bluuebunny/crossref_metadata_2025_split huggingface dataset:
Hotspots and bottlenecks for the enhancement of the environmental sustainability of pig systems, with emphasis on European pig systems
Authors: Pexas Georgios , Kyriazakis Ilias 
Published: November 2023

AbstractAlthough pig systems start from a favourable baseline of environmental impact compared to other livestock systems, there is still scope to reduce their emissions and further mitigate associated impacts, especially in relation to nitrogen and phosphorous emissions. Key environmental impact hotspots of pig production systems are activities associated with feed production and manure management, as well as direct emissions (such as methane) from the animals and energy use. A major contributor to the environmental impacts associated with pig feed is the inclusion of soya in pig diets, especially since European pig systems rely heavily on soya imported from areas of the globe where crop production is associated with significant impacts of land use change, deforestation, carbon emissions, and loss of biodiversity. The “finishing” pig production stage contributes most to these environmental impacts, due to the amount of feed consumed, the efficiency with which feed is utilised, and the amount of manure produced during this stage. By definition therefore, any substantial improvements pig system environmental impact would arise from changes in feed production and manure management. In this paper, we consider potential solutions towards system environmental sustainability at these pig system components, as well as the bottlenecks that inhibit their effective implementation at the desired pace and magnitude. Examples include the quest for alternative protein sources to soya, the limits (perceived or real) to the genetic improvement of pigs, and the implementation of alternative manure management strategies, such as production of biogas through anaerobic digestion. The review identifies and discusses areas that future efforts can focus on, to further advance understanding around the potential sustainability benefits of modifications at various pig system components, and key sustainability trade-offs across the environment—economy—society pillars associated with synergistic and antagonistic effects when joint implementation of multiple solutions is considered. In this way, the review opens a discussion to facilitate the development of holistic decision support tools for pig farm management that account for interactions between the “feed * animal * manure” system components and trade-offs between sustainability priorities (e.g., environmental vs economic performance of pig system; welfare improvements vs environmental impacts).
Prevalence and outcome of chronic hepatitis C patients admitted with COVID-19 to intensive care units: a blessing in disguise
Authors: Negm Essamedin M. , El-Sokkary Rehab H. , Malek Mai M. , Ezzat Heba M. , Tawfik Ahmed E. , Abed Heba Ali , ELdeeb Seham Mahmoud , Mohamed Mohamed Sorour , Kassem Hamdy M. , Mosallem Ahmed , Mowafy Sherif M. S. 
Published: November 2023

Abstract
Background
Managing COVID-19 pneumonia is, in reality, one of the biggest challenges in the history of intensive care medicine. The link between comorbidity and COVID-19 remains unclear. Worldwide, Egypt has the highest prevalence of hepatitis C virus (HCV). The study’s objectives were to assess the prevalence of chronic hepatitis C as a risk factor among COVID-19 patients and to investigate the impact of it and the prior exposure to different HCV management protocols on the clinical characteristics and outcome of COVID-19 patients.

Results
Of 2106 confirmed cases of COVID-19, CLD, malignancy, and chronic kidney disease were significant risk factors for death [OR (95% CI) = 2.78 (1.29–5.98), 2.72 (1.14–6.46) and 3.79 (1.39–10.36) respectively]. The mortality rate was 24.3%. A total of 99 cases (4.7%) with CLD were investigated during the study period; 69 patients (3.3%) were categorized as HCV-positive. Among the positive HCV cases, 49 patients (2.3%) received anti-hepatitis C medications. The mortality rate was 46.4% and 73.3% between HCV and non-HCV hepatic patients, respectively. Triple therapy showed a statistically significant association with a better outcome (p value = 0.009).

Conclusions
In the present report, chronic liver diseases, chronic kidney disease, and malignancy were significant risk factors for mortality among COVID-19 patients. The Egyptian mass management of chronic hepatitis C may explain the favorable outcome of COVID-19 among these patients. Intervention trials are required to prove that direct-acting antivirals are effective in preventing COVID-19.
Prediction of gap balancing based on 2-D radiography in total knee arthroplasty for knee osteoarthritis patients
Authors: Zhang Zhuo , Luo Yang , Zhang Chong , Wang Xin , Zhang Tianwei , Zhang Guoqiang 
Published: November 2023

Abstract
Background
To investigate the influence of osteophytes on postoperative gap balancing, and to work out a predictive model of the relationship between osteophyte size and gap gaining in primary total knee replacement.

