared to dietary management and exercise. There is a need for clinicians to educate patients more on the need for lifestyle modifications.
Screening for Chronic Kidney Disease in an Urban Population in Nigeria
Authors: Okafor Umezurike Hughes , Ogbobe Obianuju , Ugwu Nkem , Nebo Chidinma , Asogwa Promise 
Published: May 2024

Background:
Chronic kidney disease has been reported to be on the increase globally and worse in the developing countries. Early detection has been associated with a better outcome. The objective of the study is to screen for kidney disease and its risk factors in the urban population in Nigeria.

Materials and Methods:
This is a cross-sectional nonrandomized study of residents of Enugu metropolis of Nigeria. Ethical approval was obtained from the ethical committee of the hospital. The study population was consecutive subjects aged 18 years and above who gave consent to the study. The details of the study were explained to the participants and informed consent obtained. The biodata, relevant clinical parameters, and blood and urine samples were obtained from each participant. The serum creatinine and urine protein of each participant were assessed. The estimated glomerular filtration rate (eGFR) was calculated using the modification of diet in renal disease epidemiology formula. Kidney disease is defined as eGFR <60 ml/min/1.73 m2 and/or proteinuria. The data obtained were analyzed using SPSS software version 20. The results were presented in tables and charts as frequencies, mean and standard deviation. P < 0.05 was considered statistically significant.

Results:
Four hundred and sixty-six participants participated in the study, 77.3% were females with a male: female ratio of 1:3.4. The age range was 18–90 years with a mean of 35.7 ± 12.7 years; 11.8%, 1.3%, and 0.6% had hypertension, diabetes mellitus, and kidney disease, respectively. Systolic blood pressures (BPs) of 140 mmHg and above and diastolic BP of 90 mmHg and above were found in 20% and 18.5% of the participants, respectively. Furthermore, 16.9% of the participants had a random blood glucose >11 mmol/l. The range of serum creatinine was 27.3–1029.1 μmol/l with a median of 69.1umol/l. eGFR <60 ml/min/1.73 m2 was found in 6.6% and proteinuria in 18.2%; however, 23.1% of the participants had kidney disease detected by eGFR <60 ml/min/1.73 m2 and/or proteinuria. Age, male sex, BP, and body mass index were found to have a statistically significant inverse relationship with kidney function.

Conclusion:
Prevalence of kidney disease in an urban population in Nigeria is high. The risk factors were hypertension, increasing age, male sex, and obesity.
Public–private Partnership in Hemodialysis in Nigeria
Authors: Liman Hamidu Muhammad , Sakajiki Aminu Muhammad , Makusidi Muhammad Aliyu , Isah Ibrahim Babatunde , Ahmed Faruk Umar , Galadima Muazu , Yeldu Samaila Musa , Arkilla Bello Magaji 
Published: May 2024

Background:
Public–private partnership (PPP) in hemodialysis delivery in Nigeria is a new concept. We set out to compare the performance of Specialist Hospital Sokoto's (SHS) renal center operating with this model with four other neighboring government-operated dialysis centers.

Materials and Methods:
We reviewed the 6-year records (May 2011 to April 2017) of Dialysis Center of SHS, operated under a PPP and compared some performance indicators with four government-operated dialysis centers over the same period. Comparisons were made using Chi-square and corresponding P values were reported accordingly. P < 0.05 was considered significant.

Results:
A total of 1167 patients’ data were studied. Of these, 252 (21.6%) patients with end-stage renal disease were dialyzed at SHS. The SHS dialysis center experienced 5 months of interruption in dialysis service. Only 38 (15.1%) patients sustained dialysis beyond 90 days and 105 (41.7%) patients had more than three sessions of hemodialysis. Only one patient was referred for kidney transplant from the dialysis center during the review period. SHS performed better than Federal Medical Center and Sir Yahaya Hospitals in terms of service availability, duration on hemodialysis, and greater number of hemodialysis sessions (χ2 = 29.06, df = 3, P < 0.001).

