bluuebunny/crossref_metadata_2025_split huggingface dataset:
Rare variants in genes coding for components of the terminal pathway of the complement system in preeclampsia
Authors: Lokki A , Triebwasser Michael , Daly Emma , COHORT FINNPEC , Kurki Mrtja , Perola Markus , Auro Kirsi , Salmon Jane , Java Anuja , Daly Mark , Atkinson John , Laivuori Hannele , Meri Seppo 
Published: April 2024

Abstract

Preeclampsia is a common multifactorial disease of pregnancy. Dysregulation of the complement activation is among emerging candidates responsible for disease pathogenesis. In a targeted exomic sequencing study we identified 14 variants within nine genes coding for components of the membrane attack complex (MAC, C5b-9) that are associated with preeclampsia. We found two rare missense variants in the C5 gene that predispose to preeclampsia (rs200674959: I1296V, OR (CI95) = 24.13 (1.25–467.43), p-value = 0.01 and rs147430470: I330T, OR (CI95) = 22.75 (1.17–440.78), p-value = 0.01). In addition, one predisposing rare variant and one protective rare variant were discovered in C6 (rs41271067: D396G, OR (CI95) = 2.93 (1.18–7.10), p-value = 0.01 and rs114609505: T190I, 0.02 OR (CI95) = 0.47 (0.22–0.92), p-value = 0.02). The results suggest that variants in terminal complement pathway predispose to preeclampsia.
Pituitary adenylate cyclase-activating polypeptide (PACAP) in the paraventricular nucleus of the thalamus: Influence on binge-type eating in male and female mice
Authors: Barson Jessica , Curtis Genevieve , Carpenter Brody , Pirino Breanne , Hawks Annie , Li George 
Published: April 2024

Abstract

Binge eating disorder, characterized by the overconsumption of food in a discrete time period, is the most common eating disorder in the United States, but its neurological basis is not fully understood. The paraventricular nucleus of the thalamus (PVT) is a limbic brain region implicated in eating, and the anorexigenic neuropeptide, pituitary adenylate cyclase-activating polypeptide (PACAP), is densely expressed in the PVT. This study sought to examine the possible involvement of PACAP in the PVT in binge-type eating. First, a model of binge-type eating was established in mice. Male and female C57BL/6J mice were given limited access to Milk Chocolate Ensure Plus® or had access only to chow and water. Under this model, while males and females both engaged in binge-type eating with Ensure, females engaged in this behavior to a greater degree than males. Next, the role of PACAP in the PVT was defined in relation to binge-type eating. Using quantitative real-time PCR, females were found to have higher baseline levels of PVT PACAP mRNA than males, but only males showed an increase in levels of PACAP after a history of binge-type eating, and only males showed a reduction in levels of PACAP immediately prior to a binge session. Using chemogenetics in PACAP-Cre transgenic mice on a C57BL/6J background, activation of PVT PACAP+ cells with a Cre-dependent Gq-DREADD was found to reduce binge-type eating, significantly in male but not female mice. These results indicate that PVT PACAP is involved in binge-type eating in a sex-dependent manner, with a decrease in PVT PACAP levels preceding binge-type eating in male mice, and enhanced PVT PACAP+ cell activity suppressing binge-type eating in male mice. Together, these results suggest that the PACAP system could be targeted in specific patient populations to help treat binge eating disorder.
Effectiveness of Community Engagement Using M-Mama Champions in Improving Literacy of Obstetric Danger Signs, Birth Preparedness and Complication Readiness Among Pregnant Women in Bahi, Dodoma. A Community-Based, Cluster Randomized Controlled Trial
Authors: Sanga Alex , Kibusi Stephen , Kengia James Tumaini 
Published: April 2024

