bluuebunny/crossref_metadata_2025_split huggingface dataset:
Diagnostic challenge of Creutzfeldt-Jakob disease in a patient with multimorbidity: a case-report
Authors: Yaqub Amber , Ikram Mohammad Kamran , Blankevoort Jeroen , Ikram Mohammad Arfan 
Published: October 2023

Abstract
Background
Creutzfeldt-Jakob disease (CJD) is a rapidly progressive and ultimately fatal neurodegenerative condition caused by prions. The clinical symptoms of CJD vary with its subtype, and may include dementia, visual hallucinations, myoclonus, ataxia, (extra)pyramidal signs and akinetic mutism. In the early course of disease however, several clinical symptoms of CJD may mimic those of co-existing morbidities.

Case presentation
We report a male in his 60s with a history of situs inversus totalis and Churg Strauss syndrome, who presented with speech fluency disturbances, neuropsychiatric symptoms and allodynia, a few months after becoming a widower. Initially presumed a bereavement disorder along with a flare-up of Churg Strauss, his symptoms gradually worsened with apraxia, myoclonic jerks and eventually, akinetic mutism. MRI revealed hyperintensities at the caudate nucleus and thalami, while the cerebrospinal fluid was positive for the 14-3-3 protein and the real-time quick test, making the diagnosis of CJD highly probable. This case illustrates the complexities that may arise in diagnosing CJD when pre-existing multimorbidity may cloud the clinical presentation. We also discuss the potential mechanisms underlying the co-occurrence of three rare conditions (situs inversus totalis, Churg Strauss syndrome, CJD) in one patient, taking into consideration the possibility of coincidence as well as common underlying factors.

Conclusions
The diagnosis of CJD may be easily missed when its clinical symptoms are obscured by those of pre-existing (rare) multimorbidity. This case highlights that when the multimorbidity has neurological manifestations, an extensive evaluation remains crucial to establish the diagnosis, minimize the risk of prion-transmission and provide appropriate guidance to patients and their caregivers.
Impact of maternal psoriasis on adverse maternal and neonatal outcomes: a systematic review and meta-analysis
Authors: Rahmati Shoboo , Moameri Hossein , Mohammadi Neda Malek , Norouzi Mojtaba , Ghalekhani Nima , Beigzadeh Amin , Changizi Nasrin , Sharifi Hamid 
Published: September 2023

Abstract
Background
There is a dearth of robust evidence regarding the correlation between psoriasis with maternal and neonatal outcomes, making it challenging to establish definitive recommendations for the management of these patients. This systematic review and meta-analysis aimed to review the evidence with regard to the impact of maternal psoriasis on maternal and neonatal outcomes.

Methods
Following the PRISMA guideline, a systematic search of English articles using PubMed, Embase, Scopus, ScienceDirect, Web of Science, Google Scholar, and the Cochrane Library was conducted. The search was performed from inception to 22nd of May 2022.

Result
A significant association was observed between psoriasis and maternal outcomes, including cesarean delivery [OR = 1.25 (95% CI: 1.13–1.30, p-value = 0.001)], (pre)eclampsia [OR = 1.29 (95% CI: 1.15–1.44, p-value = 0.0001)], gestational diabetes [Odds Ratio (OR) = 1.23 (95% Confidence Intervals (CI): 1.15–1.30, p-value = 0.001)], gestational hypertension [OR = 1.31 (95% CI: 1.18–1.45, p-value = 0.001)] and preterm birth [OR = 1.22 (95% CI: 1.10–1.35, p-value = 0.001)]. Also, there was a significant association between psoriasis and neonatal outcomes, including small for gestational age [OR = 1.07 (95% CI: 1.02–1.11, p-value = 0.053)], low birth weight [OR = 1.19 (95% CI: 1.02–1.38, p-value = 0.001)] and stillbirth [OR = 1.27 (95% CI: 1.04–1.55, p-value = 0.023)].

