bluuebunny/crossref_metadata_2025_split huggingface dataset:
Hyperthyroidism in a Twin Pregnancy With a Hydatidiform Mole and a Coexisting Live Fetus: Management Dilemmas
Authors: Jacobson Samantha , Stetco Jonathan-Raphaël , Brown Richard , Garfield Natasha 
Published: January 2025

Abstract
Hyperthyroidism in twin pregnancies involving a hydatidiform mole and a coexisting live fetus is a rare condition requiring careful management. We present a 34-year-old pregnant woman at 12 weeks' gestation with severe nausea, vomiting, and mild vaginal bleeding. A transvaginal ultrasound revealed a dichorionic diamniotic twin pregnancy with 1 normal fetus and 1 hydatidiform mole, leading to hyperthyroidism from elevated β human chorionic gonadotropin levels. Conservative management without antithyroid medications, combined with regular monitoring, allowed the pregnancy to continue to term, resulting in the delivery of a healthy baby at 39 weeks. Postpartum management required treatment of retained products of conception. This case highlights the complexities in the management of complications for both mother and fetus.
Exploring and Teaching the Medieval in Afro/Africanfuturism
Authors: Tracy Kisha G. 
Published: January 2025

Abstract
This article explores the benefits of introducing undergraduate students to the genre of Afro/Africanfuturism as an entryway for a survey of medieval Africa. By first exploring fiction written by and about African and African diasporic people, students can become oriented to both the unique aspects of African literature and the common elements of the human experience that exist across time periods and geography. The short story “Egoli” by Zimbabwean author T. L. Huchu is an example of Africanfuturism that incorporates medieval African history, literature, culture, language, and heritage as an integral characteristic of its storytelling. Reading and analyzing this story as well as the genre more broadly allows students to identify aspects of African culture that they will then find connections to as they continue on to study medieval Africa and texts such as the Malian Epic of Sundiata. They become more confident in encountering literature from a time and place that may be unfamiliar to them.
Ugly Seed
Authors: Essex Isaac 
Published: January 2025

Abstract
This piece speculates on cross-special interactions and capacities of sesame: its role within global capital markets, its simultaneous capacity as a restorative crop to sites of exhaustion, and its role in trans health care. In these modes the sesame plant extends its reach, coming into relation with multitudinous entities, traversing barriers of laboring and gendered bodies as a bridge between modalities of thinking vis-à-vis extractive environmental degradation and the multiple becomings of trans personhood. Through these fragments, the author endeavors a dialogue between decolonial environmental humanities, anti-extractive modes of thought, and trans studies, moving contemplatively in a hybrid speculation that attempts to hold simultaneous complexities.
Differences in Brain Volume and Thickness between Shammah (Smokeless Tobacco) Users and Non-Users: A Cross-Sectional Study
Authors: Majrashi Naif A. , Alyami Ali S. , Almansour Mohammed Ali , Alyami Mohmmed Hussain , Almansour Mohmmed Hamad , Alhashlan Essa , Shubayr Nasser , Hendi Ali M. , Ageeli Wael A. , Madkhali Yahia , Alwadani Bandar , Refaee Turkey A. , Waiter Gordon D. 
Published: January 2025

Aims/Background Previous research has shown that smoking tobacco is associated with changes or differences in brain volume and cortical thickness, resulting in a smaller brain volume and decreased cortical thickness in smokers compared with non-smokers. However, the effects of smokeless tobacco on brain volume and cortical thickness remain unclear. This study aimed to investigate whether the use of shammah, a nicotine-containing smokeless tobacco popular in Middle Eastern countries, is associated with differences in brain volume and thickness compared with non-users and to assess the influence of shammah quantity and type on these effects. Methods Male shammah users (aged 20 to 47 years, n = 30) and non-users (n = 39) underwent 1.5T magnetic resonance imaging (MRI) scans, and cortical brain volumes and thicknesses were measured using FreeSurfer. Results Significant differences were found in the volume of the right pallidum (p = 0.02), total pallidum (p = 0.02), total ventricle (p = 0.02), middle posterior corpus callosum (p = 0.04), and brainstem (p = 0.02) between shammah users and non-users. Furthermore, yellow shammah users exhibited smaller volumes in the right lateral ventricle (p = 0.02), total lateral ventricle (p = 0.03), and right putamen (p = 0.02) compared with users of other types of shammah. Regarding cortical thickness, significant differences were observed in the right medial orbito-frontal thickness (p = 0.03), left rostral middle frontal thickness (p = 0.03), and right rostral anterior cingulate thickness (p = 0.04). Conclusion These findings shed light on the potential neurobiological effects of shammah use, particularly the yellow shammah, and highlighting the need for further research to fully understand its implications for brain structure and function.
Community and familial dynamics influencing risk behavior for HIV acquisition among adolescent girls and young women in Uganda: Qualitative analysis using Protective Motivation Theory
Authors: Apondi Rose , Bastiaens Hilde , Nöstlinger Christiana , Galbraith Jennifer , Aholou Tiffiany M. , Medley Amy , Wanyenze Rhoda K. , Awor Anna C. , Serwadda David M. , Aluzimbi George , Cheptoris Juliet , Ogwal Moses , Nakyanjo Neema , Patel Pragna 
Published: January 2025

