bluuebunny/crossref_metadata_2025_split huggingface dataset:
A large multicenter Ralstonia pickettii outbreak in critically ill patients during the COVID-19 pandemic: Epidemiological and clinical characteristics of 66 cases
Authors: Viana-Cárdenas Erika , Triana Abel , Cárdenas-Álvarez Jorge , Carvajal-Diaz Edwin , Mendoza Humberto , Viasus Diego 
Published: February 2024

Objective To describe a multicenter outbreak of R. pickettii that occurred in a large number of critically ill patients in a city in Colombia, during the COVID-19 pandemic. Methods In April 2021, the National Institute for Food and Drug Surveillance (INVIMA) reported an outbreak of R. pickettii infection associated with contaminated intravenous medications. The Municipal Health Department began collecting data for all cases identified by the hospitals and the results of microbiological studies. Medical records and death certificates of included cases were reviewed. Results Between March and May 2021, 66 cases of R. pickettii bloodstream infections from nine hospitals were documented. The median age of the patients was 60 years (IQR 51–72), and most of them had comorbidities (78.8%), mainly arterial hypertension and diabetes mellitus. At the time of the R. pickettii bloodstream infection, 89.4% had COVID-19, 86.4% were on mechanical ventilation, and 98.5% were receiving corticosteroids. The overall mortality was 81.8%. Nearly 60% of the deaths were related to R. pickettii bloodstream infections. R. pickettii was identified in the cultures from intravenous medications. Conclusions This large multicenter outbreak caused by intravenous medications contaminated with R. pickettii mainly affected critically ill COVID-19 patients. Mortality was high and largely related to R. pickettii bloodstream infection.
The Needle Shield Size and Applied Force of Subcutaneous Autoinjectors Significantly Influence the Injection Depth
Authors: Staples Anne-Sofie Madsen , Poulsen Mette , Præstmark Kezia Ann Friis , Sparre Thomas , Sand Traberg Marie 
Published: February 2024

Background: This study examines how shield-triggered autoinjectors (AIs), for subcutaneous drug delivery, affect injection depth. It focuses on shield size and applied force, parameters that could potentially lead to inadvertent intramuscular (IM) injections due to tissue compression. Method: A blinded ex-vivo study was performed to assess the impact of shield size and applied force on injection depth. Shields of 15, 20, and 30 mm diameters and forces from 2 to 10 N were investigated. The study involved 55 injections in three Landrace, Yorkshire, and Duroc (LYD) pigs, with injection depths measured with computed tomography (CT). An in-vivo study, involving 20 injections in three LYD pigs, controlled the findings, using fluoroscopy (FS) videos for depth measurement. Results: The CT study revealed that smaller shield sizes significantly increased injection depth. With a 15 mm diameter shield, 10 N applied force, and 5 mm needle protrusion, the injection depth exceeded the needle length by over 3 mm. Injection depth increased with higher applied forces until a plateau was reached around 8 N. Both applied force and size were significant factors for injection depth (analysis of variance [ANOVA], P < .05) in the CT study. The FS study confirmed the ex-vivo findings in an in-vivo setting. Conclusions: The study demonstrates that shield size has a greater impact on injection depth than the applied force. While conducted in porcine tissue, the study provides useful insights into the relative effects of shield size and applied force. Further investigations in humans are needed to confirm the predicted injection depths for AIs.
Intravenous versus intramuscular oxytocin injection for preventing uterine atonic primary postpartum haemorrhage in third stage of labour: A double-blind randomised controlled trial
Authors: Okaforcha Emmanuel Ikechukwu , Eleje George Uchenna , Ikechebelu Joseph Ifeanyichukwu , Ezeama Chukwuemeka Okwudili , Igbodike Emeka Philip , Ugwu Emmanuel Onyebuchi , Okpala Boniface Chukwuneme , Mbachu Ikechukwu Innocent , Umeononihu Osita Samuel , Ogabido Chukwudi Anthony , Onwusulu Daniel Nnaemeka , Oguejiofor Charlotte Blanche , Okafor Chidinma Charity , Olisa Chinedu Lawrence , Ikwuka David Chibuike , Ofor Ifeanyichukwu Jude , Okafor Chigozie Geoffrey 
Published: February 2024