Conclusion:
PPP has improved the availability of dialysis service, mean duration on dialysis, and mean number of dialysis sessions but did not improve the kidney transplant referral rate at SHS. There is a need to encourage the current arrangement in the Hospital as well as other centers offering similar partnerships.
The Need and Art of Establishing Skill and Simulation Centers to Strengthen Skill-Based Medical Education
Authors: Archana S. , Nilakantam Sathish Raju , Hathur Basavanagowdappa , Dayananda Melanahalli 
Published: May 2024

Background:
Evidence-based medicine seeks to improve medical education, which requires high competency levels in various clinical skills such as examination of patients and execution of clinical techniques on patients by integrating skill and simulation-based teaching and learning as supplementary to traditional methods of bedside clinical teaching. Hence, a safely prepared and controlled environment with trained interdisciplinary teams is very essential in providing such effective medical education to students as well as health-care professionals. The ongoing skill and simulation center project aims to provide teaching, training, and learning in various clinical procedures for both medical students and clinicians.

Materials and Methods:
The project management cycle framework was used which included the phases of planning, designing, training, and implementation. Having picked the model for the proposed skill and simulation center, that is, redefining medical education with skill and simulation-based teaching, training, and learning, it was decided to establish this skill and simulation center.

Results:
The functional skill and simulation center unit with the state-of-the-art infrastructure along with a trained multidisciplinary team was achieved. There are also academic programs, which include the demonstration of various clinical and surgical skills and workshops on simulation-based medical education.

Conclusion:
It was possible to establish a comprehensive skill and simulation center and achieve best practices in medical education by optimal investment in infrastructure and improving the available human resources. Detailed planning is required, across a variety of domains. We hope our experiences shared in this article will help other medical colleges and hospitals across the region, both nationally and globally, toward establishing similar educational facilities.
Prevalence and Risk Factors for Hepatitis C Virus Co-infection among Human Immunodeficiency Virus-Infected Patients and Effect of Hepatitis C Virus Infection on Acquired Immunodeficiency Syndrome Cases at Baseline
Authors: Yakubu Abdulmumini , Hali Bello , Maiyaki Abubakar Sadiq 
Published: May 2024

Background:
Hepatitis C virus (HCV) co-infection with human immunodeficiency virus (HIV) exists as both viruses have the common routes of transmission. HIV infection has adverse effect on the natural history of HCV infection; however, the effect of HCV infection on the natural history of HIV infection is unclear.

Materials and Methods:
This study was cross-sectional comprising of treatment-naïve adult HIV-infected patients attending clinics at Usmanu Danfodiyo University Teaching Hospital, Sokoto and Specialist Hospital Sokoto. The study participants were screened for HCV anti]body and assayed for transaminases and CD4+ T-lymphocytes count levels. The symptoms of acquired immunodeficiency syndrome (AIDS)-defining illnesses were asked among the study participants. The questionnaire was used for the collection of data, and SPSS software version 20 was used for the analysis of data. Student's t-tests, Pearson’s, Chi-square, and Fisher's exact tests were used for the statistical analysis, and P < 0.05 was considered statistically significant.

Results:
The prevalence of HIV/HCV co-infection was 20.6%. Self-intravenous drugs usage was not statistically significant (P = 0.210). HIV mono-infected patients had significantly lower alanine aminotransferase levels compared to HIV/HCV co-infected study participants (P = 0.048). AIDS status at the baseline was comparable between HIV mono-infected and HIV/HCV co-infected study participants. (P = 0.227; 0.200; 0.130).

Conclusion:
Moderately high prevalence of HIV/HCV co-infection was observed in the current study. HCV co-infection had no effect on AIDS status at baseline. There is a need for routine screening of HCV infection in HIV-infected individuals.
Influence of Seasonal Changes on Asthma Exacerbation in a Sudan Savanna Region
Authors: Abbas Aminu , Okpapi Juliana U. , Njoku Chibueze H. , Abba Abdallah A. , Isezuo Simeon A. , Danasabe Isah M. 
Published: May 2024

Background:
Asthma accounts for 1 out of every 250 deaths worldwide. Many of these deaths are preventable as they occur as a result of suboptimal long-term medical care and delay in seeking help during severe exacerbation. It is believed that increased concentrations of dust, high winds, low temperatures, and low humidity may cause exacerbation of asthma.

Objective:
The aim of this study is to assess seasonal variation in asthma exacerbation among patients attending Usmanu Danfodiyo University Teaching Hospital, Sokoto.

Materials and Methods:
Eighty-seven patients aged 16 years and above with physician-diagnosed asthma were selected by systematic random sampling. Clinical information was obtained from each participant about history of asthma exacerbation and health-care utilization. Meteorological data were obtained from the Nigerian Meteorological Agency corresponding to period of patient's recruitment.