Background
In Uganda, adolescent girls’, and young women’s (AGYW-15-24 years) current HIV prevalence is fourfold compared with their male counterparts due to compounded social, economic, and environmental factors. Using the Protective Motivation Theory (PMT), we explored HIV-acquisition risk sources and perceived protective factors from AGYW and caregivers’ perspective.

Materials and methods
During 2018, we conducted a qualitative study guided by PMT to explore factors influencing HIV acquisition among AGYW. We purposively sampled two groups of key informants, AGYW at high-risk for HIV acquisition (uninfected) and AGYW living with HIV, varied by age and place of residence (urban/rural). We conducted 34 focus group discussions with AGYW, nine with AGYW parents, and 25 key informant interviews. Data were analyzed using the framework method based on the PMT and developed from participants’ narratives.

Results
AGYW were knowledgeable about HIV, HIV acquisition risk factors, and HIV prevention interventions. Nonetheless, few AGYW knew about pre-exposure prophylaxis (PrEP). Imbalance in power relations between the genders explained inability of AGYW making safe healthy decisions, with social norms giving men power over women. Parents modelling positively influenced HIV risk behavior. Many AGYW viewed staying in school a protective factor both while at school and further for life. AGYW identified alcohol use, desire for material possessions, discounting HIV disease severity, social norms, and poverty as barriers to engaging in self-protective behaviors. Several AGYW believed that access to AGYW-focused programs would facilitate healthy sex-positive, protective behaviors.

Discussion
While PMT focuses on individual factors confirmed by our findings, we found HIV risk behavior to be influenced by complex contextual factors including poverty, gender inequality and cultural norms. Distinct HIV risk factors among AGYW require policy and comprehensive targeted interventions addressing violence, alcohol consumption, increased economic opportunities, educational opportunities, safe-sex practices, and PrEP scale-up which may prevent HIV in AGYW and facilitate HIV epidemic control.
Acceptability, feasibility and appropriateness of intensified health education, SMS/phone tracing and transport reimbursement for uptake of voluntary medical male circumcision in a sexually transmitted infections clinic in Malawi: A mixed methods study
Authors: Matoga Mitch M. , Kudowa Evaristar , Tsidya Mercy , Tseka Jennifer , Ndalama Beatrice , Bonongwe Naomi , Mathiya Esther , Jere Edward , Yatina Dumbo , Kamtambe Blessings , Hosseinipour Mina C. , Chasela Charles S. , Jewett Sara 
Published: January 2025

Introduction
Uptake of voluntary medical male circumcision (VMMC) remains a challenge in many settings. Innovative implementation strategies are required to scale-up VMMC uptake.

Methodology
RITe was a multi-faceted intervention comprising transport reimbursement (R), intensified health education (IHE) and SMS/Telephone tracing (Te), which increased the uptake of VMMC among uncircumcised men with sexually transmitted infections (STIs) in Malawi. Using a concurrent exploratory mixed-method approach, we assessed the intervention’s acceptability, feasibility and appropriateness among men with STIs and healthcare workers (HCWs) at Bwaila District Hospital. Participants completed Likert scale surveys and participated in-depth interviews (IDIs) and focus group discussions (FGDs). We calculated percentages of responses to survey items and summarized common themes using thematic analysis. Median scores and interquartile ranges (IQR) were calculated for acceptability, feasibility and appropriateness of each strategy at baseline and end-line and compared using the Wilcoxon signed rank test.

