bluuebunny/crossref_metadata_2025_split huggingface dataset:
Erros envolvendo troca de medicamentos na dispensação de um hospital: quais classes de medicamentos estão envolvidas?
Authors: Morais Jéssica Octávia de , Martins Jordânia Ferreira , Melo Lays Cássia Santos Duarte , Soares Lorena Aguiar , Sanches Cristina , Baldoni André Oliveira , Pereira Mariana Linhares 
Published: April 2024

Erros podem ocorrer nos processos de prescrição, dispensação e administração do medicamento. Um destes erros se dá pela troca de medicamentos no momento da dispensação e dessa maneira, pode haver falha no tratamento e/ou risco para o paciente. O objetivo deste estudo é identificar as principais classes de medicamentos envolvidas neste tipo de erro. Para o mesmo, foram utilizados registros manuais de erros de dispensação, que consiste nas notificações do período de 01/12/2009 a 14/07/2019 de um hospital de médio porte de Minas Gerais, e, classificou-se cada medicamento desses erros de acordo com a classe anatômico-terapêutico-química - em inglês Anatomical Therapeutic Chemical (ATC). Dentre o total de erros (n=3937) notificados pelas três farmácias do hospital, observou-se a ocorrência de 755 (19,18%) erros relacionados com a troca de medicamentos, sendo que os medicamentos do tipo “Look-Alike” e “Sound-Alike” (LASA) (N=303; 40,13%), os agentes anti-infecciosos (N=238; 31,52%) e medicamentos potencialmente perigosos (N=189; 25,03%) estão envolvidos na maioria dos erros deste estudo. Dessa maneira, a automatização do serviço e a educação continuada dos profissionais da saúde são umas das alternativas para evitar esses erros, promover segurança do paciente, contribuindo com desfechos clínicos favoráveis aos pacientes.
Miocardite aguda associada a edema cerebral difuso em paciente com Covid-19: relato de caso
Authors: Rossa Isabella Cristina Mendes , Marques Gustavo Lenci , Twardowschy Carlos Alexandre 
Published: April 2024

A infecção pelo vírus da síndrome respiratória aguda grave 2 (SARS-CoV-2), além de provocar danos graves ao sistema respiratório, pode desencadear lesões cardíacas e cerebrais. Estudos sugerem que tanto o parênquima cerebral quanto o miocárdio podem ser infectados diretamente pelo vírus. Ademais, o estado hiperinflamatório secundariamente desencadeado promove inflamação endotelial, vascular e miocárdica, instabilidade de placas, estado de hipercoagulabilidade e desbalanço eletrolítico. O presente trabalho tem como objetivo descrever o caso de uma paciente com COVID-19 com apresentação de miocardite aguda associada a edema cerebral. Tratava-se de uma paciente do sexo feminino, 44 anos, admitida com sintomas da COVID-19. Ao longo da internação, ela apresentou elevação de troponina cardíaca I, assim como hipocinesia difusa na ecocardiografia transtorácica, o que sugeriu o diagnóstico de miocardite. Em seguida, uma tomografia de crânio evidenciou edema cerebral difuso e herniação tonsilar, sendo que a paciente evoluiu com morte encefálica. O caso relatado mostra um provável impacto da miocardite sobre o sistema nervoso central, sendo possível inferir que o baixo débito pode reduzir a perfusão cerebral, provocando a piora do prognóstico, devido ao processo de resposta endógena do edema. Além disso, apresenta a possibilidade de dano direto do vírus ao miocárdio e ao parênquima cerebral, visto que esse fato poderia desencadear um desfecho de igual gravidade. Nesse sentido, existe a necessidade de outros estudos para investigação dos efeitos do SARS-CoV-2 nesses tecidos, pois não foi possível descartar a ação direta do vírus no tecido cardíaco e cerebral.
Two new species of Pseudocrangonyx (Amphipoda: Pseudocrangonyctidae) from the hyporheic zones in South Korea
Authors: LEE CHI-WOO , MIN GI-SIK 
Published: April 2024