Results:
Eighty-seven patients comprising 60 females and 27 males aged 32.1 ± 10.8 years participated in the study. Among the study participants, 50.6%, 28.7%, and 20.7% had exacerbation during harmattan, rainy, and dry (hot) seasons, respectively. Correlation analysis shows a significant negative relationship between temperature and asthma exacerbation (r = −0.372, P < 0.01).

Conclusion:
This study shows that asthma exacerbation is most frequent during the harmattan season and low temperature is associated with its exacerbation.
Effect of duration of exposure on health complaints, systemic inflammatory responses, immunological markers, and pulmonary function tests among workers working at the vegetable market
Authors: Ravibabu Kalahasthi , Adepu Vinay Kumar , Prakash Jamalpur Ravi , Nagaraju Raju , Surendar Jakkam 
Published: May 2024

BACKGROUND:
The vegetable markets are a rich source of organic dust and bioaerosol exposure. The effect of duration of exposure on health complaints, systemic inflammatory responses (SIR), immunological markers, and pulmonary function tests (PFT) among loading and unloading workers at the vegetable market was not explored.

OBJECTIVE:
The current study was undertaken to assess the effect of duration of exposure on health complaints, SIR, immunological markers, and PFT among workers working at the vegetable market.

MATERIALS AND METHODS:
The study design is descriptive, 45 male participants with no smoking habit and having more than 3 years of experience were enrolled in the study. The study participants were categorized into low (n = 23) and high (n = 22) exposure groups based on the median duration of exposure, which is the multiplication of years of exposure and working hours per day. The demographic details, health complaints, SIR, immunological, and PFT parameters were investigated and compared between low and high exposure groups.

RESULTS:
Workers with a prolonged duration of exposure have reported a considerable increase in musculoskeletal disorders, eye irritation, and skin allergies. SIR such as serum albumin, high sensitivity C-reactive protein, lymphocytes, white blood cell count, and immunological markers (immunoglobulin E and immunoglobulin A) were considerably increased, and PFT were significantly decreased in the high exposure group as compared to the low-exposure group.

CONCLUSIONS:
Contemporary study revealed that high duration of exposure contributes to augmented health complaints, SIR, immunological markers, and reduced competence of PFT among loading and unloading workers at vegetable markets. Therefore, this study suggests workplace hygiene practices with the use of personal protective equipment might lower the health effects and inflammation markers.
Psychological Experiences in Women with Polycystic Ovary Syndrome: A Qualitative Study
Authors: Farajzadegan Ziba , Kazemi Ashraf , Salehi Mehrdad , ZareMobini Fatemeh 
Published: May 2024

Abstract

Background:
Polycystic Ovary Syndrome (PCOS) is the most common endocrine disorder among women of reproductive years. In addition to multiple physical problems, this syndrome has many psychological complications. Thus, the present study attempted to explore the psychological experiences of women with PCOS in Iran’s sociocultural context.

Materials and Methods:
The study was carried out in Isfahan, Iran, using a qualitative content analysis method. The participants were selected through purposive sampling from women with PCOS, their spouses, and healthcare providers in hospitals, clinics, workplaces, universities, and physicians’ offices between September 2018 and November 2019. Data collection was performed through semi-structured interviews until data saturation. Data analysis was based on conventional content analysis. The interviews were transcribed and coded. Afterward, categories and concepts were extracted by grouping similar codes.

Results:
A total of 13 women with PCOS, four spouses, and 13 healthcare providers participated in this study. Data analysis yielded five main categories, including the patient’s psychological reactions following infertility and its probability, psychological issues following menstrual disorders, patients’ fear and concerns about the probability of developing chronic diseases, psychological problems following the disease, and psychological problems resulting from body appearance.

Conclusions:
The results of this study showed that women with PCOS were exposed to multiple psychological problems. Therefore, preventing and controlling the psychological consequences of PCOS and its complications requires healthcare providers’ support and comprehensive and long-term planning to promote the mental health of these women.
The Effect of Fetus Stimulation Techniques on Newborn Behavior
Authors: Valiani Mahboubeh , HadiAlijanvand Samira 
Published: May 2024

Background:
Many factors affect fetal behavior, which can also affect the baby's capacity and change interaction with the caregiver. The aim of this study was to investigate the effect of performing fetal sensory systems stimulation techniques by mother during pregnancy on the neonate's habituation behavior.