Conclusion
Maternal psoriasis could negatively impact maternal and neonatal outcomes. Our results strengthen the importance of close monitoring of the mothers’ psoriasis status before and during pregnancy.
Active management of the third stage of labor and associated factors among maternity care providers in public health facilities in Eastern Ethiopia: a multi-center study
Authors: Fissahaye Birhane , Dheresa Merga , Assefa Nega , Tesfaye Dejene , Eyeberu Addis , Balis Bikila , Debella Adera , Gebremichael Berhe , Getachew Tamirat 
Published: September 2023

AbstractIntroductionThe third stage of labor is the shortest, most critical, and hazardous stage as it is linked with postpartum hemorrhage, the leading cause of maternal mortality and morbidity. Postpartum hemorrhage can be prevented by 60% with active management of the third stage of labor (AMTSL). Few studies have been conducted in different parts of Ethiopia showing rates of AMTSL ranging from 16.7% to 43.3%. Limited information, however, exists about its practice in our study area. Thus, we aimed to assess the practice of AMTSL and associated factors among maternity care providers in public health facilities in eastern Ethiopia.MethodsAn institution-based cross-sectional study design was used among 270 maternity care providers in public health facilities in eastern Ethiopia. They were recruited using cluster sampling techniques in their health facilities from July 15—October 30/2021. Pretested self-administered questionnaires and an observational checklist were used to collect data. Descriptive, binary, and multivariable logistic regression analyses were performed. Adjusted odds ratios with 95% confidence intervals were used for statistically significant associations.ResultsGood practice of AMTSL occurred in 40.3% (95% CI: 34.5%—46.1%) of births. Being trained (aOR 3.02; 95% CI 1.60–5.70); presence of birth assistance (aOR 2.9; 95% CI 1.42–6.04); having the highest educational level (aOR 4.21; 95% CI 1.08–16.40); and having good knowledge (aOR 3.00; 95% CI 1.45–6.20) were factors statistically associated with maternity care providers’ good practice of AMTSL.ConclusionActive management of the third stage of labor was practiced with low rates in the study area. Therefore, we suggest that the stakeholders could enhance the presence of birth assistance during all births and provide education to attain higher educational levels and continuously update the maternity care providers’ level of knowledge through comprehensive and on-the-job training to increase the good practice of the third stage of labor.
A registration trend in eyelid skin cancers and associated risk factors in Iran, 2005–2016
Authors: Safi Sare , Ahmadzade Mohadese , Karimi Saeed , Akbari Mohammad Esmaeil , Rouientan Hamidreza , Abolhosseini Mohammad , Rezaei Kanavi Mozhgan , Khorrami Zahra 
Published: September 2023

Abstract
Background
Eyelid skin cancers are the most prevalent ophthalmic malignancies. This study aimed to evaluate the association of the Human Development Index (HDI) and lifestyle risk factors with eyelid skin cancers in Iran.

Methods
This ecological study analyzed the data collected from the Iranian National Population-based Cancer Registry (2005–2016). The data on provincial-level eyelid skin cancer risk factors were obtained from national sources. The association between provincial HDI and lifestyle risk factors with the prevalence of eyelid skin cancers was assessed.

Results
The mean 12-year age-standardized incidence rate (ASIR) of eyelid skin cancers was 16.22 per 100,000 (9,104 cases). The overall ASIR showed an upward trend with an estimated annual average increase of 0.006 per year. There were positive correlations between the prevalence of overall eyelid skin cancers and provincial HDI, smoking, and obesity (r = 0.32, 0.42, and 0.37, respectively). In multivariate analysis, obesity/overweight remained a positive predictor for high prevalence of total eyelid skin cancers (OR = 1.97, 95%CI = 1.08–3.58, P = 0.026), carcinoma (2.10, 1.15–3.83, P = 0.015), and basal cell carcinoma (1.48, 0.99–2.20, P = 0.054).

Conclusions
An increasing trend in ASIR of eyelid skin cancers was observed in more than a decade in Iran which was positively associated with provincial HDI and prevalence of obesity. The findings of the study highlight the importance of promotional programs for preventing obesity/overweight and appropriate allocation of screening facilities based on the HDI level.
AUDIT-C as a possible source of referral during the COVID-19 pandemic for participants presenting patterns of high-risk alcohol consumption in a South African township
Authors: Goldschmidt Lynne , Mncina Buyisile , Langa Malose , Rebello Steven , Budaza Thokozile , Tshabalala Josephine , Kinfu Yohannes , Achoki Tom 
Published: September 2023

Abstract
Background
Unhealthy alcohol use is a leading contributor to premature death and disability worldwide. The World Health Organization’s Global Status Report on Alcohol and Health ranked South Africa as having one of the riskiest patterns of alcohol consumption, which calls for intervention. Recognising the need for effective primary care interventions, particularly in the absence of appropriate alcohol-related harm reduction policies at national and local levels, this paper highlights the opportunities and challenges associated with a two-pronged, community-centred approach to the identification of unhealthy alcohol use and interventions.