Abstract

Background: Maternal mortality remains a global public health issue, Sustainable Development Goal 3 targets to reduce it to less than 70 for every 100,000 live births by 2030. Maternal mortality whose peak is during intrapartum and the first day post-partum, 75% of it is accounted for by obstetric danger signs complications. Tanzania’s maternal mortality ratio stands at 104 for every 100,000 live births higher than the SDG target. Innovations that include M-MAMA Champions as facilitators in women groups are necessary to improve the literacy level of obstetric danger signs, birth preparedness, and complication readiness among pregnant women and enhance obstetric emergency response and service utilization, for essential interventions in healthcare facilities alone haven’t been able to reduce maternal mortality due to poor services utilization.
Methods: In a community-based, parallel-group cluster randomized controlled trial (cRCT) design, a total of 120 first and second-trimester pregnant women will be randomized at a ratio of 1:1 to the intervention and control groups. The sensitizing pregnant women on Obstetric danger signs, birth preparedness, and complication readiness by the empowered M-MAMA Champions to the intervention arm will be done for a period of one month, each two-hour session will be delivered in an interval of two weeks, using participatory learning and action model. The effect of the intervention will be determined using repeated ANOVA analysis, of which the effect of M-MAMA Champions on literacy level and practice between arms will be determined.
Discussion; Implementation fidelity of the intervention will be ensured through implementation observation by the researcher, research assistants, and the community health workers.
Ethics approval and consent to participate; The University of Dodoma Research Ethics Committee approved this study (Ref. No. MA.84/261/02/1/115). The study will ensure the protection of the participants’ values, dignity, and integrity per the Helsinki Declaration by the World Medical Association.
Applications of Generative Artificial Intelligence (AI) in Medical Education: A Current Application and Future Prospects in Saudi Arabia
Authors: Al-Qahtani Ali S , Al-Garni Abdulaziz M , Almohaya Abdullah Y. 
Published: April 2024

Abstract

Background: The integration of Artificial Intelligence (AI) into medical education has transformative potential, yet systematic evidence regarding its adoption and impact remains limited. This study aims to evaluate the knowledge, attitude, practice and perception related to AI integration among health staff in Saudi Arabian health colleges.
Methods: A cross-sectional design was employed, utilizing an online questionnaire distributed to faculty, clinicians, and administrative personnel across Saudi health colleges. The questionnaire, developed based on expert input and literature review, assessed knowledge and perception regarding AI integration. Validity was ensured through expert review, pilot testing, and cognitive interviews. The questionnaire consisted of 6 domains (academic leadership, academic quality, generative AI in curriculum design and development, teaching methods, assessment and evaluation, and ethics, and challenges).
Results: A total of 313 participants were included in this survey, of the respondents, 73.31% were male, with assistant professors comprising nearly half of them (48.55%). Regarding AI use, 37.94% report that they never use general AI, while 30.55% use it sometimes, and 21.86% use it rarely. Significant differences in AI familiarity were observed according to academic rank (p = 0.028). Academic leadership, academic quality, and generative AI received the highest mean scores (4.29±0.64, 4.16±0.70, and 4.16±0.71 respectively), while ethics and challenges scored the lowest (3.80±0.76). Users of AI consistently reported higher mean scores across domains compared to non-users, with statistically significant differences observed for all domains except ethics and challenges. There was a statistically significant correlation between all domains.
Conclusions: The study highlights the importance of strategic AI integration in Saudi Arabian medical education to effectively address healthcare challenges and enhance learning methodologies and practices.
Cardiac safety after AstraZeneca COVID-19 vaccination: A cohort observational study
Authors: Karem Khalid , Barsoum Mina , Sabet Sameh , William Viola 
Published: April 2024