Results
A total of 300 surveys, 17 IDIs and 4 FGDs were conducted with men and HCWs between baseline and end-line. The mean age for men in the survey was 29 years (SD ±8) and most were married/cohabiting (59.3%). Mean age for HCWs was 38.5 years (SD ±7), and most were female (59.1%). For acceptability, participants agreed that RITe was welcome, approvable, and likable. Despite participants agreeing that RITe was a good idea, fit and suitability influenced appropriateness, particularly at baseline, which improved at end-line for Te and R. For feasibility, HCWs agreed that RITe was easy to implement, but expressed concerns that R (end-line median = 4, IQR: 2, 4) and Te (end-line median = 4, IQR: 4, 4), were unsustainable. Interviews corroborated the survey results. Participants reported that IHE provided important information, Te was a good reminder and R was attractive, but they reported barriers to R and Te such as electricity, limited access to phones and distrust in the government.

Conclusions
The RITe intervention was acceptable, feasible and appropriate. However, culture/religion and structural barriers affected perceptions of appropriateness and feasibility, respectively. Continued awareness raising on VMMC and addressing setting-specific structural factors are required to overcome barriers that impede demand-creation interventions for VMMC.
Treatment of refractory poly articular course juvenile idiopathic arthritis with tofacitinib: Extended experience from Bangladesh
Authors: Iman Kazi , Akter Laboni , Rahman Mohammad Masudur , Laila Kamrul , Islam Mohammad Imnul , Rahman Shahana A. 
Published: January 2025

Background
Juvenile Idiopathic arthritis (JIA) is one of the most common chronic diseases in children. It still remains a challenge to treat refractory poly-articular course JIA patients, especially in Bangladesh, where patients from low socio-economic backgrounds are unable to manage biological agents. Tofacitinib is one of the alternative options to biological agents, which can be taken orally and is cost effective. The purpose of this prospective observational study was to evaluate the efficacy of tofacitinib in the treatment of refractory poly-articular course JIA cases.

Materials and methods
This study was carried out in the Department of Pediatrics, Bangabandhu Sheikh Mujib Medical University (BSMMU). A total number of 50 refractory polyarticular course JIA patients received JAK-2 inhibitor, tofacitinib along with other drugs according to the recommended doses. The disease activity level was measured by Juvenile Arthritis Disease Activity Score-27 (JADAS-27). All the cases were assessed at baseline, 6th, 12th and52nd week of tofacitinib therapy. The relevant statistical tests were applied for data analysis.

Results
After treating the refractory cases with tofacitinib, arthritis subsided, and laboratory parameters improved in all the cases. Overall JADAS-27 score improvement was 40.67%, 56.38% and 96% at 6th, 12th and 52nd week of follow-up respectively. It was also possible to taper the dose of steroid gradually and stopped it by 24 weeks. Tofacitinib was well tolerated with minimum side effects.

Conclusions
Tofacitinib was effective to all the children with poly-articular course JIA. It was well tolerated and had very few tolerable adverse effects.
Expanded non-invasive prenatal testing offers better detection of fetal copy number variations but not chromosomal aneuploidies
Authors: Yang Shaozhe , Zhuang Yuan , Li Junfeng , Fu Xiuhong 
Published: January 2025

Purpose
To evaluate the clinical performance of expanded non-invasive prenatal testing (NIPT-plus) and compare its effectiveness in screening for chromosomal aneuploidies with that of NIPT.

Methods
Screening results, confirmatory invasive testing results, and follow-up data from pregnant women who underwent either NIPT (6792 cases) or NIPT-Plus (5237 cases) testing at Luohe Central Hospital, China, from January 2019 to June 2023 were collected. The positive predictive value (PPV), sensitivity, specificity, and other indicators for different types of chromosomal abnormalities in NIPT/NIPT-plus screening were calculated. The willingness of pregnant women with various types of abnormalities to undergo confirmatory invasive testing and the proportion of pregnancy terminations were investigated.

Results
The average number of unique reads in NIPT-plus samples was 5.26 times greater than that in NIPT samples. There was no significant difference in the PPV or positive rate between NIPT-plus and NIPT for screening chromosomal aneuploidies. Compared with the low-risk group, the high-risk group had a greater PPV; however, in the NIPT-plus group, there was no significant disparity in the PPV between the low-risk and high-risk groups. Compared with rare autosomal aneuploidies (RAAs), pregnant women had a higher rate of confirmatory invasive testing for common trisomies, sex chromosomal abnormalities (SCAs), and copy number variations (CNVs). However, the rate of pregnancy termination for common trisomies, RAAs, and CNVs was higher than that for SCAs.

