bluuebunny/crossref_metadata_2025_split huggingface dataset:
Post-COVID-19 pulmonary complications among recovered COVID-19 patients: a cross-sectional study from Addis Ababa, Ethiopia
Authors: Seyoum Abebaw Bekele , Tegegnework Sisay Shine , Mengistu Mahider Molla , Mekonnen Tenbite Daniel , Asabel Abdurahman Mohammedamin , Dagnaw Alazar Gizate , Deribe Abenet Girma , Derese Tadios Niguss , Hundie Tsegaye Gebreyes , Getahun Bisrat Kassa , Huluka Dawit Kebede 
Published: October 2023

Abstract
Background
The COVID-19 pandemic has been linked to chronic pulmonary complications all over the world. Respiratory complications such as chronic cough, dyspnea, increased respiratory rate, and oxygen support demand are prevalent in recovered COVID-19 patients. These problems are long-term and have a negative impact on one’s quality of life. Patients must be evaluated for potential complications, and risk factors must be found. Some reports around the world explain the factors that contribute to the development of these complications. However, to the best of our understanding, no reports of post-COVID-19 complications have been reported from Ethiopia.

Methods
Facility based cross-sectional study was done among 405 participants selected by simple random sampling technique. Structured questionnaire which includes participants’ demographic, clinical and 3rd month visit characteristics was collected by Open Data Kit and exported to SPSS version 25.0 for analysis. Percentage with frequency and median with Interquartile range was used in descriptive statistics. The association between variables was analyzed with bivariate and multi variable logistic regression. A statistical significance was declared at p-value < 0.05, with 95% confidence interval.

Results
The median (Interquartile range) age of participants was 57.0 (43.0, 65.0) years, 63.2% were males. The prevalence of post-COVID-19 pulmonary complication in recovered COVID-19 patients was 14.1% (95% CI: 10.8%, 17.8%). After adjusting for possible confounders on multivariate analysis, older age [AOR = 0.227, 95% CI (0.08–0.66)] and consolidation [AOR = 0.497, 95% CI (0.258–0.957)] were shown to have significant association with post COVID-19 pulmonary complications.

Conclusion
The prevalence of post COVID-19 pulmonary complication was observed to be lower than other reports globally. Older age and the presence of consolidation on lung imaging were associated with those complications. Clinicians are recommended to consider assessing the lasting effects of the pandemic, beyond immediate care, and should also investigate the COVID-19 history in patients presenting with respiratory issues.
Robot versus video-assisted thoracoscopic thymectomy for large thymic epithelial tumors: a propensity-matched analysis
Authors: Zhu Long-fei , Zhang Ling-min , Zuo Chun-jian , Sun Tian-yu , Jiang Bin 
Published: October 2023

AbstractBackgroundBoth video-assisted thoracoscopic surgery (VATS) thymectomy and robot-assisted thoracoscopic surgery (RATS) thymectomy have been suggested as technically sound approaches for early-stage thymic epithelial tumors. However, the choice of VATS or RATS thymectomy for large and advanced thymic epithelial tumors remains controversial. In this study, the perioperative outcomes of VATS and RATS thymectomy were compared in patients with large thymic epithelial tumors (size ≥5.0 cm).MethodsA total of 113 patients with large thymic epithelial tumors who underwent minimally invasive surgery were included. Sixty-three patients underwent RATS, and 50 patients underwent VATS. Patient characteristics and perioperative variables were compared.ResultsCompared with the VATS group, the RATS group experienced a shorter operation time (median: 110 min vs.130 min;P < 0.001) and less blood loss (30.00 ml vs. 100.00 ml,P < 0.001). No patients in the RATS group needed conversion to open surgery, but in the VATS series, five patients required conversion to open procedures (0% vs. 14.29%,P = 0.054). The rate of concomitant resection in the RATS group was similar to that in the VATS group (11.43% vs. 5.71%;P = 0.673). There was no significant difference between the two groups in the duration of chest tube (P = 0.587), postoperative complications (P = 1.000), and the duration of postoperative hospital stay (P = 0.141).ConclusionFor large thymic epithelial tumors, RATS thymectomy can be performed safely and effectively in a radical fashion. Due to the advanced optics and precise instrument control, concomitant resections can be easily achieved in larger thymic epithelial tumors using the robotic approach.
Effect of breathing patterns on mandibular cortical bone quality in children and establishment of a preliminary screening model
Authors: Wang Gaoli , Saif Badr Sultan , Cheng Bo , Li Hongfei , Li Yutong , Liu Jiawen , Ren Xiaoyong , Zou Rui , Wang Fei 
Published: October 2023