Abstract

Background
Vaccination is a well-established part of preventive and public health medicine but is not without risk. Most of the side effects related to COVID-19 vaccines are minor including local symptoms at the injection site and some systemic symptoms, such as fatigue, headache, and fever. Some preliminary reports mentioned a more serious side effect; myocarditis seen after certain COVID-19 vaccines. The purpose of this study was to reveal any decrease in left ventricular systolic function in patients receiving the AstraZeneca COVID-19 vaccine compared to healthy individuals who did not receive the vaccine.
Methods
This study included 150 people divided into two equal groups; the case group included individuals who received AstraZeneca COVID-19 vaccines, and the sex- and age-matched control group included healthy individuals who did not receive any of the COVID-19 vaccines. Echocardiographic parameters for assessment of systolic function were evaluated after full vaccination.
Results
By the end of the study, no difference was found between the case and control groups regarding the left ventricular ejection fraction (LVEF), the S' wave of the mitral valve, or the global longitudinal strain (GLS).
Conclusions
AstraZeneca COVID-19 vaccination was not associated with myocardial damage, as evaluated by 2D echocardiography, tissue Doppler, and speckle tracking echocardiography.
Post-traumatic Talus Avascular necrosis. Designing and additive manufacturing of talus implant as an alternative for leg amputation
Authors: Antounian Francois , Avagyan Hayk , Ghaltaghchyan Tsovinar , Holovenko Yaroslav , Khachatryan Hayk , Aghayan Marina 
Published: April 2024

Abstract

This study presents the design and development of a meshed implant intended for talus replacement surgery. Our focus was on a young adult patient who had sustained severe damage to the talus, resulting in avascular necrosis (AVN) and subsequent bone collapse. This condition caused persistent and debilitating pain, leading the medical team to consider amputation of the left foot at the ankle level as a last resort. Instead, we proposed an innovative approach involving the fabrication of a patient-specific implant specifically designed for pan-talar fusion. The implant was created using selective laser melting technology, which allowed for precise and accurate construction of the unique mesh structure. To ensure its mechanical integrity, we conducted uniaxial compression experiments, which confirmed that the proposed structure met all essential mechanical requirements, including compressive loading. The patient underwent regular monitoring for a period of 12 months. The meshed implant exhibited excellent osteoconductive properties, as evidenced by the successful ingrowth of bone into the mesh pores, resulting in a fusion between the implant and the surrounding bones.
The prognostic value of lymph node to primary tumor standardized uptake value ratio in cancer patients: A meta-analysis
Authors: Yap Wing-Keen , Hsu Ken-Hao , Wang Ting-Hao , Lin Chia-Hsin , Kang Chung-Jan , Huang Shih-Ming , Lin Huan-Chun , Hung Tsung-Min , Chang Kai-Ping , Tsai Tsung-You 
Published: April 2024

Abstract

Objective: The lymph node to primary tumor standardized uptake value ratio (NTR) is an innovative parameter derived from positron emission tomography (PET) scans that captures the intricate relationship between primary tumors and associated lymph nodes. This meta-analysis aimed to investigate the prognostic value of NTR in cancer patients.
Methods: A systematic search of PubMed, Cochrane, and Embase databases was conducted to identify studies investigating the association between NTR and survival outcomes in cancer patients. The pooled adjusted hazard ratios (aHRs) and 95% confidence intervals (CIs) were calculated using a random-effects model.
Results: Twelve studies comprising a total of 2037 patients were included in the meta-analysis. Elevated NTR was significantly associated with worse overall survival aHR (2.21, 95% CI 1.63 to 2.99), disease-free survival aHR (3.27, 95% CI 2.12 to 5.05), and distant metastasis-free survival aHR (2.07, 95% CI 1.55 to 2.78) in cancer patients. Subgroup analyses by cancer type showed consistent results across various malignancies, including head and neck squamous cell carcinoma, endometrial carcinoma, lung cancer, breast cancer, and nasopharyngeal carcinoma.
Conclusions: This meta-analysis provides evidence for a significant association between elevated NTR and worse survival outcomes in cancer patients. Elevated NTR may serve as a useful prognostic biomarker for cancer patients, and could potentially be used to guide treatment decisions and monitor disease progression. Future studies should aim to validate these findings in larger and more diverse patient populations, and investigate the underlying mechanisms for the observed association between NTR and survival outcomes.
‘I am a father but not pregnant’—a qualitative analysis of the perspectives of pregnant couples on male partner role during pregnancy care in Bamenda, Cameroon
Authors: Foglabenchi Lily Haritu , Stöckl Heidi , Marchant Tanya 
Published: April 2024