Conclusion
By enhancing sequencing data, NIPT-plus can effectively screen for CNVs as well as chromosomal aneuploidies. However, NIPT-plus does not have an advantage over standard NIPT in screening for chromosomal aneuploidies.
Prediction of mortality and prioritisation to tertiary care using the ‘OUR-ARCad’ risk score gleaned from the second wave of COVID-19 pandemic—A retrospective cohort study from South India
Authors: Gopalan Narendran , Viswanathan Vinod Kumar , Srinivasalu Vignes Anand , Arumugam Saranya , Bhaskar Adhin , Manoharan Tamizhselvan , Chandrasekar Santosh Kishor , Bujagaruban Divya , Arumugham Ramya , Jagadeeswaran Gopi , Pandian Saravanan Madurai , Ponniah Arunalatha , Senguttuvan Thirumaran , Chinnaiyan Ponnuraja , Dhanraj Baskaran , Chadha Vineet Kumar , Purushotham Balaji , Murhekar Manoj Vasanth 
Published: January 2025

Background
Judicious utilisation of tertiary care facilities through appropriate risk stratification assumes priority, in a raging pandemic, of the nature of delta variant-predominated second wave of COVID-19 pandemic in India. Prioritisation of tertiary care, through a scientifically validated risk score, would maximise recovery without compromising individual safety, but importantly without straining the health system.

Methods
De-identified data of COVID-19 confirmed patients admitted to a tertiary care hospital in South India, between April 1, 2021 and July 31, 2021, corresponding to the peak of COVID-19 second wave, were analysed after segregating into ‘survivors’ or ‘non-survivors’ to evaluate the risk factors for COVID-19 mortality at admission and formulate a risk score with easily obtainable but clinically relevant parameters for accurate patient triaging. The predictive ability was ascertained by the area under the receiver operator characteristics (AUROC) and the goodness of fit by the Hosmer-Lemeshow test and validated using the bootstrap method.

Results
Of 617 COVID-19 patients (325 survivors, 292 non-survivors), treated as per prevailing national guidelines, with a slight male predilection (358/617 [58.0%]), fatalities in the age group above and below 50 years were (217/380 [57.1%]) and (75/237 [31.6%]), p<0.001. The relative distribution of the various parameters among survivors and non-survivors including self-reported comorbidities helped to derive the individual risk scores from parameters significant in the multivariable logistic regression. The ‘OUR-ARCad’ risk score components were—Oxygen saturation SaO2<94%-23, Urea > 40mg/dL-15, Neutrophil/Lymphocytic ratio >3–23, Age > 50 years-8, Pulse Rate >100–8 and Coronary Artery disease-15. A summated score above 50, mandated tertiary care management (sensitivity-90%, specificity-75%; AUC-0.89), validated in 2000 bootstrap dataset.

Conclusions
The OUR-ARCad risk score, could potentially maximize recovery in a raging COVID-19 pandemic, through prioritisation of tertiary care services, neither straining the health system nor compromising patient’s safety, delivering and diverting care to those who needed the most.
Healthcare resource utilization and costs in immunodeficient patients receiving subcutaneous Ig: Real-world evidence from France
Authors: Lefèvre Guillaume , Borget Isabelle , Lefèvre Cinira , Maherzi Chahrazed , Nucit Arnaud , Hennaoui Mouna , Schmidt Aurélie , Lennon Hannah , Grenier Benjamin , Daydé Florent , Mahlaoui Nizar 
Published: January 2025

Background
Subcutaneous immunoglobulin (SCIg) replacement therapy is indicated for patients with hypogammaglobulinemia caused by primary (PID) and secondary immunodeficiencies (SID).

Objective
To compare healthcare resource utilization (HCRU) and related direct medical costs of patients in France treated with weekly conventional SCIg (cSCIg) vs monthly hyaluronidase-facilitated SCIg (fSCIg).

Methods
This retrospective study of Ig-naïve patients with PID or SID newly receiving a SCIg between 2016 and 2018, extracted from the French National Healthcare reimbursement database (SNDS), analyzed the SCIg-related HCRU and reimbursed costs generated from in-hospital (hospitalizations and SCIg doses) or at-home (nurse visits [NV] and pump provider visits [PPV], drug doses) SCIg administration.