Objectives: To compare the efficacy and safety of intravenous and intramuscular oxytocin in preventing atonic primary postpartum haemorrhage in the third stage of labour. Methods: A double-blind randomised clinical study on consenting women without risk factors for primary postpartum haemorrhage in labour at term. Two hundred and thirty-two women were randomly allotted into intravenous ( n = 115) and intramuscular ( n = 117) oxytocin groups in the active management of the third stage of labour. All participants received 10 IU of oxytocin, either IV or IM, and 1 ml of water for injection as a placebo via a route alternate to that of administration of oxytocin within 1 min of the baby’s delivery. The primary outcome measures were mean postpartum blood loss and haematocrit change. Trial Registration No.: PACTR201902721929705. Results: The baseline socio-demographic and clinical characteristics were similar between the two groups ( p > 0.05). There was no statistically significant difference between the two groups with regards to the mean postpartum blood loss (254.17 ± 34.85 ml versus 249.4 ± 39.88 ml; p = 0.210), haematocrit change (2.4 (0.8%) versus 2.1 (0.6%); p = 0.412) or adverse effects ( p > 0.05). However, the use of additional uterotonics was significantly higher in the intravenous group (25 (21.73%) versus 17 (14.53%); p = 0.032). Conclusion: Although oxytocin in both study groups showed similar efficacy in terms of preventing atonic primary postpartum haemorrhage, participants who received intravenous oxytocin were more likely to require additional uterotonics to reduce their likelihood of having an atonic primary postpartum haemorrhage. However, both routes have similar side effect profiles.
Return-to-Golf Rate After Shoulder Arthroplasty: A Systematic Review and Meta-analysis
Authors: Galal Youssef , Sheth Mihir , Lederman Evan , Shah Anup 
Published: February 2024

Background: With advancements in the technology, techniques, and biomechanical understanding of shoulder arthroplasty, higher rates of postoperative return to various sports have been seen in the past decade. Purpose: To observe the return-to-golf rate after various types of shoulder arthroplasty (anatomic total shoulder arthroplasty [TSA], hemiarthroplasty [HA], and reverse total shoulder arthroplasty [RSA]) and also to review the protocols for return to golf. Study Design: Scoping review; Level of evidence, 4. Methods: The PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines were followed in a search of PubMed, JSTOR, Google Scholar, ScienceDirect, and CORE using the keywords “return to sport,”“shoulder arthroplasty,”“golf,”“TSA,”“shoulder arthroplasty,”“hemiarthroplasty,”“reverse shoulder arthroplasty,”“RSA,”“sports,” and “athlete.” Of 145 preliminary results, 10 retrospective studies (n = 178 patients) published between 1998 and 2021 were included in the final analysis. Results: The mean patient age was 65 years. Of the 172 patients with reported return-to-sport rates, the mean return-to-golf rate was 75.8% for all types of shoulder arthroplasty. Of these 172 patients, 107 patients were categorized by type of procedure: Anatomic TSA had the highest return-to-golf rate at 77.6% (49/107), followed by HA at 64.3% (14/107) and RSA at 59.1% (44/107). Four studies commented on return to the full 18 holes of golf, with a return-to-sport timeline ranging from 5 to 6 months postoperatively. One study specified the return-to-golf timeline based on the type of shot and reported the mean number of weeks before putting, chipping, and returning to the course as 20, 22, and 27 weeks, respectively. Two studies that reported on golf playing frequency noted an increase from before to 1 year after TSA, from a mean of 1.6 and 0.7 times per week to 2.0 and 1.7 times per week, respectively. Only 1 study, published in 1998, provided a comprehensive return-to-golf protocol. Conclusion: The return-to-golf rate after shoulder arthroplasty was highest after anatomic TSA (78%) compared with HA (64%) and RSA (59%). The most commonly reported duration before returning to a full 18 holes was 5 to 6 months, but patients returned to putting and chipping earlier.
Early Childhood Caries and Dental Care Utilization in Mangalore, India: Parents’ Perceptions
Authors: Suprabha B.S. , Shenoy R. , Mahabala K.Y. , Nayak A.P. , Rao A. , D’Souza V. 
Published: February 2024