Abstract
Objective
This retrospective study analyzed breathing patterns and age subgroups effect on cortical bone quality of the mandible in growing subjects, aiming to explore the application value of facial skeletal pattern combined with cortical bone density detection in early screening diagnosis of mouth breathing.

Methods
One hundred twenty-six participants were divided into four groups: mouth breathing group (7–9, 10–12 years old) and nasal breathing group (7–9, 10–12 years old). The mandibular anterior, middle, and posterior cortical bone mineral density (CBMD), cortical bone width (MCW), ANB, and FMA values were measured. Independent T-test and Mann–Whitney U test were used to compare the measured values. Binary logistic regression was employed to analyze the correlation between measured variables and the children’s breathing patterns. ROC analysis was used to determine the ability of the cortical bone density measurements in early screening diagnosis of MB.

Results
Mouth breathing had a negative impact on CBMD and MCW of the pre-mandibular (Pog) in subjects aged 7–9 years and also impacted the development of (Pog) and submandibular (Me) sites in subjects aged 10–12 years. Older children in the nasal breathing group have higher CBMD, MCW, and SNB values and lower FMA values. Single-factor and multiple-factor logistic binary regression analysis showed that FMA, MSPogCBMD, MSPogMCW, and ANB are correlated factors for children at risk of mouth breathing.

Conclusion
Mouth breathing pattern is closely associated with decreased mandibular CBMD and MCW values in children aged 7–12, where the anterior (Pog) and inferior (Me) sites of anterior mandible are more significantly affected. Furthermore, in combination with facial skeletal pattern, it provides a basis for the early warning diagnosis of mouth breathing.
An ethno-botanical study of medicinal plants used for the management of respiratory tract disorders in northern parts of Palestine
Authors: Shawarb Nuha , Badrasawi Manal , Qaoud Hassan Abu , Hussein Fatima 
Published: October 2023

Abstract
Background
The medicinal application of natural plant remedies is well established. These medicinal plants are still in use within the Palestinian community to treat several illnesses. This research is intended to study the use of natural plants to treat different types of respiratory tract disorders.

Method
This ethno botanical study focused on the medicinal plants that are used to treat respiratory diseases in the northern part of Palestine; Nablus, Tulkarm, Qalqilia, and Jenin. A questionnaire was distributed to 120 respondents. The data obtained included names of the plants used, the parts used, the diseases for which the products were applied, as well as the method of preparation. To evaluate results, percentages (%), Fic (factor of informant consensus), and FL (fidelity-level) were calculated.

Results
A total of 120 participants were selected for the final analysis. The highest percentage of herbal use was reported for flu 85.8% (103 participants) followed by cough 83.3%, while the lowest percentage of users was for bronchitis with 54.1%. The study showed that 31 plant species of 19 families were used for respiratory disorders treatment. Six species were from the Lamiaceae family, three species from the Apiaceae family, two species from Amaryllidaceae, Fabaceae, Myrtaceae, Rutaceae and Zingiberaceae, and one plant species for each of the rest of families. Leaves and fruits were the most commonly used parts of plants. Decoction was the method of preparation and was taken as a hot drink. Chamomile, mint, sage, lemon, and ginger were in the recipes for the five respiratory diseases.