Results
Overall, 2,012 patients (PID:534; SID:1,478) were analyzed. The follow-up duration varied between 7.5 and 8.7 months according to sub-groups. Compared with fSCIg-treated patients, monthly mean rates of NV and PPV were respectively 2.5 and 3.1 times higher in PID, and 1.6 and 3.1 times higher in SID cSCIg-treated patients. Monthly mean rates for SCIg administration-related hospitalizations were lower overall, while their costs were 1.6 and 1.8 times higher for cSCIg than fSCIg subgroups, in PIDs and SIDs respectively; these results are due to more frequent hospitalizations with fSCIg being mainly shorter, without stayover. Total HCRU costs from the French NHI’s perspective were estimated to be lower with fSCIg vs cSCIg, in PIDs and SIDs.

Conclusion
This study provides real-world evidence of SCIg administration in a large French population. Patients with PID or SID treated with fSCIg had fewer at-home HCRU and lower overall costs for in-hospital or at-home SCIg administration compared with cSCIg-treated patients.
Magnetic resonance angiography in diagnostic long-term follow-up of primary patency of the MOTIV drug-eluting bioresorbable vascular scaffold in the region below the knee: 5 years of experience
Authors: Nasel Christian , Kirschner Mario , Rizzi Karoline , Schweinhammer Nicola , Moser Ewald 
Published: January 2025

Purpose
Treatment of peripheral artery disease (PAD) in the region below the knee (BTK) is dissatisfying as failure of treated target lesions (TLF) is frequent and diagnostic imaging is often challenging. In the BTK-region metallic drug-eluting stents (mDES) yielded best results concerning primary patency (PP), but also annihilate signal in magnetic resonance angiography (MR-A). A recently introduced non-metallic drug eluting bioresorbable Tyrocore® vascular scaffold (deBVS), that offers an option for re-treatment of lesions due to its full degradation within 3–4 years after placement, was investigated with respect to its compatibility with MR-A to unimpededly depict previously treated target lesions.

Methods
Patency of the deBVS in the BTK-region was assessed retrospectively using contrast enhanced MR-A of the lower limbs in patients with PAD of Lafontaine-grades II-IV (n = 19). Clinically driven MR-A censoring was triggered by an assumed target lesion failure (CD-TLF), which served to compute the probability of PP during the observation period of 5 years. Compatibility of this particular deBVS with MRI was additionally proven via in-vitro experiments.

Results
The scaffold was found to be fully compatible with MRI. The normalised intra-luminal signal measured in MR-A increased significantly after successful deBVS-placement. The retrospective 5-years PP-probability was 0.87 (CI95%: [0.71,1.0]) with 2 stent-occlusions observed after 90 days. No major adverse events occurred.

Conclusion
Assessment of PAD in the BTK-region after placement of the Tyrocore®-deBVS using MRA is feasible. The promising high PP-probability after 5-years and the persistent full interpretability of treated target lesions by MR-A after stent-placement encourage further prospective assessment of this deBVS in treatment of PAD in the BTK-region.
Travel medicine training and experience among primary care physicians in Qatar
Authors: Al-Dahshan Ayman , Kehyayan Vahe , Al-Kubaisi Noora , Mahfoud Ziyad , Selim Nagah 
Published: January 2025

Background
Travel medicine (TM) focuses on preventing and managing travel-related issues. Evidence has become more important than expert opinions in the development of TM standards. This study aimed to evaluate the training and experience of TM among Primary Care Physicians (PCPs) in Qatar and their associated factors.

Methods
A cross-sectional study design was employed. A structured questionnaire was utilized to gather data from all PCPs working in publicly funded primary health centers.

Results
The study involved 360 PCPs (response rate: 89.5%). Of these, 42.3% reported postgraduate training (15.1%) or experience (27.5%) in TM, with common training forms including workshops (67%), postgraduate programs (24%), and short courses (15%). About 81.8% expressed interest in TM training. Regarding confidence in practicing TM, 20% felt very confident, while 50% felt moderately confident. In practice, 25.8% conducted comprehensive pre-travel risk assessments, and 22.5% responded to traveler queries without formal consultations. Multivariable logistic regression analysis showed that PCPs who graduated from medical schools in Arab countries, conducting more than ten TM consultations per month, performing comprehensive pre-travel assessments, and those expressing high confidence were more likely to be associated with TM training or experience.

Conclusion
Many PCPs in Qatar lack prior training and experience in TM, raising concerns about their ability to provide adequate care to traveling patients. There is a significant need for targeted TM training for PCPs, especially since the majority express a keen interest in receiving such training.