Materials and Methods:
This semi-experimental study was conducted in 2019 in Isfahan, Iran. Mothers who referred to public comprehensive health centers in the 27th week of gestation and met the inclusion criteria were selected by convenience sampling method and randomly assigned to two groups of intervention and control. Fetal learning programs were held twice a day from the 27th week to the end of the pregnancy. The habituation domain of the neonate's behavior was assessed by the Brazelton's Neonatal Behavioral Assessment Scale (BNBAS) 3–5 days after the delivery. The mean score of habituation domain of BNBAS among 72 subjects in the intervention and control groups was compared by the Mann–Whitney test.

Results:
The habituation domain of all 72 newborns born approximately at the gestational age of 38 weeks was assessed. The Mann–Whitney test results indicated that the two groups were significantly different in terms of the total mean score of habituation domain 3–5 days after birth (z = –4.37, p < 0.001) and the score of the intervention group was higher than that of the control group.

Conclusions:
Generally, it can be concluded that the fetal stimulation techniques can positively affect the neonate's behaviors including the domain of habituation.
Determinants of Maternal Near Miss among Women in Northeast Iran: A Facility-Based Case-Control Study
Authors: Abdollahpour Sedigheh , Miri Hamid Heidarian , Azmoude Elham , Pieranj Mahsa , Kabirian Maryam 
Published: May 2024

Abstract

Background:
The investigation of Maternal Near-Miss (MNM) risk factors is important for the global reduction of maternal mortality. This study aimed to identify the determinants of MNM among pregnant women in northeastern Iran.

Materials and Methods:
A prospective case-control study was conducted on 250 women referred to the maternity ward of Nohom-e-Dey hospital in Torbat-e Heydarieh, Iran, from June 2018 to May 2020. Applying the criteria of the World Health Organization tool, near-miss mothers were taken as cases, and mothers with normal obstetric outcomes were selected as controls with convenience sampling. Logistic regression models using Stata version 14.0 and odds ratios (95% confidence intervals) were reported.

Results:
A total of 123 MNM cases and 127 controls were included in the study. The multiple logistic regression represented that having had previous abortion, living in rural or urban areas, whether the mother went through C/S or vaginal delivery and level of prenatal education were associated with MNM. Besides, having experienced chronic medical diseases during pregnancy had the strongest association with MNM, and next were complications during childbirth and neonatal outcomes which were associated with MNM, although in terms of statistical association, only the first two mentioned factors were statistically significant.

Conclusions:
Determinants of MNM could be experiencing chronic medical disorders during maternal complications. Health providers need to carefully manage past medical history and adverse perinatal outcomes, especially in pregnant women who live in rural areas. Encouraging mothers to attend pregnancy training classes is effective in reducing MNM.
Critical Care Nurses’ Knowledge of Tracheostomy Care
Authors: Abu-Sahyoun Rasha , ALBashtawy Mohammed , Mohammad Khitam , Abu Baker Nisren , Al-Sheyab Nihaya , Alyahya Mohammed , Nawafleh Hani , ALBashtawy Sa’d , Ayed Ahmad , Musa Ahmad , ALBashtawy Bayan , Al-Amer Rasmieh , ALBashtawy Zaid , Alkhawaldeh Abdullah 
Published: May 2024

Background:
Tracheostomy care is a standard procedure that nurses perform in Critical Care Units (CCUs) to reduce complications from tracheostomy. The literature indicates a clear variety of care and practice in managing tracheostomy patients within the healthcare system. This study was conducted to assess the knowledge level of tracheostomy care among nurses in CCUs in Jordanian hospitals.

Materials and Methods:
A cross-sectional descriptive design was used for this study. A convenience sample of 260 nurses working in the CCUs of four government hospitals completed a self-reported structured questionnaire. Data were collected from January 2021 to March 2021. A t-test and one-way Analysis of Variance (ANOVA) were used to assess the differences among socio-demographic variables in terms of knowledge score.

Results:
The result revealed that the level of knowledge was suboptimal. There was a statistically significant difference in the mean level of knowledge regarding tracheostomy care (in all dimensions) by age (F = 22.595, p < 0.001), educational level (F = 355.30, p < 0.001), and work experience (F = 13.63, p < 0.001). For gender, there was a statistically significant difference in knowledge of the tracheostomy suctioning dimension (p = 0.001).

Conclusions:
The level of knowledge among nurses regarding tracheostomy care was moderate, indicating an urgent need for education.