Conclusion
In Palestine, patients with respiratory diseases rely heavily on the use of herbal remedies. Leaves and fruits were the most commonly used plat elements. Age and marriage were significantly associated with the use of botanical remedies. Whereas there was no significant association between the source of information about medicinal plants and the location where medicinal plants were purchased. It is vital to conduct comprehensive clinical investigations and pharmacological assessments of these herbal remedies, in order to identify their efficacy, safety, and toxicity levels.
Caffeine-folic acid-loaded-chitosan nanoparticles combined with methotrexate as a novel HepG2 immunotherapy targeting adenosine A2A receptor downstream cascade
Authors: Hamed Alaa , Ghareeb Doaa , Mohamed Tarek M. , Hamed Mahmoud , Nofal Mohammed S. , Gaber M. 
Published: October 2023

Abstract
Background
Methotrexate (MTX) is a common chemotherapeutic drug that inhibits DNA synthesis and induces apoptosis. Treatment with MTX increased CD73 expression, which leads to higher levels of extracellular adenosine. Adenosine levels are also high in the tumor microenvironment through Cancer cells metabolism. That promotes the survival of cancer cells and contributes to tumor immune evasion through the Adenosine 2a Receptor. A2A receptor antagonists are an emerging class of agents that treat cancers by enhancing immunotherapy, both as monotherapy and in combination with other therapeutic agents. Caffeine is an adenosine receptor antagonist. Herein, we demonstrate the ability of a novel well prepared and characterized nano formula CAF-FA-CS-NPs (D4) for A2aR blockade when combination with MTX to improve its antitumor efficacy by enhancing the immune system and eliminating immune suppression.

Methods
CAF-FA-CS-NPs (D4) were prepared and characterized for particle size, loading efficiency, and release profile. Molecular docking was used to validate the binding affinity of caffeine and folic acid to A2A receptor. The effects of the nano formula were evaluated on human liver cancer cells (HepG2), breast cancer cells (MCF-7), and MDA-MB-231, as well as normal human cells (WI-38). Different combination ratios of MTX and D4 were studied to identify the optimal combination for further genetic studies.

Results
Molecular docking results validated that caffeine and folic acid have binding affinity to A2A receptor. The CS-NPs were successfully prepared using ionic gelation method, with caffeine and folic acid being loaded and conjugated to the nanoparticles through electrostatic interactions. The CAF loading capacity in D4 was 77.9 ± 4.37% with an encapsulation efficiency of 98.5 ± 0.37. The particle size was optimized through ratio variations. The resulting nanoparticles were fully characterized. The results showed that (D4) had antioxidant activity and cytotoxicity against different cancer cells. The combination of D4 with MTX (IC50 D4 + 0.5 IC50 MTX) resulted in the downregulation of Bcl-2, FOXP3, CD39, and CD73 gene expression levels and upregulation of Bax and A2AR gene expression levels in HepG2 cells.

Conclusions
This study suggests that CAF-FA-CS-NPs (D4) in combination with MTX may be a promising candidate for cancer immunotherapy, by inhibiting A2aR signaling and leading to improved immune activation and anti-tumor activity of MTX.
An effectiveness evaluation of a community-based course for medical students: a randomized controlled trial in the teaching of epidemiology
Authors: Zhang Yongming , Huang Ting , Tang Mengling , Meng Lin , Wu Xiaolu , Chen Kun 
Published: October 2023

Abstract
Background
Epidemiology is considered to be the fundamental science of public health and plays an important role in clinical competence and professional development. The objective of this study is to evaluate the effectiveness of a short-term course for the teaching of epidemiology, which was designed as a community-based class for medical students.

Method
This course was designed according to Kern’s six-step approach to curriculum development. A total of 75 undergraduates were recruited. Forty-one students were assigned to an experimental group engaged in theoretical teaching and practical courses, while 34 students were assigned to the control group only taking theoretical courses. All participants were asked to complete a pre- and post-course survey and to take a test after completing the course. The scores between the experimental and control groups were compared using the Wilcoxon test.

Result
The experimental group showed significantly higher self-assessment scores in course understanding (p = 0.0126) and clinical practice skills (p = 0.0005) after completing the course, while no significant difference was observed in the control group. In addition, students in the experimental group reported significantly higher interest (p = 0.0015), stronger learning motivation (p = 0.0113) and a better mastery of epidemiology (p = 0.0167) after completing the course than those in the control group. However, test scores (p = 0.0859) and pass rates (p = 0.1755) demonstrated no statistical significance between the two groups.