Methods
One hundred and ten patients were enrolled in the study. Pre- and postoperative radiographs were collected and analyzed. They were assigned to the training dataset and test dataset randomly at a ratio of 9:1 by using the statistical package R (version 4.0.5). Size and marginal distances of osteophytes, planned bone cut planes, predicted bone cuts and joint gaps were labeled on the preoperative standing anteroposterior and lateral views, while actual bone cuts and joint gaps were recorded on the postoperative plain films, respectively. Statistical analysis was performed.

Results
Actual joint gaps were significantly related to the distances of medial and lateral predictive bone cutting lines, bone cut thickness on tibial side and posterior condylar, as well as size and marginal distances of osteophytes (P < 0.05). A predictive equation was generated, with a root mean square error (RMSE) of 3.4761 in validation. A 2-D planning system with adjustable input parameters and dim predictive outputs on joint gap was developed. The equation is $$S \left(Joint Gap\right)=1.82+0.15*y+0.552*Tibial cut+0.953*Femoral cut+0.197*Post Condyle$$

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Conclusion
Postoperative joint gap can be predicted on the basis of preoperative measurements on 2-D plain films. Larger sample size may help improve the effectiveness and accuracy of the predictive equation.
Frequency of hepatitis C virus infection in patients with pediatric inflammatory bowel disease: a cross-sectional study
Authors: Tarek Sara , Eskander Ayman E. , Meshaal Safa , Badr Eman , El-Hakeem Asmaa Abd 
Published: November 2023

Abstract
Background
Patients with pediatric inflammatory bowel disease (PIBD) are believed to be at higher risk of hepatitis C virus (HCV) infection not only due to using of immunosuppressive drugs but also because of repeated blood transfusion and endoscopic and other invasive procedures used for diagnoses and effective controlling of the disease, so this study aimed to assess the frequency of HCV infection, in patients with PIBD at the New Children’s Hospital, Cairo University, and identify the potential risk factors.

Methods
This cross-sectional analytic study included 165 IBD patients between 1 and 16 years old of both sexes who were attending the Pediatric Gastroenterology Clinic in the New Children’s University Hospital, Cairo University. All patients were screened for anti-HCV antibodies using ELISA. Factors related to IBD (severity, modalities of the treatment, and invasive procedures), to infection (blood transfusion history and family history of hepatitis), and liver enzymes were registered. The risk factors were evaluated by multivariate logistic regression analysis.

Results
Present and/or past HCV infection was found in five (3%) of the IBD patients. The multivariate logistic regression to detect independent predictors of HCV +ve antibodies patients had statistically significant value with number of hospital admission related to IBD with p-value = 0.002, odd ratio (OR) = 1.467, and confidence interval (CI) = 95% (1.145–1.879) and with number of hospital admission unrelated to IBD with p-value = 0.024, OR = 0.750, and CI 95% (0.585–0.963).

Conclusion
The frequency of HCV infection in PIBD patients was 3%. Thus, the frequency of HCV infection in PIBD patients is similar to that in the normal population of the developing countries, and it is strongly related to hospital admission due to IBD or non-IBD causes.
Extrahepatic bile duct fibroma in an infant: a case report
Authors: Hasan Md. Samiul , Islam S. M. Nazmul , Huq Umama , Parvez Mashud , Khan Hasiba Mahshed , Mahmud Refoyez , Rahman Ashrarur 
Published: November 2023

Abstract
Background
Extrahepatic bile duct tumor in neonates and infants is extremely rare. Fibroma in neonates and infants has been reported in different body parts but not in the bile duct. We report a 2-month-old girl with common bile duct (CBD) fibroma.