Background: Parents often underuse dental care services for their children with early childhood caries (ECC), resulting in a high burden of untreated dental caries. Aim: To describe parental perceptions and challenges in dental care utilization for their children with ECC. Design: A descriptive qualitative study was conducted with parents of children with ECC seeking dental care in Mangalore, India. Data were collected through focus group discussions using an interview guide. Manual line-by-line coding and content analysis methods were used for data analysis. Results: Three categories were generated from data obtained through 5 focus groups of 27 participants: dental care visiting patterns, the significance of dental visits, and challenges to dental care utilization. Parents would only visit the dentist when they perceived their children’s tooth problems. The challenges faced include time constraints, misinformation, lack of awareness and motivation, costs, fear, and anxiety of the children and the parents themselves. Parents perceived improvements in the awareness of their children’s oral health and quality of life after dental visits. Conclusion: Attending dental services to treat their children’s tooth problems was the primary way of attaining awareness about prevention among the parents of children with ECC. Increased oral health awareness and improved quality of life can motivate parents to seek further dental care for their children. Collaboration with multidisciplinary stakeholders is required to improve oral health awareness among parents of children with ECC. Knowledge Transfer Statement: The study’s results will help plan targeted preventive programs for children with ECC. The study suggests dental care utilization by children with ECC is based on parental perceptions of their children’s tooth problems. It outlines the challenges that affect dental visits of children with ECC and the role of multidisciplinary stakeholders. Improved oral health awareness and quality of life following dental treatment can facilitate further dental visits.
How a broken vertebra can lead to a fatal hemorrhage: a case report
Authors: Ploumen Roxanne A. W. , van Wezenbeek Martin R. , Willems Paul C. P. H. , Gerretsen Suzanne C. , Ten Bosch Jan A. 
Published: February 2024

Abstract
Background
Unintentional falls are common among the elderly and given the expected increase of the aging population, these falls contribute to a high number of admissions to the emergency department. Relatively low-energy trauma mechanisms can lead to serious injuries in the elderly, with contributing factors being comorbidities, medication use and degenerative abnormalities.

Case presentation
A 94-year-old female suffered an unintentional fall at home. Upon arrival of the ambulance at her house she was hemodynamically stable and mobilized to the gurney with assistance. During primary survey at the emergency department, her blood pressure and oxygen saturation decreased, she was not able to move her legs anymore and lost consciousness. A full-body CTA was performed, which showed a fracture through the vertebral body of L2 with significant dislocation and a large active bleeding of the corpus, extending to the retroperitoneum and the epidural space. Despite resuscitation, her vital signs deteriorated and given the severe abnormalities on CTA, it was decided to discontinue further treatment, after which she deceased. The performed CTA and an x-ray from 2016 suggested diffuse idiopathic skeletal hyperostosis, which might have contributed to the severity and instability of the vertebral fracture. Mobilization after the fall might have increased the dislocation of the fracture. The use of oral anticoagulants worsened the subsequent bleeding and the extension to the epidural space caused the paralysis of the legs.