Pseudocrangonyx Akatsuka & Komai, 1922, is the most diverse group of subterranean amphipods in the groundwater communities of Far East Asia and is related to the biogeographic origin and evolution of subterranean amphipod fauna in the region. In this study, we describe two new subterranean species of pseudocrangonyctid amphipods, P. seomjinensis sp. nov. and P. danyangensis sp. nov., from the hyporheic zones in South Korea. These new species can be distinguished from their congeners by the length of the uropod 2 outer ramus, the number of accessory flagella of antenna 1, and telson shape. Additionally, we determined sequences of the nuclear 28S rRNA and the mitochondrial cytochrome c oxidase subunit I gene of the new species for molecular analyses.
Benralizumab in severe eosinophilic asthma by previous biologic use and key clinical subgroups: real-world XALOC-1 programme
Authors: Jackson David J. , Pelaia Girolamo , Emmanuel Benjamin , Tran Trung N. , Cohen David , Shih Vivian H. , Shavit Anat , Arbetter Douglas , Katial Rohit , Rabe Adrian Paul J. , Garcia Gil Esther , Pardal Marisa , Nuevo Javier , Watt Michael , Boarino Silvia , Kayaniyil Sheena , Chaves Loureiro Cláudia , Padilla-Galo Alicia , Nair Parameswaran 
Published: April 2024

BackgroundPivotal phase 3 trials and real-world studies have demonstrated benralizumab's overall efficacy and safety in severe eosinophilic asthma (SEA). Additional large-cohort data are needed to confirm its real-world effectiveness in SEA according to previous biologic use and key baseline characteristics important for treatment selection.MethodsXALOC-1 is a large, multinational, retrospective, observational, real-world study programme of benralizumab in adults with SEA. This 48-week integrated analysis assessed annualised exacerbation rate (AER), maintenance oral corticosteroid (mOCS) use, asthma symptom control and lung function during a 12-month baseline period and up to 48 weeks after benralizumab initiation. Subgroup analyses were based on previous biologic use and key baseline clinical characteristics (mOCS use, blood eosinophil count, exacerbation history, age at asthma diagnosis, fractional exhaled nitric oxide level and presence of atopy and chronic rhinosinusitis with nasal polyps).ResultsOut of 1002 patients analysed, 380 were biologic-experienced. At week 48, 71.3% were exacerbation-free (versus17.2% at baseline); relative reduction in AER was 82.7% overall and 72.9% in biologic-experienced patients; rates were maintained across all key clinical characteristic subgroups. Of patients using mOCS at baseline (n=274), 47.4% (130 out of 274) eliminated their use by week 48; the mean reduction from baseline in daily dose was 51.2% and, notably, 34.9% in biologic-experienced patients (n=115). Clinically significant improvements in asthma symptom control and lung function were observed.ConclusionIn this large, real-world programme, SEA patients treated with benralizumab had substantial improvements in clinical outcomes irrespective of previous biologic use and key clinical characteristics important to therapeutic decision-making in clinical practice.
A review of emerging health threats from zoonotic New World mammarenaviruses
Authors: Lendino Arianna , Castellanos Adrian A. , Pigott David M. , Han Barbara A. 
Published: April 2024

AbstractDespite repeated spillover transmission and their potential to cause significant morbidity and mortality in human hosts, the New World mammarenaviruses remain largely understudied. These viruses are endemic to South America, with animal reservoir hosts covering large geographic areas and whose transmission ecology and spillover potential are driven in part by land use change and agriculture that put humans in regular contact with zoonotic hosts.We compiled published studies about Guanarito virus, Junin virus, Machupo virus, Chapare virus, Sabia virus, and Lymphocytic Choriomeningitis virus to review the state of knowledge about the viral hemorrhagic fevers caused by New World mammarenaviruses. We summarize what is known about rodent reservoirs, the conditions of spillover transmission for each of these pathogens, and the characteristics of human populations at greatest risk for hemorrhagic fever diseases. We also review the implications of repeated outbreaks and biosecurity concerns where these diseases are endemic, and steps that countries can take to strengthen surveillance and increase capacity of local healthcare systems. While there are unique risks posed by each of these six viruses, their ecological and epidemiological similarities suggest common steps to mitigate spillover transmission and better contain future outbreaks.
45 years of tetracycline post exposure prophylaxis for STIs and the risk of tetracycline resistance: a systematic review and meta-analysis
Authors: Vanbaelen Thibaut , Manoharan-Basil Sheeba Santhini , Kenyon Chris 
Published: April 2024