Case presentation
A 2-month-old girl presented with jaundice and pale stool for 15 days. Her perinatal period was uneventful. On examination, we found the girl deeply icteric and having hepatomegaly but no palpable lump. Laboratory investigations revealed direct hyperbilirubinemia with elevated liver enzymes. Ultrasonography revealed hepatomegaly with focal dilatation of the extrahepatic bile duct (2.1 × 0.5 cm). Our preliminary diagnosis was a type I choledochal cyst. Considering the clinical scenario, we planned for exploration without further imaging. On exploration, we found the liver blackish and a hard mass involving the common CBD and cystic duct. The gall bladder was filled with clear mucus. After excising the mass, the gall bladder, and CBD, we reconstructed the anatomy with Roux-N-Y hepaticojejunostomy. The postoperative period was uneventful except for minor bile leakage during the first four postoperative days, which stopped spontaneously. Histopathology revealed spindle-shaped fibrous tissue admixed with collagenous tissue, compatible with a fibroma. A liver biopsy showed the features of cirrhosis. However, liver function tests were normal 2 weeks after surgery. The baby was thriving at 6 months of follow-up, hepatomegaly was resolved, and there was no clinical or radiological sign of recurrence.

Conclusions
CBD fibroma is a rare cause of obstructive jaundice in neonates and infants. The earliest possible excision of the tumor and bile drainage restoration are necessary to halt the progression of liver damage.
Oncology Clinicians' Perspectives on Online Patient Portal Use in Pediatric and Adolescent Cancer
Authors: Sisk Bryan A. , Bereitschaft Christine , Enloe Madi , Schulz Ginny , Mack Jennifer , DuBois James 
Published: November 2023

PURPOSE Online patient portals represent widely available communication tools in pediatric oncology. Previous studies have not evaluated clinicians' perspectives on portal use, including issues related to access to adolescents' portals. METHODS We performed semistructured interviews with physicians and advanced practice providers (APPs) who care for children or adolescents with cancer. We performed thematic analysis of benefits, problems, and accommodations related to portal use in oncology. RESULTS We interviewed 29 physicians and 24 APPs representing 26 institutions. Participants described five themes of benefits provided by portals: (1) empowering adolescents, (2) improving efficiency and accuracy of communication, (3) promoting open and adaptive communication, (4) supporting parents in managing care, and (5) bolstering clinical relationships. Participants described eight themes of problems caused by portal access: (1) creating emotional distress and confusion, (2) increasing workload and changing workflows, (3) threatening adolescent confidentiality, (4) adolescents lacking interest to engage, (5) diminishing clinical relationship, (6) misusing portal messages, (7) diminishing quality of sensitive documentation, and (8) parents losing access to adolescents' records. Participants described three themes related to accommodations they made as a result of portal access: (1) modifying note writing, (2) providing anticipatory guidance about viewing results, and (3) adapting workflows. Some portal functions created either benefits or problems depending on the clinical context. CONCLUSION Oncologists identified benefits and problems created by portal use, which were sometimes in tension, depending on the clinical context. To make portals useful, we must take steps to mitigate risks while preserving functionality for parents and adolescent patients.
Exploring Challenges Related to Breast Cancer to Identify Opportunities for Advocacy in Hawassa City, Southern Ethiopia: A Community-Based, Qualitative Study
Authors: Bogale Netsanet , Balta Bargude , Demissie Gulema , Geleta Dereje , Rakoff Michele , Anderson Brandon , Johnson Natalie , Yee Lisa , Taylor Lesley 
Published: November 2023