Methods
This approach included the use of the Alcohol Use Disorders Identification Test–Consumption (AUDIT-C) as a means of screening to identify individuals at moderate (score of 5–7) to high risk (score of 8 +) alcohol use, raising awareness, and investigating the potential utility of brief advice and referrals as a means of reducing risk.

Results
Of the 54,187 participants, 43.0% reported engaging in moderate-risk alcohol consumption, with 22.1% reporting high-risk alcohol consumption. Resistance to brief advice was observed to increase with higher AUDIT-C scores. Similarly, participants engaging in high-risk alcohol consumption were resistant to accepting treatment referrals, with fewer than 10% open to receiving a referral.

Conclusions
While men were most likely to report patterns of high-risk alcohol consumption, they were more resistant to accepting referrals. Additionally, participants who were willing to receive brief advice were often resistant to taking active steps to alter their alcohol use. This study highlights the need to consider how to prevent harmful patterns of alcohol use effectively and holistically, especially in low socioeconomic settings through primary health care and community services.
Potential molecular targets and drugs for basement membranes-related intervertebral disk degeneration through bioinformatics analysis and molecular docking
Authors: Zhou Zelin , Qin Weicheng , Zhang Peng , He Jiahui , Cheng Zhaojun , Gong Yan , Zhu Guangye , Liang De , Ren Hui , Jiang Xiaobing , Sun Yuping 
Published: October 2023

Abstract
Background
Through bioinformatics analysis to identify the hub genes of Intervertebral disc degeneration (IVDD) associated with basement membranes (BMs) and find out the potential molecular targets and drugs for BMs-related annulus fibrosus (AF) degeneration based on bioinformatic analysis and molecular approach.

Methods
Intervertebral disc degeneration (IVDD) related targets were obtained from GeneCards, DisGenet and OMIM databases. BMs related genes were obtained from Basement membraneBASE database. The intersection targets were identified and subjected to protein-to-protein interaction (PPI) construction via STRING. Hub genes were identified and conducted Gene ontology (GO) and pathway enrichment analysis through MCODE and Clue GO in Cytospace respectively. DSigDB database was retrieved to predict therapeutic drugs and molecular docking was performed through PyMOL, AutoDock 1.5.6 to verify the binding energy between the drug and the different expressed hub genes. Finally, GSE70362 from GEO database was obtained to verify the different expression and correlation of each hub gene for AF degeneration.

Results
We identified 41 intersection genes between 3 disease targets databases and Basement membraneBASE database. PPI network revealed 25 hub genes and they were mainly enriched in GO terms relating to glycosaminoglycan catabolic process, the TGF-β signaling pathway. 4 core targets were found to be significant via comparison of microarray samples and they showed strong correlation. The molecular docking results showed that the core targets have strong binding energy with predicting drugs including chitosamine and retinoic acid.

Conclusions
In this study, we identified hub genes, pathways, potential targets, and drugs for treatment in BMs-related AF degeneration and IVDD.
Curriculum mapping of a dental materials science course: a reality check and way forward
Authors: Lin Galvin Sim Siang , Foo Jia Yee , Foong Chan Choong 
Published: October 2023

Abstract
Background
Dental materials science is an important subject, but research on curriculum mapping in preclinical dental materials science courses is still scarce. The present study aimed to conduct a curriculum mapping in analysing elements and suggesting recommendations for an institutional dental materials science course.

Methods
Curriculum mapping was conducted for the Year 2 undergraduate dental materials science course (Bachelor of Dental Surgery programme) in a Malaysian dental school. Based on Harden’s framework, the following steps were used to map the curriculum of the institutional dental materials science course: (1) scoping the task; (2) deciding the mapping format; (3) populating the windows, and (4) establishing the links. Two analysts reviewed the curriculum independently. Their respective analyses were compared, and discrepancies were discussed until reaching a consensus. A SWOT analysis was also conducted to evaluate the strengths, weaknesses, opportunities, and threats associated with the curriculum.

