bluuebunny/crossref_metadata_2025_split huggingface dataset:
Case Report: Complete tomographic resolution of focal choroidal excavation complicated with choroidal neovascularization after anti-VEGF treatment
Authors: Zhioua Braham Imène , Haddar Selim , Boukari Mejdi , Mokrani Manel , Mili Ilhem , Zhioua Raja 
Published: October 2023

Purpose: We report a case of focal choroidal excavation (FCE) that resolved after intravitreal injection of anti-vascular endothelial growth factor (VEGF) for choroidal neovascularization (CNV) and we describe its tomographic features. Case report: A 43-year-old female presented with blurred vision and metamorphopsia in her left eye (LE) evolving for 10 years. The best corrected visual acuity (BCVA) was 20/20 in the right eye and 20/32 in the LE. Fundus examination revealed the presence of a yellowish foveal lesion which corresponded to a conforming FCE associated to a pachychoroid on swept-source optical coherence tomography (OCT). The OCT-Angiography showed a foveal flow void in the choriocapillaris layer corresponding to the FCE area. Three years later, the patient complained of visual impairment, more metamorphopsia with a BCVA of 20/80 on her LE. The OCT showed intraretinal fluid with a foveal retinal pigment epithelium (RPE) detachment. The OCT-angiography confirmed the presence of CNV. Two months after one intravitreal bevacizumab injection, the OCT documented the complete resolution of macular edema, the regression of the CNV tissue and the restoration of a normal aspect of the fovea without any FCE. Her BCVA improved to 20/32 with resolution of the metamorphopsia. The OCT aspect remained stable during 3 years of follow-up. Conclusion: CNV can develop in FCE and anti-VEGF therapy is a good option treatment. After treatment, FCE pattern can change et may completely resolve.
Case Report: complete pathological response after chemotherapy for borderline pancreatic cancer
Authors: SAIDANI Ahmed , BELHADJ Anis , Fahd Khefacha , RAKKEH Hichem , BEN OTHMENE Mohamed Raouf , CHEBBI Faouzi 
Published: October 2023

Background: Patients with borderline pancreatic cancer have a poor prognosis despite the recent development of multidisciplinary treatments that include chemotherapy. Nowadays induction chemotherapy is developing into a powerful cure to convert borderline resectable pancreatic cancer (BRPC) and locally advanced pancreatic cancers (LAPC) into a resectable cancer. This report supplements published data on the management border line pancreatic cancer and emphasizes the possibility of complete pathological response after chemotherapy in such cases. Case presentation: A 60-year-old man, with a type 2 Diabetes Mellitus, was diagnosed with a 3-centimeter T2N1M0 borderline pancreatic head tumor. Ultrasound endoscopy found a close contact with the superior mesenteric vein (< 180°) and an endoscopically guided biopsy confirmed the diagnosis of ductal adenocarcinoma. The patient underwent systemic chemotherapy with six injections of FOLFIRINOX without radiotherapy. The radiological re-staging revealed a cancer down-sizing of 2cm and tumor became resectable. The patient underwent a Whipple procedure with uneventful follow-up. The pathological examination of the specimen concluded to pathological complete response. The twelve lymph nodes evaluated were negative. Following surgery, adjuvant chemotherapy FOLFIRINOX was given. After three years of follow-up, there is no evidence of recurrence.
Practical Tips for using a Human Library approach In medical education
Authors: Malhi Rebecca , Perez Grace , Shafiq Javeria , Johnston Aaron 
Published: October 2023

A Human Library is a structured event that brings people from different groups together. It simulates the format of a customary library, with ‘Readers’ borrowing ‘Books’, who are human volunteers sharing their lived experiences and perspectives. Rooted in principles of social psychology, Human Libraries provide opportunities for Books and Readers to interact in meaningful dialogue. The goal of each interaction is to give the Reader new understanding of the Book’s life. The Human Library was originally developed as a strategy to challenge prejudice through conversation and personal connection, but the approach is remarkably versatile. We repurposed it for a medical education context in order to provide learners in medical school with information and inspiration, particularly about rural life and rural medicine. We organized and held two Human Library events where pre-medical and undergraduate medical students (Readers) engaged in dialogue with rural physicians (Books). However, the strategy could be used to address a wide variety of challenging subjects where the potential Readers are biased or lack experience. This article draws upon research literature and our own experiences of running Human Library events to give practical advice for other organizations who might want to use this novel approach in medical education.
Medical education in Bangladesh from Student and Teacher’s Perspective: Impact and challenges of the COVID-19 pandemic
Authors: Rahman M. Wakilur , Hasan Md Mahfuzul , Palash Md. Salauddin , Asaduzzaman Md 
Published: October 2023