PURPOSE The aim of this study was to explore breast cancer (BC) challenges to identify opportunities for advocacy in southern Ethiopia in 2022. METHODS Twenty-five participants from four local districts (kebeles) in Hawassa City were selected as key contributors to future work. Semistructured in-depth interviews were held for two clinicians, two local health bureau managers, two media managers, and three religious leaders. Two focus group discussions were conducted: one included six BC survivors and a caregiver; the other included two health extension workers, three members of the Women's Development Group, two community volunteers, one kebele leader, and one traditional healer. RESULTS To our knowledge, our study was the first time that most participants had assembled. Many referred to patients as victims and BC as a killer disease or curse. Community and religious leaders were concerned about challenges and willing to collaborate. Survivors, providers, and religious leaders were identified as key sources of information, positive messages, and leadership. CONCLUSION Recommendations for advocacy work in Hawassa include lobbying for BC as a health priority; including BC within the health extension package; initiating programs for earlier detection; educating the community to remove stigmas of the disease and treatments; working with media to disseminate messages that are inclusive of people in remote areas and speaking different languages; improving availability, affordability, and access to care; and assisting patients with psychosocial support. A strategic collaboration between religious leaders and health care providers was identified to increase community awareness and support advocacy for patients.
Dual Prognostic Classification of Triple-Negative Breast Cancer by DNA Damage Immune Response and Homologous Recombination Deficiency
Authors: Stecklein Shane R. , Barlow William , Pusztai Lajos , Timms Kirsten , Kennedy Richard , Logan Gemma E. , Seitz Rob , Badve Sunil , Gökmen-Polar Yesim , Porter Peggy , Linden Hannah , Tripathy Debu , Hortobagyi Gabriel N. , Godwin Andrew K. , Thompson Alastair , Hayes Daniel F. , Sharma Priyanka 
Published: November 2023

PURPOSE Triple-negative breast cancer (TNBC) is a heterogeneous disease. We previously showed that homologous recombination deficiency (HRD) and the DNA damage immune response (DDIR) signature are prognostic in TNBC. We hypothesized that these biomarkers reflect related but not completely interdependent biological processes, that their combined use would be prognostic, and that simultaneous assessment of the immunologic microenvironment and susceptibility to DNA damaging therapies might be able to identify subgroups with distinct therapeutic vulnerabilities. METHODS We analyzed the dual DDIR/HRD classification in 341 patients with TNBC treated with adjuvant anthracycline-based chemotherapy on the SWOG S9313 trial and corroborated our findings in The Cancer Genome Atlas breast cancer data set. RESULTS DDIR/HRD classification is highly prognostic in TNBC and identifies biologically and immunologically distinct subgroups. Immune-enriched DDIR+/HRD+ TNBCs have the most favorable prognosis, and DDIR+/HRD– and DDIR–/HRD+ TNBCs have favorable intermediate prognosis, despite the latter being immune-depleted. DDIR–/HRD– TNBCs have the worst prognosis and represent an internally heterogeneous group of immune-depleted chemoresistant tumors. CONCLUSION Our findings propose DDIR/HRD classification as a potentially clinically relevant approach to categorize tumors on the basis of therapeutic vulnerabilities.
A Case of Aplasia Cutis Congenita in the Setting of Maternal Carbimazole Use in the First Trimester
Authors: McGrath Colin , O’Hanrahan Nancy , Dennedy Michael Conall , Boyle Michael A 
Published: November 2023

Abstract
Aplasia cutis congenita (ACC) is one of several congenital malformations associated with antithyroid/thiourylene drug use in pregnancy. While uncommon among the general population (1-3/100 000 cases), the risk among those on thiourylenes is between 1.6% and 3%. The scalp is the most common site for this congenital anomaly.
We present the case of a male infant with multifocal ACC of the scalp discovered at birth and born to a mother with Graves disease that was controlled during pregnancy using carbimazole. Thyroid function tests were normal throughout the pregnancy. There was no involvement of underlying subcutaneous tissue or structures. At age 18 months, the single largest lesion remained with only partial coverage. Prospective management involved periodic surveillance with planned 2-stage repair.
This case reinforces the association between the antithyroid drugs carbimazole (CMZ) and methimazole (MMI) and supports the proposition of an MMI/CMZ embryopathy. It adds to a literature of case reports in which malformations arise in offspring of such mothers whose thyrotoxicosis is controlled antenatally, thereby challenging the suggestion that ACC is attributable to poorly controlled disease rather than thiourylenes. As yet the underlying mechanism is not understood, nor is it known why MMI and CMZ may cause potentially significant embryopathy while congenital defects attributable to the structurally similar propylthiouracil are typically less severe.
Measuring body temperature in birds – the effects of sensor type and placement on estimated temperature and metabolic rate
Authors: Andreasson Fredrik , Rostedt Elin , Nord Andreas 
Published: November 2023