Results
Course learning outcomes, course contents, levels of cognitive and psychomotor competencies, learning opportunities, learning resources, learning locations, assessments, timetable, staff, curriculum management and students’ information were successfully scoped from the institutional dental materials science course. The present curriculum’s strengths included comprehensiveness, alignment with standards, adequate learning opportunities, well-defined assessment methods, and sufficient learning resources. However, the identified weaknesses were repetition in curriculum content, limited emphasis on the psychomotor domain, dependency on a single academic staff, and limited integration of technology. The SWOT analysis highlighted the opportunities for curriculum improvement, such as revising repetitive content, emphasising the psychomotor domain, and incorporating advanced teaching strategies and technology.

Conclusions
The present dental materials science curriculum demonstrated several strengths with some areas for improvement. The findings suggested the need to revise and optimise the course content to address gaps and enhance student learning outcomes. Ongoing monitoring and evaluation are necessary to ensure the curriculum remains aligned with emerging trends and advancements in dental materials science.
Design and development of a mobile-based self-care application for patients with depression and anxiety disorders
Authors: Moulaei Khadijeh , Bahaadinbeigy Kambiz , Mashoof Esmat , Dinari Fatemeh 
Published: October 2023

Abstract
Background and Aim
Depression and anxiety can cause social, behavioral, occupational, and functional impairments if not controlled and managed. Mobile-based self-care applications can play an essential and effective role in controlling and reducing the effects of anxiety disorders and depression. The aim of this study was to design and develop a mobile-based self-care application for patients with depression and anxiety disorders with the goal of enhancing their mental health and overall well-being.

Materials and methods
In this study we designed a mobile-based application for self -management of depression and anxiety disorders. In order to design this application, first the education- informational needs and capabilities were identified through a systematic review. Then, according to 20 patients with depression and anxiety, this education-informational needs and application capabilities were approved. In the next step, the application was designed.

Results
In the first step, 80 education-information needs and capabilities were identified. Finally, in the second step, of 80 education- informational needs and capabilities, 68 needs and capabilities with a mean greater than and equal to 3.75 (75%) were considered in application design. Disease control and management, drug management, nutrition and diet management, recording clinical records, communicating with physicians and other patients, reminding appointments, how to improve lifestyle, quitting smoking and reducing alcohol consumption, educational content, sedation instructions, introducing health care centers for depression and anxiety treatment and recording activities, personal goals and habits in a diary were the most important features of this application.

Conclusion
The designed application can encourage patients with depression and stress to perform self-care processes and access necessary information without searching the Internet.
Timing of SGLT2i initiation after acute myocardial infarction
Authors: von Lewinski Dirk , Kolesnik Ewald , Aziz Faisal , Benedikt Martin , Tripolt Norbert J. , Wallner Markus , Pferschy Peter N. , von Lewinski Friederike , Schwegel Nora , Holman Rury R. , Oulhaj Abderrahim , Moertl Deddo , Siller-Matula Jolanta , Sourij Harald 
Published: September 2023

Abstract
Background
Pharmacological post-MI treatment is routinely initiated at intensive/cardiac care units. However, solid evidence for an early start of these therapies is only available for dual platelet therapy and statins, whereas data on beta blockers and RAAS inhibitors are heterogenous and mainly limited to STEMI and heart failure patients. Recently, the EMMY trial provided the first evidence on the beneficial effects of SGLT2 inhibitors (SGLT2i) when initiated early after PCI. In patients with type 2 diabetes mellitus, SGLT2i are considered “sick days drugs” and it, therefore, remains unclear if very early SGLT2i initiation following MI is as safe and effective as delayed initiation.

Methods and results
The EMMY trial evaluated the effect of empagliflozin on NT-proBNP and functional and structural measurements. Within the Empagliflozin group, 22 (9.5%) received early treatment (< 24 h after PCI), 98 (42.2%) within a 24 to < 48 h window (intermediate), and 111 (48.1%) between 48 and 72 h (late). NT-proBNP levels declined by 63.5% (95%CI: − 69.1; − 48.1) in the early group compared to 61.0% (− 76.0; − 41.4) in the intermediate and 61.9% (− 70.8; − 45.7) in the late group (n.s.) within the Empagliflozin group with no significant treatment groups—initiation time interaction (pint = 0.96). Secondary endpoints of left ventricular function (LV-EF, e/e`) as well as structure (LVESD and LVEDD) were also comparable between the groups. No significant difference in severe adverse event rate between the initiation time groups was detected.