Background: In low- and middle-income countries like Bangladesh, where medical education faces a range of challenges-such as lack of infrastructure, well-trained educators, and advanced technologies, abrupt changes in methodologies without adequate preparation are more challenging than in higher-income countries. This was worsened during the COVID-19 pandemic and these challenges have resulted in a change in medical education methodology. This study assesses the medical education procedure, impacts and adaptation strategies and challenges of the COVID-19 pandemic in the medical education system of Bangladesh from learners' as well as educators' perspectives. Methods: The study collected data from 22 Medical Colleges/Universities across 18 districts of eight divisions using quantitative and qualitative methods. A total of 408 samples were collected consisting of 316 from students and 92 from medical teachers. Descriptive analysis and probit model were performed for obtaining results. Results: The efficacy of online learning was questionable, but results showed that it was more effective for theory classes (92.4%) followed by clinical classes (75.63%) and the efficacy rate was low for practical classes (54.11%). All types of classes (theory, practical and clinical) are currently using mixed methods to some extent in medical education in Bangladesh. Regarding impacts and adaptation strategy, approximately 75.3% of the students surveyed expressed their acceptance of online education. Over 80% of the participants acknowledged the advantages of online learning, highlighting the freedom to learn from home, cost and time savings, and avoiding physical closeness with other students as major benefits. Conclusions: To address future challenges like the COVID-19 pandemic in medical education in Bangladesh, a comprehensive policy approach such as strengthening technological infrastructure, promoting blended learning approaches, enhancing faculty training and support, integrating telemedicine into the curriculum, and continuously evaluating and improving policies and interventions can enhance the resilience of its medical education system, and prepare for future challenges.
Community engagement in maternal and perinatal death surveillance and response (MPDSR): Realist review protocol
Authors: Mbuo Mary , Okello Immaculate , Penn-Kekana Loveday , Willcox Merlin , Portela Anayda , Palestra Francesca , Mathai Matthews 
Published: October 2023

Background: While there has been a decline in maternal and perinatal mortality, deaths remain high in sub-Saharan Africa and Asia. With the sustainable development goals (SDGs) targets to reduce maternal and perinatal mortality, more needs to be done to accelerate progress and improve survival. Maternal and perinatal death surveillance and response (MPDSR) is a strategy to identify the clinical and social circumstances that contribute to maternal and perinatal deaths. Through MPDSR, an active surveillance and response cycle is established by bringing together different stakeholders to review and address these social and clinical factors. Community engagement in MPDSR provides a strong basis for collective action to address social factors and quality of care issues that contribute to maternal and perinatal deaths. Studies have shown that community members can support identification and reporting of maternal and/or perinatal deaths. Skilled care at birth has been increasing globally, but there are still gaps in quality of care. Through MPDSR, community members can collaborate with health workers to improve quality of care. But we do not know how community engagement in MPDSR works in practice; for whom it works and what aspects work (or do not work) and why. This realist review answers the question: which strategies of community engagement in MPDSR produce which outcomes in which contexts? Methods: For this realist review, we will identify published and grey literature by searching relevant databases for articles. We will include papers published from 2004 in all languages and from all countries. We have set up an advisory group drawn from academia, international organizations, and practitioners of both MPDSR and community engagement to guide the process. Conclusion: This protocol and the subsequent realist review will use theoretical approaches from the community engagement literature to generate theory on community engagement in MPDSR. Prospero registration number: CRD42022345216
Impact of individual, household, and area characteristics on health and social care outcomes for people with multimorbidity: Protocol for a multilevel analysis
Authors: MacRae Clare , Mercer Stewart W. , Lawson Andrew , Marshall Alan , Pearce Jamie , Abubakar Eleojo , Zheng Chunyu , van den Akker Marjan , Williams Thomas , Swann Olivia , Pollock Louisa , Rawlings Anna , Fry Rich , Lyons Ronan A. , Lyons Jane , Mizen Amy , Dibben Chris , Guthrie Bruce 
Published: October 2023