AbstractThere is considerable interest in the use of doxycycline post exposure prophylaxis (PEP) to reduce the incidence of bacterial sexually transmitted infections (STIs). An important concern is that this could select for tetracycline resistance in these STIs and other species. We searched PubMed and Google Scholar, (1948–2023) for randomized controlled trials comparing tetracycline PEP with non-tetracycline controls. The primary outcome was antimicrobial resistance (AMR) to tetracyclines in all bacterial species with available data. Our search yielded 140 studies, of which three met the inclusion criteria. Tetracycline PEP was associated with an increasedprevalence of tetracycline resistance in Neisseria gonorrhoeae, but this effect was not statistically significant (Pooled OR 2.3, 95% CI 0.9-3.4). PEP had a marked effect on the N. gonorrhoeae tetracycline MIC distribution in the one study where this was assessed. Prophylactic efficacy was 100% at low MICs and 0% at high MICs. In the one study where this was assessed, PEP resulted in a significant increase in tetracycline resistance in commensal Neisseria species compared to the control group (OR 2.9, 95% CI 1.5-5.5) but no significant effect on the prevalence of tetracycline resistance in Staphylococcus aureus. The available evidence suggests that PEP with tetracyclines could be associated with selecting tetracycline resistance in N. gonorrhoeae and commensal Neisseria species.
Factors affecting anophthalmic socket reconstruction outcomes using autologous oral mucosal graft
Authors: Aryasit Orapan , Panyavisitkul Yanin , Damthongsuk Parichat , Singha Penny , Rattanalert Narisa 
Published: April 2024

Abstract
Background
Limited studies have reported surgical outcomes that are defined by strict criteria following grade 2 or 3 socket reconstruction using an oral mucosal graft (OMG). We aimed to determine factors influencing surgical outcomes of anophthalmic socket reconstruction using OMG in patients with grade 2 or 3 socket contractures.

Methods
Thirty-seven patients who underwent socket reconstruction with autologous OMG between January 2007 and December 2017 were retrospectively analyzed. The successful outcome was defined as an eye prosthesis wearing without experiencing displacement and the absence of any re-operations or additional surgeries following socket reconstruction. Factors affecting surgical outcomes were identified using multivariate analysis.

Results
A total of 15 male and 22 female patients (mean age: 40.2 ± 17.2 years) were included. The median duration of socket contracture was 21.5 years. Grade 2 and 3 socket contractures, based on Tawfik’s classification, were reported in 20 and 17 patients, respectively. Twenty-eight and eight patients underwent socket reconstruction using OMG alone and OMG combined with a hard palate graft, respectively. The success rates of grades 2 and 3 socket contracture reconstruction were 80.0% and 52.9%, respectively. Multivariate analysis demonstrated that only grade 3 contractures were predictive of worse outcomes. At the final visit (mean follow-up: 6.3 years), 34 patients (91.9%) could wear their eye prostheses.

Conclusions
Socket reconstruction using autologous OMG can provide acceptable results in grade 2 and 3 contractures; however, satisfactory results were more significantly reported in grade 2 than in grade 3 contractures.
Pelvic floor muscle contraction automatic evaluation algorithm for pelvic floor muscle training biofeedback using self-performed ultrasound
Authors: Muta Miyako , Takahashi Toshiaki , Tamai Nao , Suzuki Motofumi , Kawamoto Atsuo , Sanada Hiromi , Nakagami Gojiro 
Published: April 2024

Abstract
Introduction
Non-invasive biofeedback of pelvic floor muscle training (PFMT) is required for continuous training in home care. Therefore, we considered self-performed ultrasound (US) in adult women with a handheld US device applied to the bladder. However, US images are difficult to read and require assistance when using US at home. In this study, we aimed to develop an algorithm for the automatic evaluation of pelvic floor muscle (PFM) contraction using self-performed bladder US videos to verify whether it is possible to automatically determine PFM contraction from US videos.

Methods
Women aged ≥ 20 years were recruited from the outpatient Urology and Gynecology departments of a general hospital or through snowball sampling. The researcher supported the participants in their self-performed bladder US and videos were obtained several times during PFMT. The US videos obtained were used to develop an automatic evaluation algorithm. Supervised machine learning was then performed using expert PFM contraction classifications as ground truth data. Time-series features were generated from the x- and y-coordinate values of the bladder area including the bladder base. The final model was evaluated for accuracy, area under the curve (AUC), recall, precision, and F1. The contribution of each feature variable to the classification ability of the model was estimated.