Conclusions
It is important to be aware of the possible serious consequences of unintentional falls in the elderly population and to provide strict immobilization of the spinal column until proper imaging.
Shaping the scientific future of environmental sciences in times of multiple crises: a summary of the 12th SETAC Young Environmental Scientists Meeting in Landau in der Pfalz 2023 -
Authors: Schmitz Markus , Meyer Frederik , Oster Sophie , Schmitt Tobias , Rocha Carolina P. , Green-Ojo Bidemi , Dechent Bianca , Liu Huiting , Schmitt Marius , Wehrli Micha , Weighman Kristi , Eriksson Andreas N. M. 
Published: February 2024

AbstractSETAC has a long-standing history of supporting students and early career scientists in the fields of ecotoxicology and environmental chemistry. The Student Advisory Council (SAC) advocates for the diverse interests of young SETAC members offering guidance to peers and serving as a resounding voice for aspiring scientists in dialogues with the SETAC Europe Council.Founded and shaped by a rewarding liaison between SETAC Europe and its German Language Branch, the SAC now has a strong international representation, with its members being distributed all over Europe. With this publication, we want to build upon the relationship between the SETAC Europe students and the SETAC German Language Branch.The Young Environmental Scientists (YES) Meeting, which was first held as a regular conference 14 years ago, is a keystone event organized by the students of SETAC and the SAC. This year, in 2023, the 12th YES meeting took place in Landau in der Pfalz, Germany.Not only has it been the first European in-person YES Meeting since the COVID-19 pandemic, but with this year’s iteration, the YES meeting returned to its roots in Landau, where 2009 the very first YES meeting was hosted. From August 28th to September 1st, 107 participants from 37 countries and five continents had the opportunity to showcase their research in seven thematic sessions, engage in four workshops, listen to six expert/career talks, and two keynotes from established scientists. In reference to the meeting-motto science through crises, this comment pays special emphasis on topical program points in touching the ongoing multiple crises. We are convinced that sharing our experience from hosting this conference will underline the importance of continuing this unique meeting format and hopefully inspire future scientific events organized by students for students.
Integrated metabolomics and transcriptomics analysis highlight key pathways involved in the somatic embryogenesis of Darjeeling tea
Authors: Awon Vivek Kumar , Dutta Debabrata , Banerjee Saptadipa , Pal Soumili , Gangopadhyay Gaurab 
Published: February 2024

Abstract
Background
Darjeeling tea is a globally renowned beverage, which faces numerous obstacles in sexual reproduction, such as self-incompatibility, poor seed germination, and viability, as well as issues with vegetative propagation. Somatic embryogenesis (SE) is a valuable method for rapid clonal propagation of Darjeeling tea. However, the metabolic regulatory mechanisms underlying SE in Darjeeling tea remain largely unknown. To address this, we conducted an integrated metabolomics and transcriptomics analysis of embryogenic callus (EC), globular embryo (GE), and heart-shaped embryo (HE).

Results
The integrated analyses showed that various genes and metabolites involved in the phenylpropanoid pathway, auxin biosynthesis pathway, gibberellin, brassinosteroid and amino acids biosynthesis pathways were differentially enriched in EC, GE, and HE. Our results revealed that despite highly up-regulated auxin biosynthesis genes YUC1, TAR1 and AAO1 in EC, endogenous indole-3-acetic acid (IAA) was significantly lower in EC than GE and HE. However, bioactive Gibberellin A4 displayed higher accumulation in EC. We also found higher BABY BOOM (BBM) and Leafy cotyledon1 (LEC1) gene expression in GE along with high accumulation of castasterone, a brassinosteroid. Total flavonoids and phenolics levels were elevated in GE and HE compared to EC, especially the phenolic compound chlorogenic acid was highly accumulated in GE.

Conclusions
Integrated metabolome and transcriptome analysis revealed enriched metabolic pathways, including auxin biosynthesis and signal transduction, brassinosteroid, gibberellin, phenylpropanoid biosynthesis, amino acids metabolism, and transcription factors (TFs) during SE in Darjeeling tea. Notably, EC displayed lower endogenous IAA levels, conducive to maintaining differentiation, while higher IAA concentration in GE and HE was crucial for preserving embryo identity. Additionally, a negative correlation between bioactive gibberellin A4 (GA4) and IAA was observed, impacting callus growth in EC. The high accumulation of chlorogenic acid, a phenolic compound, might contribute to the low success rate in GE and HE formation in Darjeeling tea. TFs such as BBM1, LEC1, FUS3, LEA, WOX3, and WOX11 appeared to regulate gene expression, influencing SE in Darjeeling tea.
“Cooperation between physicians and physios fosters trust you know”: a qualitative study exploring patients’ experience with first-contact physiotherapy for low back pain in French primary care
Authors: Kechichian Amélie , Pommier Dylan , Druart Léo , Lowry Véronique , Pinsault Nicolas , Desmeules François 
Published: February 2024