Background
Multimorbidity is one of the greatest challenges facing health and social care systems globally. It is associated with high rates of health service use, adverse healthcare events, and premature death. Despite its importance, little is known about the effects of contextual determinants such as household and area characteristics on health and care outcomes for people with multimorbidity. This study protocol presents a plan for the examination of associations between individual, household, and area characteristics with important health and social care outcomes.

Methods
The study will use a cross-section of data from the SAIL Databank on 01 January 2019 and include all people alive and registered with a Welsh GP. The cohort will be stratified according to the presence or absence of multimorbidity, defined as two or more long-term conditions. Multilevel models will be used to examine covariates measured for individuals, households, and areas to account for social processes operating at different levels. The intra-class correlation coefficient will be calculated to determine the strength of association at each level of the hierarchy. Model outcomes will be any emergency department attendance, emergency hospital or care home admission, or mortality, within the study follow-up period.

Discussion
Household and area characteristics might act as protective or risk factors for health and care outcomes for people with multimorbidity, in which case results of the analyses can be used to guide clinical and policy responses for effective targeting of limited resources.
Impact of sarcopenic obesity on post-hepatectomy bile leakage for hepatocellular carcinoma
Authors: Hayashi Hikaru , Shimizu Akira , Kubota Koji , Notake Tsuyoshi , Masuo Hitoshi , Yoshizawa Takahiro , Hosoda Kiyotaka , Sakai Hiroki , Yasukawa Koya , Soejima Yuji 
Published: October 2023

Background
Post-hepatectomy bile leakage (PHBL) is a potentially fatal complication that can arise after hepatectomy. Previous studies have identified obesity as a risk factor for PHBL. In this study, we investigated the impact of sarcopenic obesity on PHBL in hepatocellular carcinoma (HCC) patients.

Methods
In total, we enrolled 409 patients who underwent hepatectomy without bilioenteric anastomosis for HCC between January 2010 and August 2021. Patients were grouped according to the presence or absence of PHBL. Patient characteristics, including body mass index and sarcopenic obesity, were then analyzed for predictive factors for PHBL.

Results
Among the 409 HCC patients included in the study, 39 developed PHBL. Male sex, hypertension, cardiac disease, white blood cell counts, the psoas muscle area, and visceral fat area, and intraoperative blood loss were significantly increased in the PHBL (+) group compared with the PHBL (−) group. Multivariate analysis showed that the independent risk factors for the occurrence of PHBL were intraoperative blood loss ≥370 mL and sarcopenic obesity.

Conclusions
Our results show that it is important to understand whether a patient is at high risk for PHBL prior to surgery and to focus on reducing intraoperative blood loss during surgery for patients with risk factors for PHBL.
Bioactive compounds intake in the Brazilian population: Trends and determinants of socioeconomic inequalities between 2008 and 2018
Authors: Carnauba Renata A. , Sarti Flavia M. , Hassimotto Neuza M. A. , Lajolo Franco M. 
Published: October 2023

Objective
The present study aims at evaluating trends and determinants of socioeconomic inequalities in consumption of bioactive compounds in representative sample of the Brazilian population the period from 2008–2009 to 2017–2018.

Methods
Data from two cross-sectional population-based surveys were analyzed in the study, using descriptive analysis and estimation of inequalities in consumption. Trends in polyphenol and carotenoid intake were estimated using food consumption data from National Dietary Survey (NDS) 2008–2009 (n = 34,003) and 2017–2018 (n = 46,164). Evolution and determinants of inequalities in bioactive compounds intake were identified using analysis of inequality based on concentration index.