Results
The 1144 videos obtained from 56 participants were analyzed. We split the data into training and test sets with 7894 time series features. A light gradient boosting machine model (Light GBM) was selected, and the final model resulted in an accuracy of 0.73, AUC = 0.91, recall = 0.66, precision = 0.73, and F1 = 0.73. Movement of the y-coordinate of the bladder base was shown as the most important.

Conclusion
This study showed that automated classification of PFM contraction from self-performed US videos is possible with high accuracy.
A multisite feasibility randomized clinical trial of mindfulness-based resilience training for aggression, stress, and health in law enforcement officers
Authors: Christopher Michael , Bowen Sarah , Witkiewitz Katie , Grupe Daniel , Goerling Richard , Hunsinger Matthew , Oken Barry , Korecki Tyrus , Rosenbaum Nils 
Published: April 2024

Abstract
Background
Law enforcement officers (LEOs) are exposed to significant stressors that can impact their mental health, increasing risk of posttraumatic stress disorder, burnout, at-risk alcohol use, depression, and suicidality. Compromised LEO health can subsequently lead to aggression and excessive use of force. Mindfulness training is a promising approach for high-stress populations and has been shown to be effective in increasing resilience and improving mental health issues common among LEOs.

Methods
This multi-site, randomized, single-blind clinical feasibility trial was intended to establish optimal protocols and procedures for a future full-scale, multi-site trial assessing effects of mindfulness-based resilience training (MBRT) versus an attention control (stress management education [SME]) and a no-intervention control, on physiological, attentional, and psychological indices of stress and mental health. The current study was designed to enhance efficiency of recruitment, engagement and retention; optimize assessment, intervention training and outcome measures; and ensure fidelity to intervention protocols. Responsiveness to change over time was examined to identify the most responsive potential proximate and longer-term assessments of targeted outcomes.

Results
We observed high feasibility of recruitment and retention, acceptability of MBRT, fidelity to assessment and intervention protocols, and responsiveness to change for a variety of putative physiological and self-report mechanism and outcome measures.

Conclusions
Results of this multi-site feasibility trial set the stage for a full-scale, multi-site trial testing the efficacy of MBRT on increasing LEO health and resilience, and on decreasing more distal outcomes of aggression and excessive use of force that would have significant downstream benefits for communities they serve.

Trial registration
ClinicalTrials.gov, NCT03784846. Registered on December 24th, 2018.
Understanding health system resilience in responding to COVID-19 pandemic: experiences and lessons from an evolving context of federalization in Nepal
Authors: Regmi Shophika , Bertone Maria Paola , Shrestha Prabita , Sapkota Suprich , Arjyal Abriti , Martineau Tim , Raven Joanna , Witter Sophie , Baral Sushil 
Published: April 2024

Abstract
Introduction
The COVID-19 pandemic has tested the resilience capacities of health systems worldwide and highlighted the need to understand the concept, pathways, and elements of resilience in different country contexts. In this study, we assessed the health system response to COVID-19 in Nepal and examined the processes of policy formulation, communication, and implementation at the three tiers of government, including the dynamic interactions between tiers. Nepal was experiencing the early stages of federalization reform when COVID-19 pandemic hit the country, and clarity in roles and capacity to implement functions were the prevailing challenges, especially among the subnational governments.

Methods
We adopted a cross-sectional exploratory design, using mixed methods. We conducted a desk-based review of all policy documents introduced in response to COVID-19 from January to December 2020, and collected qualitative data through 22 key informant interviews at three tiers of government, during January-March 2021. Two municipalities were purposively selected for data collection in Lumbini province. Our analysis is based on a resilience framework that has been developed by our research project, ReBUILD for Resilience, which helps to understand pathways to health system resilience through absorption, adaptation and transformation.

Results
In the newly established federal structure, the existing emergency response structure and plans were utilized, which were yet to be tested in the decentralized system. The federal government effectively led the policy formulation process, but with minimal engagement of sub-national governments. Local governments could not demonstrate resilience capacities due to the novelty of the federal system and their consequent lack of experience, confusion on roles, insufficient management capacity and governance structures at local level, which was further aggravated by the limited availability of human, technical and financial resources.