Abstract
Background
Physiotherapists working in collaboration with family physicians in French multidisciplinary primary healthcare clinics are now able to manage acute low back pain patients as first-contact practitioners in advanced practice roles. This includes medical act delegation such as making a medical diagnosis and prescribing medication. The aim of this study is to explore patients’ experience and perceptions when attending a first-contact physiotherapist (FCP) in an advanced practice collaborative primary care model for acute low back pain (LBP).

Methods
A qualitative study using semi-structured interviews was conducted. Patients that consulted a FCP for acute LBP care in new collaborative model were included. Interviews were transcribed verbatim and inductive thematic analysis was performed to generate themes related to patients’ experience and perceptions.

Results
Ten patients were interviewed (3 women, 7 men; mean age 36.5 ± 9.63 years). All LBP participants experienced important level of pain and disability. Four overarching themes related to patients’ experience with the new FCP model were formalized: 1) “Going to see a physiotherapist who specializes in painful movements, well that makes sense to me”, 2) “Physiotherapist offered to give me exercises to do at home to relieve the back pain”, 3) “I went there feeling confident”, 4) “The physiotherapist can do more than just send you to see more appropriate people”. Participants highlighted the need to receive timely and high-quality care and were receptive with being autonomously managed by a FCP. Overall, patients’ experiences with FCP model of care were positive. Participants were highly confident in the FCP’s ability to perform delegated medical tasks including making a medical diagnosis and prescribing oral medication such as analgesic drugs. Patients felt that a greater expansion of FCPs’ scope of practice was needed to improve the model.

Conclusion
Findings from this study can inform the implementation of FCP in countries where patients are not typically granted FCP by underlining that patients are favourable towards the advance practice model as such models support timely and high-quality care. Further research is needed to better determine the future advance practice physiotherapists’ scope of practice in French primary and secondary care settings.
Association between colorectal cancer, the frequency of Bacteroides fragilis, and the level of mismatch repair genes expression in the biopsy samples of Iranian patients
Authors: Nazarinejad Nooshin , Hajikhani Bahareh , Vaezi Amir Abbas , Firoozeh Farzaneh , Sameni Fatemeh , Yaslianifard Somayeh , Goudarzi Mehdi , Dadashi Masoud 
Published: February 2024

Abstract
Background
Deficient DNA mismatch repair (MMR) can cause microsatellite instability (MSI) and is more common in colorectal cancer (CRC) patients. Understanding the carcinogenic mechanism of bacteria and their impact on cancer cells is crucial. Bacteroides fragilis (B. fragilis) has been identified as a potential promoter of tumorigenesis through the alteration of signaling pathways. This study aims to assess the expression levels of msh2, msh6, mlh1, and the relative frequency of B. fragilis in biopsy samples from CRC patients.

Materials and methods
Based on the sequence of mlh1, msh2, and msh6 genes, B. fragilis specific 16srRNA and bacterial universal 16srRNA specific primers were selected, and the expression levels of the target genes were analyzed using the Real-Time PCR method.

Results
Significant increases in the expression levels of mlh1, msh2, and msh6 genes were observed in the cancer group. Additionally, the expression of these MMR genes showed a significant elevation in samples positive for B. fragilis presence. The relative frequency of B. fragilis in the cancer group demonstrated a significant rise compared to the control group.

Conclusion
The findings suggest a potential correlation between the abundance of B. fragilis and alterations in the expression of MMR genes. Since these genes can play a role in modifying colon cancer, investigating microbial characteristics and gene expression changes in CRC could offer a viable solution for CRC diagnosis.