Conclusion
Very early administration of SGLT2i after acute myocardial infarction does not show disadvantageous signals with respect to safety and appears to be as effective in reducing NT-proBNP as well as improving structural and functional LV markers as initiation after 2–3 days.
Integrative evaluation and experimental validation of the immune-modulating potential of dysregulated extracellular matrix genes in high-grade serous ovarian cancer prognosis
Authors: Wu Qihui , He Xiaoyun , Liu Jiaxin , Ou Chunlin , Li Yimin , Fu Xiaodan 
Published: September 2023

Abstract
Background
High-grade serous ovarian cancer (HGSOC) is a challenging malignancy characterized by complex interactions between tumor cells and the surrounding microenvironment. Understanding the immune landscape of HGSOC, particularly the role of the extracellular matrix (ECM), is crucial for improving prognosis and guiding therapeutic interventions.

Methods and results
Using univariate Cox regression analysis, we identified 71 ECM genes associated with prognosis in seven HGSOC populations. The ECMscore signature, consisting of 14 genes, was validated using Cox proportional hazards regression with a lasso penalty. Cox regression analyses demonstrated that ECMscore is an excellent indicator for prognostic classification in prevalent malignancies, including HGSOC. Moreover, patients with higher ECMscores exhibited more active stromal and carcinogenic activation pathways, including apical surface signaling, Notch signaling, apical junctions, Wnt signaling, epithelial-mesenchymal transition, TGF-beta signaling, and angiogenesis. In contrast, patients with relatively low ECMscores showed more active immune-related pathways, such as interferon alpha response, interferon-gamma response, and inflammatory response. The relationship between the ECMscore and genomic anomalies was further examined. Additionally, the correlation between ECMscore and immune microenvironment components and signals in HGSOC was examined in greater detail. Moreover, the expression of MGP, COL8A2, and PAPPA and its correlation with FAP were validated using qRT-PCR on samples from HGSOC. The utility of ECMscore in predicting the prospective clinical success of immunotherapy and its potential in guiding the selection of chemotherapeutic agents were also explored. Similar results were obtained from pan-cancer research.

Conclusion
The comprehensive evaluation of the ECM may help identify immune activation and assist patients in HGSOC and even pan-cancer in receiving proper therapy.
Minimally invasive valve surgery including patients of combined simultaneous surgery: a retrospective study
Authors: Ling Yun , Chen Huaxin , Zhu Pengxiong , Li Tian , Xue Bangde , Liu Jun 
Published: September 2023

Abstract
Objective
This study investigated the perioperative safety and advantages of performing a minimally invasive valve surgery (MIVS) and conducting a preliminary examination of the combined simultaneous surgery (CSS).

Methods
A total of 29 patients (16 men and 13 women; mean age, 58.41 ± 13.08 years) who underwent MIVS at our center from July 2021 to March 2022 were selected. Among them, 16 patients underwent aortic valve surgery (AVS), 13 patients underwent mitral valve surgery (MVS), and four patients additionally underwent CSS.

Results
The MIVS time ranged from 165 to 420 min, with a mean of 230.54 ± 54.61 min; the cardiopulmonary bypass (CPB) time ranged from 54 to 164 min, with a mean of 120.24 ± 25.98 min; the aortic cross-clamp (ACC) time ranged from 36 to 118 min, with a mean of 78.66 ± 21.01 min and an automatic heart resuscitating rate was 89.66%; the mean tracheal intubation time was 6.30 ± 3.87 h, and the median total postoperative drainage was 317.5 (35, 1470) ml. No difference was observed between preoperative and postoperative left ventricular ejection fraction (LVEF) (61.90% ± 6.28% vs. 60.21% ± 5.52%, P = 0.281). The difference in postoperative drainage (419.20 ml ± 377.20 ml vs. 588.75 ml ± 673.63 ml, P = .461), tracheal intubation time (6.66 h ± 4.27 h vs. 4.63 h ± 1.11 h, P = .359), intensive care unit (ICU) stay (3.96 ± 8.62 days vs. 2.00 ± 0.816 days, P = .658), and postoperative hospital stay (9.96 ± 8.45 days vs. 8.25 ± 1.26 days, P = .694) between MIVS and CSS was not significant.

Conclusion
MIVS in our center may be safe and effective. Additionally, CSS may be a feasible option that could be performed after a thorough preoperative evaluation and multidisciplinary discussion.