Conclusion
The short-term practical course in epidemiology exerted significantly positive effects on the improvement of student learning enthusiasm, course understanding and clinical practice skills. These findings provide new ideas and statistical evidence for the development of epidemiological instruction. Future studies should explore how to more widely and optimally apply community-based courses to the teaching of epidemiology.
Preparing ethical review systems for emergencies: next steps
Authors: Wright Katharine , Aagaard Nic , Ali Amr Yusuf , Atuire Caesar , Campbell Michael , Littler Katherine , Mandil Ahmed , Mathur Roli , Okeibunor Joseph , Reis Andreas , Ribeiro Maria Alexandra , Saenz Carla , Sekhoacha Mamello , Gooshki Ehsan Shamsi , Singh Jerome Amir , Upshur Ross 
Published: October 2023

AbstractEthical review systems need to build on their experiences of COVID-19 research to enhance their preparedness for future pandemics. Recommendations from representatives from over twenty countries include: improving relationships across the research ecosystem; demonstrating willingness to reform and adapt systems and processes; and making the case robustly for better resourcing.
How did providers of home care for older adults manage the early phase of the Covid-19 pandemic? A qualitative case study of managers’ experiences in Region Stockholm
Authors: Agerholm Janne , Burström Bo , Schön Pär , Liljas Ann 
Published: October 2023

Abstract
Background
In the spring of 2020, the Covid-19 outbreak sent a shock wave through the Swedish society and placed an extraordinary pressure on the health and social care system for older people. In the initial phase there were few guidelines for care providers to follow and staff in home care organisations often had to tackle challenges posed by the pandemic as they appeared. The aim of this study was to understand how the spread of Covid-19 was managed in organisations providing home care to older adults in different municipalities in Region Stockholm, and what actions were taken to minimise the spread of the disease among clients and staff.

Method
A descriptive qualitative study was performed based on eight interviews with managers of home care providers for older adults in three different municipalities in Region Stockholm.Three of the eight providers operate within an integrated care system. Data were analysed using conventional content analysis.

Results
Three themes were identified covering actions taken to handle the spread of the virus, feelings of insecurity and anxiety, and internal and external factors influencing how the pandemic was tackled. There was no single strategy followed by all municipalities or organisations, however, there were similarities between the organisations. One such example was the introduction of cohort care and the experience of lacking personal protective equipment. Providers in the integrated care system emphasized some advantages with their system that was seen as facilitators for minimising the risk of spreading the virus, like the joint meetings with managers from both health and social care and the close contact with healthcare professionals in relation to dissemination of hygiene instructions.

Conclusion
Social care workers providing home care to older persons are an important group in preventing dissemination of infectious diseases like Covid-19. For better readiness and preparedness for future pandemics, municipal home care services would need larger stocks of personal protective equipment, clear guidelines and more training on how to reduce dissemination of disease. Ways to achieve closer communication between health and social care providers should also be investigated.
The renin-angiotensin-aldosterone system (RAAS) signaling pathways and cancer: foes versus allies
Authors: Hassani Bahareh , Attar Zeinab , Firouzabadi Negar 
Published: October 2023

AbstractThe renin-angiotensin-aldosterone system (RAAS), is an old system with new fundamental roles in cancer biology which influences cell growth, migration, death, and metastasis. RAAS signaling enhances cell proliferation in malignancy directly and indirectly by affecting tumor cells and modulating angiogenesis. Cancer development may be influenced by the balance between the ACE/Ang II/AT1R and the ACE2/Ang 1–7/Mas receptor pathways. The interactions between Ang II/AT1R and Ang I/AT2R as well as Ang1-7/Mas and alamandine/MrgD receptors in the RAAS pathway can significantly impact the development of cancer. Ang I/AT2R, Ang1-7/Mas, and alamandine/MrgD interactions can have anticancer effects while Ang II/AT1R interactions can be involved in the development of cancer. Evidence suggests that inhibitors of the RAAS, which are conventionally used to treat cardiovascular diseases, may be beneficial in cancer therapies.Herein, we aim to provide a thorough description of the elements of RAAS and their molecular play in cancer. Alongside this, the role of RAAS components in sex-dependent cancers as well as GI cancers will be discussed with the hope of enlightening new venues for adjuvant cancer treatment.Graphical abstract
Current ART, determinants for virologic failure and implications for HIV drug resistance: an umbrella review
Authors: SeyedAlinaghi SeyedAhmad , Afsahi Amir Masoud , Moradi Ali , Parmoon Zohal , Habibi Pedram , Mirzapour Pegah , Dashti Mohsen , Ghasemzadeh Afsaneh , Karimi Elaheh , Sanaati Foziye , Hamedi Zahra , Molla Ayoob , Mehraeen Esmaeil , Dadras Omid 
Published: October 2023