Abstract

Background
The reduction of maternal mortality has stagnated globally. Estimates project a rise to 140.9 deaths per 100,000 live births by 2030, which is double the Sustainable Development Goal target. Male involvement in pregnancy care has been proposed as an intervention to improve maternal and child health outcomes. However, there is limited understanding of how communities view the role of men beyond the instrumentalist approach that only targets men as accompanying partners without altering the underlying gender and socio-cultural determinants that shape their involvement in pregnancy care. This study broadens existing research by exploring and and contextualising the role of male partners during pregnancy in Bamenda, Cameroon.
Methods
This study employed a qualitative design underpinned by symbolic interactionism. We conducted 68 semi-structured interviews (SSIs) and three focus group discussions (FGDs) with purposively selected pregnant women(n= 38 SSIs; n=6, FGD) and male partners (n= 30 SSIs; n=6, FGD) in an urban hospital in the North West Regional capital—Bamenda. Nvivo was used for data management and subsequently, we performed thematic analysis using a critical discourse lens to generate manifest and latent interpretations of study findings.
Results
The role of male partners reflected hegemonic masculinity and was broadly conceptualised in three categories: breadwinner, protector/comforter, and ‘sender’ for antenatal care. Perceptions of men’s role differed between male and female participants. While women sought male involvement for pragmatic reasons like joint attendance of antenatal care, psychosocial support (affirmation) and assistance with domestic chores, men limited their involvement to roles that matched gendered preconceptions of masculinity like financial support for antenatal fees, maternal nutrition and birth supplies. Nonetheless, the perceived benefits for antenatal attendance was expressed by some men in terms of the direct access it gives them to pregnancy-related education from experts, paternal bonding and the appeal of fast-track services for couples.
Conclusion
Male involvement in maternal and child health in Bamenda Health District is an extension and reflection of how patriarchal norms on masculinity are constructed and adapted in this setting. To address gaps in male involvement, intervention designers and implementers will need to take into account prevailing culture-specific norms while deconstructing and leveraging masculine ideals to situate male involvement in the prenatal context.
Neurotoxicity post-epidural anesthesia in a patient with Vitamin B12 deficiency: a case report
Authors: Ibrahim Christelle , Maalouf Nancy 
Published: April 2024

Abstract

Background: Neurotoxicity have been reported after central neuraxial block. Some metabolic disturbances (thiamine deficiency, diabetes) were identified as contributing factor.
Case presentation: We describe a young woman with vitamin B12 deficiency who developed persistent lower extremity weakness and hypoesthesia for weeks after epidural anesthesia. Initial examination revealed bilateral distal lower extremities weakness and decreased sensations. Serial neurologic examinations showed improved motor and sensory findings. An injected lumbosacral MRI was unremarkable. Vitamin B12 level was very low. The patient received physiotherapy and Vitamin B12 supplementation. Nerve conduction study and electromyography on day-23 post-epidural anesthesia revealed evidence of peripheral nerve injury.
Conclusion: This case is the first to recognize vitamin B12 deficiency as a predisposing factor for the development of neurotoxicity following epidural anesthesia, it also emphasizes the importance of timely identification of vitamin deficiencies in patients developing neurotoxicity following central neuraxial blocks.
Neurosurgical Management of Myelomeningocele in Premature Infants: A Case Series
Authors: Stewart Addison , Hale Andrew T. , Saccomano Benjamin W. , Barkley Ariana S. , Hopson Betsy D. , Arynchyna-Smith Anastasia , Johnston James M. , Rocque Brandon G. , Blount Jeffrey P. , Rozzelle Curtis J. 
Published: April 2024