ABSTRACT
Several methods are routinely used to measure avian body temperature, but different methods vary in invasiveness. This may cause stress-induced increases in temperature and/or metabolic rate and, hence, overestimation of both parameters. Choosing an adequate temperature measurement method is therefore key to accurately characterizing an animal's thermal and metabolic phenotype. Using great tits (Parus major) and four common methods with different levels of invasiveness (intraperitoneal, cloacal, subcutaneous, cutaneous), we evaluated the preciseness of body temperature measurements and effects on resting metabolic rate (RMR) over a 40°C range of ambient temperatures. None of the methods caused overestimation or underestimation of RMR compared with un-instrumented birds, and body or skin temperature estimates did not differ between methods in thermoneutrality. However, skin temperature was lower compared with all other methods below thermoneutrality. These results provide empirical guidance for future research that aims to measure body temperature and metabolic rate in small bird models.
Dialogando sobre direitos sexuais com os usuários do SUS nos espaços de atendimento da Policlínica Piquet Carneiro – PPC/UERJ
Authors: Silva Welison Matheus Fontes da 
Published: November 2023

Os direitos sexuais, embora sejam reconhecidos em documentos nacionais e internacionais, enfrentam, ainda hoje, muitos desafios para que sejam, de fato, garantidos. Considerando que essa temática adentra por diversas áreas da nossa vida, como a saúde, a educação, a cidadania, dentre outros, torna-se relevante promover discussões sobre direitos sexuais para que estes sejam conhecidos e reconhecidos também como direitos básicos de todo ser humano. Este artigo tem como objetivo apresentar as atividades de grupos de sala de espera desenvolvidas pelo projeto de extensão “Repensando as estratégias para a prevenção e a promoção da saúde em ISTs e HIV/AIDS” realizadas nos ambulatórios da Policlínica Piquet Carneiro. Descreve os encontros com os usuários do SUS, a partir dos relatos compartilhados através da dinâmica adotada na execução dos grupos de sala de espera. As atividades ocorreram entre maio e setembro de 2019 e tiveram o alcance de 234 participantes. Os participantes são receptivos, demonstram boa aceitação e interesse durante a realização das dinâmicas e participam das atividades propostas pelos integrantes da equipe. Nossa proposta é esclarecer aos usuários, através das práticas pedagógicas, sobre os direitos sexuais, estimulando a reflexão de um modo que fosse possível relacionar esse debate a temas macropolíticos e questões analíticas enfrentadas cotidianamente, tais como o machismo, prevenção das ISTs, direitos das mulheres e da população LGBT, abuso sexual infantil, educação sexual dentro de um contexto escolar, outros. Acreditamos que o diálogo e ações de conscientização podem favorecer a mudança de atitude e contribuir para a garantia dos direitos sexuais.
Uso de redes sociais como ferramenta de conscientização contra o tabagismo
Authors: Oliveira Braga Lucas , Gregório de Góes Vanessa , Bispo do Carmo Beatriz , Garcia de Andrade Maíra , De Oliveira Otero Geovana D’Arc , Farias da Silva Jaonayly , Borja Gómez Luis Fernando 
Published: November 2023

O fumo está associado a diversas comorbidades, compondo um dos fatores de risco mais importantes para as doenças crônicas não transmissíveis. Além de pré-dispor um vasto leque de doenças, o tabagismo causa impacto socioambiental e socioeconômico. Nesse contexto, a Liga Acadêmica de Pneumologia e Cirurgia Torácica do Acre (LAPCITO-AC) organizou e promoveu ações de impacto, cujo objetivo foi alinhar-se às intervenções realizadas pelo Ministério da Saúde em busca da prevenção e cessação do fumo. Tais ações foram contempladas virtualmente por meio de aulas, seminários e publicações nas redes sociais e plataformas da LAPCITO-AC. Por fim, notou-se que a utilização dessas mídias sociais possibilitaram uma abrangência satisfatória da população, chegando a 3.133 alcances durante as 14 publicações do projeto. Com isso, ficou evidente a importância do uso das redes sociais como veiculadora de informações para a continuação das atividades de extensão em período de distanciamento social.