Conclusions
The study findings emphasize the importance of strong and flexible governance structures and strengthened capacity of subnational governments to effectively manage pandemics. The study elaborates on the key areas and pathways that contribute to the resilience capacities of health systems from the experience of Nepal. We draw out lessons that can be applied to other fragile and shock-prone settings.
Under the dual effect of inflammation and pulmonary fibrosis, CTD-ILD patients possess a greater susceptibility to VTE
Authors: Jiang Wenli , Jia Wenhui , Dong Chunling 
Published: April 2024

AbstractAs an autoimmune disease, the persistent systemic inflammatory response associated with connective tissue disease (CTD) is involved in the development of venous thromboembolism (VTE). However, clinical data showed that the risk of VTE in patients differed between subtypes of CTD, suggesting that different subtypes may have independent mechanisms to promote the development of VTE, but the specific mechanism lacks sufficient research at present. The development of pulmonary fibrosis also contributes to the development of VTE, and therefore, patients with CTD-associated interstitial lung disease (CTD-ILD) may be at higher risk of VTE than patients with CTD alone or patients with ILD alone. In addition, the activation of the coagulation cascade response will drive further progression of the patient’s pre-existing pulmonary fibrosis, which will continue to increase the patient’s risk of VTE and adversely affect prognosis. Currently, the treatment for CTD-ILD is mainly immunosuppressive and antirheumatic therapy, such as the use of glucocorticoids and janus kinase-inhibitors (JAKis), but, paradoxically, these drugs are also involved in the formation of patients’ coagulation tendency, making the clinical treatment of CTD-ILD patients with a higher risk of developing VTE challenging. In this article, we review the potential risk factors and related mechanisms for the development of VTE in CTD-ILD patients to provide a reference for clinical treatment and prevention.
Optimization of inoculum production of Stemphylium botryosum for large-scale resistance screening of lentils
Authors: González Mario , Barilli Eleonora , Rispail Nicolas , Rubiales Diego 
Published: April 2024

Abstract
Background
Stemphylium blight incited by Stemphylium botryosum poses a significant threat to lentil crops worldwide, inducing severe defoliation and causing substantial yield losses in susceptible varieties under favorable conditions. While some moderate levels of resistance have been identified within lentil germplasm, a low number of resistant cultivars are available to farmers. Adding to the common constraints of resistance breeding, a notable challenge is generating a sufficient number of spores for large-scale screenings, which are essential for pinpointing additional sources of resistance for integration into breeding programs. Therefore, there is a pressing need to improve existing screening methods and tailor them for large-scale material selection. In pursuit of this objective, a protocol for the efficient production of fungal material has been adapted.

Results
Optimization of fungal material production was successfully achieved by comparing the use of fungal mycelia and spores. Spore production was found to be optimal when produced on solid V8-PDA(hi) medium, while liquid Richard’s medium was identified as superior for mycelium yield. Furthermore, a refined screening method was developed by evaluating the resistance of six lentil accessions to stemphylium blight. This assessment included the use of either fungal mycelia (at densities ranging from 1 to 5 g L− 1) or spores (with densities ranging from 5 × 104 to 2 × 105 conidia mL− 1) under three different relative humidity levels (from 50 to 100%). Both humidity levels and inoculum dose significantly influenced the final disease rating (DR) and the relative Area Under the Disease Progress Curve (rAUDPC). Differences among genotypes in final symptom severity (DR) became more pronounced after inoculation with inoculum densities of 5 g L− 1 of mycelium or of 105 and 2 × 105 conidia mL− 1 of spore under 100% relative humidity. Given the challenges associated with the large-scale production of S. botryosum spores, inoculations with 5 g L− 1 of mycelium is highly recommended as a practical alternative for conducting mass-scale screenings.

Conclusions
The findings from this study underscore the critical importance of maintaining high level of humidity during inoculation and disease progression development for accurately assessing resistance to stemphylium blight. The optimization of mycelial production for suspension inoculation emerges as a more reliable and efficient approach for conducting large-scale screening to assess germplasm resistance against stemphylium blight in lentil crops.