Abstract

Introduction
Myelomeningocele (MMC) is the most common neural tube defect, but rarely seen in premature infants. Most centers advocate for closure of MMC within 24 hours of birth. However, this is not always possible in severely premature infants. Given the rarity of this patient population, we aimed to share our institutional experience and outcomes of severely premature infants with MMC.
Methods
We performed a retrospective, observational review of premature infants (≤ 32 weeks gestational age) identified through our multidisciplinary spina bifida clinic (1995–2021) and surgical logs. Descriptive statistics were compiled about this sample including timing of MMC closure and incidence of adverse events such as sepsis, CSF diversion, meningitis, and death.
Results
Eight patients were identified (50% male) with MMC who were born ≤ 32 weeks gestational age. Mean gestational age of the population was 27.3 weeks (SD 3.5). Median time to MMC closure was 1.5 days (IQR = 1–80.8). Five patients were taken for surgery within the recommended 48 hours of birth; 2 patients underwent significantly delayed closure (107 and 139 days); and one patient’s defect epithelized without surgical intervention. Six of eight patients required permanent cerebrospinal fluid (CSF) diversion (2 patients were treated with ventriculoperitoneal shunting (VPS), three were treated with endoscopic third ventriculostomy (ETV) with choroid plexus cauterization (CPC) and 1 patient treated with ETV; mean of 3 years after birth, ranging from 1 day to 16 years). Two patients required more than one permanent CSF diversion procedure. Two patients developed sepsis (defined as meeting at least 2/4 SIRS criteria), and 2 patients had intraventricular hemorrhage (both grade III). No patients developed meningitis (defined as positive CSF cultures) prior to MMC closure. Median follow up duration was 9.7 years. During this time epoch, 3 patients died: Two before 2 years of age of causes unrelated to surgical intervention. One of the two patients with grade III IVH died within 24 hours of MMC closure.
Conclusions
In our institutional experience with premature infants with MMC, some patients underwent delayed MMC closure. The overall rate of meningitis, sepsis, and mortality for preterm children with MMC was similar to MMC patients born at term.
Cerebral venous sinus thrombosis with head trauma and unclassifiable myeloproliferative neoplasm: a case report
Authors: Chu Qiongxian , Zhou Zhiwei , Du Xingyu , Pan Chunhua , Zhou Hongyan , Xu Zucai , Xu Ping , Xu Zhongxiang 
Published: April 2024

Abstract

Background
Cerebral venous sinus thrombosis (CVST) is a rare and special type of cerebrovascular disease characterized by complex etiology, diverse forms of onset, non-specific clinical manifestations, and difficult to diagnosis. Myeloproliferative neoplasm-unclassifiable (MPN-U) refers to clinical manifestations, laboratory findings, and morphological features that are consistent with the diagnosis of myeloproliferative neoplasms, but do not meet further specific classification criteria, or have overlapping features of two or more MPNs. Here, we report a case of CVST with MPN-U and a history of head trauma.
Case presentation:
A 52-year-old male was admitted the hospital due to paroxysmal visual impairment for 1 year and worsening for 2 months with a history of head trauma. His increased hemoglobin was resulted from was the MPN-U, with bilateral papilledema, impaired visual field, intracranial hypertension and elevated D-dimer, the diagnosis of superior sagittal sinus thrombosis was confirmed by brain CTV and MRI. Therefore, anticoagulant treatment with low molecular weight heparin were administered in hospital, then rivaroxaban was given after discharge. the blurred vision of this patient had significantly improved after treatment.
Conclusion
It is unique that CVST with blurred vision as the main clinical manifestation and two possible causes including head trauma and MPN-U. For patients with CVST, in addition to anticoagulant therapy, it is also necessary to identify the etiologies.