Abstract
Objective
The purpose of this study is to investigate the incidence of determinants for virologic failure and to identify predisposing factors to enhance treatment efficacy. Tackling this global public health issue is the key to reducing the rate of virological failure and increasing the success of treatment for those living with HIV.

Methods
This umbrella review delves into various aspects of current anti-retroviral therapy (ART) which is the primary treatment for human immunodeficiency virus (HIV) infection. Comprehensive searches were conducted in online databases including PubMed, Embase, Scopus, and Web of Science, up to May 26, 2023. Following the screening and selection of relevant articles, eligible articles were included in the data extraction. This study adhered to the PRISMA guideline to report the results and employed the NIH quality and bias risk assessment tool to ensure the quality of included studies.

Results
In total, 40 review studies published from 2015 to 2023 were included. The bulk of these studies concurred on several major factors contributing to HIV drug resistance and virological failure. Key among these were medication adherence, baseline and therapeutic CD4 levels, the presence of co-infections, and the advanced clinical stage of the infection.

Conclusion
The resistance to HIV drugs and instances of determinants for virologic failure have a profound impact on the life quality of those infected with HIV. Primary contributors to this scenario include insufficient adherence to treatment, decreased CD4 T-cell count, elevated viral levels, and certain treatment regimens. Implementing appropriate interventions could address these issues. Sub-Saharan Africa exhibits elevated rates of determinants for virologic failure, attributed to the delay in HIV testing and diagnosis, and late initiation of antiretroviral therapy (ART). It is essential to undertake further research aimed at enhancing the detection of resistance in HIV patients and mitigating viral failure by addressing these underlying causes.
Attention mechanism based multi-sequence MRI fusion improves prediction of response to neoadjuvant chemoradiotherapy in locally advanced rectal cancer
Authors: Zhou Xuezhi , Yu Yi , Feng Yanru , Ding Guojun , Liu Peng , Liu Luying , Ren Wenjie , Zhu Yuan , Cao Wuteng 
Published: October 2023

Abstract
Background
Accurate prediction of response to neoadjuvant chemoradiotherapy (nCRT) is very important for treatment plan decision in locally advanced rectal cancer (LARC). The aim of this study was to investigate whether self-attention mechanism based multi-sequence fusion strategy applied to multiparametric magnetic resonance imaging (MRI) based deep learning or hand-crafted radiomics model construction can improve prediction of response to nCRT in LARC.

Methods
This retrospective analysis enrolled 422 consecutive patients with LARC who received nCRT before surgery at two hospitals. All patients underwent multiparametric MRI scans with three imaging sequences. Tumor regression grade (TRG) was used to assess the response of nCRT based on the resected specimen. Patients were separated into 2 groups: poor responders (TRG 2, 3) versus good responders (TRG 0, 1). A self-attention mechanism, namely channel attention, was applied to fuse the three sequence information for deep learning and radiomics models construction. For comparison, other two models without channel attention were also constructed. All models were developed in the same hospital and validated in the other hospital.

Results
The deep learning model with channel attention mechanism achieved area under the curves (AUCs) of 0.898 in the internal validation cohort and 0.873 in the external validation cohort, which was the best performed model in all cohorts. More importantly, both the deep learning and radiomics model that applied channel attention mechanism performed better than those without channel attention mechanism.

Conclusions
The self-attention mechanism based multi-sequence fusion strategy can improve prediction of response to nCRT in LARC.