Results
Consumption of total polyphenols, phenolic acids, flavonoids and carotenoid classes (except for zeaxanthin) was significantly associated with per capita income after adjustment for potential confounders, being higher income associated with higher intake of bioactive compounds. Disaggregation of inequalities showed that education was the main factor associated with consumption of flavonoids, other polyphenols and β-cryptoxanthin in 2008–2009; whilst income was the main barrier to intake of polyphenols and carotenoids in 2017–2018.

Conclusion
Income level and educational attainment have been important determinants to inequalities in bioactive compounds intake in the Brazilian population throughout the period of analysis, being higher intake of bioactive compounds-rich foods and beverages associated with higher income.
The clinical value of hsa-miR-190b-5p in peripheral blood of pediatric β-thalassemia and its regulation on BCL11A expression
Authors: Chen Meihuan , Wang Xinrui , Wang Haiwei , Zhang Min , Chen Lingji , Chen Hong , Pan Yali , Zhang Yanhong , Xu Liangpu , Huang Hailong 
Published: October 2023

Background
The B cell CLL/lymphoma 11A (BCL11A) is a key regulator of hemoglobin switching in β-thalassemia (β-thal). Previous study has suggested that dysregulated microRNAs are involved in the regulation of BCL11A expression. The aim of this study was to investigate the clinical value of hsa-miR-190b-5p in β-thal, and to confirm the regulatory effect of hsa-miR-190b-5p on BCL11A expression.

Methods
The peripheral blood of 25 pediatric β-thal patients and 25 healthy controls were selected, and qRT-PCR was used to analyze the levels of hsa-miR-190b-5p and BCL11A mRNA. The relationship between hsa-miR-190b-5p expression and hematological parameters was assessed by Pearson’s correlation test. The diagnostic power of hsa-miR-190b-5p was evaluated by ROC curves analysis. The direct integration between hsa-miR-190b-5p and BCL11A 3’-UTR was confirmed by luciferase reporter assay.

Results
Hsa-miR-190b-5p expression in pediatric β-thal was upregulated, and negatively correlated with the MCH and HbA levels, but positively correlated with the HbF level. Hsa-miR-190b-5p showed a good diagnostic capability for pediatric β-thal equivalent to that of HbA2 (AUC: 0.760 vs. 0.758). Moreover, the levels of BCL11A mRNA in pediatric β-thal were decreased, and hsa-miR-190b-5p had a negative correlation with BCL11A mRNA expression (r = -0.403). BCL11A was a target gene of hsa-miR-190b-5p. The mRNA and protein levels of BCL11A were diminished by introduction of hsa-miR-190b-5p, whereas its expression was upregulated by knockdown of hsa-miR-190b-5p.

Conclusions
Hsa-miR-190b-5p expression was upregulated in pediatric β-thal and might be an effective diagnostic biomarker. BCL11A was negatively regulated by hsa-miR-190b-5p, which might provide new target for the treatment of pediatric β-thal.
Assessing the associations between known genetic variants and substance use in people with HIV in the United States
Authors: Haas Cameron B. , Jordahl Kristina M. , Nance Robin M. , Whitney Bridget M. , Wang Lu , Delaney Joseph A. C. , Ruderman Stephanie , Jia Tongqiu , Mathews Wm. Christopher , Saag Michael S. , Lee Sulggi A. , Napravnik Sonia , Jacobson Jeffrey M. , Chander Geetanjali , McCall Elizabeth M. , Moore Richard D. , Mayer Kenneth H. , Mukherjee Shubhabrata , Lee Won Jun , Crane Paul K. , Crane Heidi , Peter Inga , Lindström Sara 
Published: October 2023

Background
The prevalence of substance use in people with HIV (PWH) in the United States is higher than in the general population and is an important driver of HIV-related outcomes. We sought to assess if previously identified genetic associations that contribute to substance use are also observed in a population of PWH.

Methods
We performed genome-wide association studies (GWAS) of alcohol, smoking, and cannabis use phenotypes in a multi-ancestry population of 7,542 PWH from the Center for AIDS Research Network of Integrated Clinical Systems (CNICS). We conducted multi-ancestry GWAS for individuals of African (n = 3,748), Admixed American (n = 1,334), and European (n = 2,460) ancestry. Phenotype data were self-reported and collected using patient reported outcomes (PROs) and three questions from AUDIT-C, an alcohol screening tool. We analyzed nine phenotypes: 1) frequency of alcohol consumption, 2) typical number of drinks on a day when drinking alcohol, 3) frequency of five or more alcoholic drinks in a 30-day period, 4) smoking initiation, 5) smoking cessation, 6) cigarettes per day, 7) cannabis use initiation, 8) cannabis use cessation, 9) frequency of cannabis use during the previous 30 days. For each phenotype we considered a) variants previously identified as associated with a substance use trait and b) novel associations.

Results
We observed evidence for effects of previously reported single nucleotide polymorphisms (SNPs) related to alcohol (rs1229984, p = 0.001), tobacco (rs11783093, p = 2.22E-4), and cannabis use (rs2875907, p = 0.005). We also report two novel loci (19p13.2, p = 1.3E-8; and 20p11.21, p = 2.1E-8) associated with cannabis use cessation.

Conclusions
Our analyses contribute to understanding the genetic bases of substance use in a population with relatively higher rates of use compared to the general population.
Comparison of two area-level socioeconomic deprivation indices: Implications for public health research, practice, and policy
Authors: Rollings Kimberly A. , Noppert Grace A. , Griggs Jennifer J. , Melendez Robert A. , Clarke Philippa J. 
Published: October 2023

Objectives
To compare 2 frequently used area-level socioeconomic deprivation indices: the Area Deprivation Index (ADI) and the Social Vulnerability Index (SVI).

Methods
Index agreement was assessed via pairwise correlations, decile score distribution and mean comparisons, and mapping. The 2019 ADI and 2018 SVI indices at the U.S. census tract-level were analyzed.

Results
Index correlation was modest (R = 0.51). Less than half (44.4%) of all tracts had good index agreement (0–1 decile difference). Among the 6.3% of tracts with poor index agreement (≥6 decile difference), nearly 1 in 5 were classified by high SVI and low ADI scores. Index items driving poor agreement, such as high rents, mortgages, and home values in urban areas with characteristics indicative of socioeconomic deprivation, were also identified.

Conclusions
Differences in index dimensions and agreement indicated that ADI and SVI are not interchangeable measures of socioeconomic deprivation at the tract level. Careful consideration is necessary when selecting an area-level socioeconomic deprivation measure that appropriately defines deprivation relative to the context in which it will be used. How deprivation is operationalized affects interpretation by researchers as well as public health practitioners and policymakers making decisions about resource allocation and working to address health equity.
Effects of rebound exercises on balance and mobility of people with neurological disorders: A systematic review
Authors: Okemuo Adaora Justina , Gallagher Dearbhla , Dairo Yetunde Marion 
Published: October 2023

Background
Therapeutic rebound exercise is gaining popularity among the general population, but its effectiveness in individuals with neurological impairments remains uncertain. To shed light on this, a systematic review was conducted between November 2021 and March 2023 to study the impact of rebound exercise on balance and mobility in this group.

Methods
Six databases were searched. Studies were included if written in English, peer-reviewed, had original research data and assessed the effect of rebound exercise in adults with neurological disorders. The outcomes measured were balance and mobility. Two reviewers independently appraised study quality using the Critical Appraisal Skills Program for Randomized Controlled Trials. Finally, a meta-summary of the included studies was completed, and a meta-analysis was performed using RevMan software version 5.3 to determine the effectiveness of the intervention.

Results
Five studies were included comprising 130 participants aged 31.32±7.67 to 58±12 years, 72% male and 28% female. Participants were in-patients with stroke (49%), multiple sclerosis (24%), Parkinson’s disease (15%) and spinal cord injury (12%). The included papers had moderate to high methodological quality. The timed up-and-go test revealed that the rebound group participants could walk 6.08 seconds quicker over three to eight weeks. Pooled results show that rebound exercise significantly improves mobility (-0.53[-0.94, -0.11], p = 0.01), but no significant improvement was observed in balance.

Conclusion
Rebound exercise has shown the potential to improve mobility in people with neurological disorders. However, the findings should be in the context that the included studies are few and participants were in in-patient settings. PROSPERO registration: CRD42021298030.