bluuebunny/crossref_metadata_2025_split huggingface dataset:
The tuberculous pleural effusion
Authors: McNally Emma , Ross Clare , Gleeson Laura E. 
Published: December 2023

Pleural tuberculosis (TB) is a common entity with similar epidemiological characteristics to pulmonary TB. It represents a spectrum of disease that can variably self-resolve or progress to TB empyema with severe sequelae such as chronic fibrothorax or empyema necessitans. Coexistence of and progression to pulmonary TB is high. Diagnosis is challenging, as pleural TB is paucibacillary in most cases, but every effort should be made to obtain microbiological diagnosis, especially where drug resistance is suspected. Much attention has been focussed on adjunctive investigations to support diagnosis, but clinicians must be aware that apparent diagnostic accuracy is affected both by the underlying TB prevalence in the population, and by the diagnostic standard against which the specified investigation is being evaluated. Pharmacological treatment of pleural TB is similar to that of pulmonary TB, but penetration of the pleural space may be suboptimal in complicated effusions. Evidence for routine drainage is limited, but evacuation of the pleural space is indicated in complicated disease.Educational aimsTo demonstrate that pleural TB incorporates a wide spectrum of disease, ranging from self-resolving lymphocytic effusions to severe TB empyema with serious sequelae.To emphasise the high coexistence of pulmonary TB with pleural TB, and the importance of obtaining sputum for culture (induced if necessary) in all cases.To explore the significant diagnostic challenges posed by pleural TB, and consequently the frequent lack of information about drug sensitivity prior to initiating treatment.To highlight the influence of underlying TB prevalence in the population on the diagnostic accuracy of adjunctive investigations for the diagnosis of pleural TB.To discuss concerns around penetration of anti-TB medications into the pleural space and how this can influence decisions around treatment duration in practice.
Use of exhaled nitric oxide in the diagnosis and monitoring of childhood asthma: myth or maxim?
Authors: Fraser Anna , Simpson Ruaraidh , Turner Steve 
Published: December 2023

Asthma is a common condition in children. This review describes the evidence from the literature and international asthma guidelines for using fractional exhaled nitric oxide (FENO) in the diagnosis and monitoring of childhood asthma. The accuracy ofFENOmeasuring devices could be further improved, the difference inFENOresults between devices are equivalent to what is considered a clinically important difference. For diagnosing asthma no guideline currently recommendsFENOis used as the first test, but many recommendFENOas part of a series of tests. A cut-off of 35 ppb is widely recommended as being supportive of an asthma diagnosis, but evidence from children at risk of asthma suggests that a lower threshold of 25 ppb may be more appropriate. Nine randomised clinical trials including 1885 children have addedFENOto usual asthma care and find that exacerbations are reduced when care is guided byFENO(OR for exacerbation compared to usual care 0.77, 95% CI 0.62–0.94). What is not clear is what cut-off(s) ofFENOshould be used to trigger a change in treatment. After 30 years of intensive research there is not sufficient evidence to recommendFENOfor routine diagnosing and monitoring asthma in children.Educational aimsTo give the reader an overview of literature that supports and does not support the role ofFENOin diagnosing asthma in children.To give the reader an overview of literature that supports and does not support the role ofFENOin monitoring asthma in children.To give the reader an understanding of the role ofFENOin international guidelines for diagnosing and monitoring asthma in children.
Which inflammatory marker, between systemic immune-inflammation index and neutrophil to eosinophil ratio, is associated with Peyronie’s disease and are there any implications for a better understanding of its mechanisms?
Authors: Crocetto Felice , Imbimbo Ciro , Barone Biagio , Turchino Davide , Bracale Umberto Marcello , Peluso Antonio , Panagrosso Marco , Falcone Alfonso , Mirto Benito Fabio , De Luca Luigi , Sicignano Enrico , Del Giudice Francesco , Busetto Gian Maria , Lucarelli Giuseppe , Giampaglia Gaetano , Manfredi Celeste , Ferro Matteo , Tarantino Giovanni 
Published: December 2023

Abstract
Background
Peyronie’s disease affects up to 9% of men and is often accompanied by pain and/or erectile dysfunction. It is characterized by an inflammatory process that is the grassroots of the subsequent fibrosis stage. There is an unmet need to evaluate its onset and progression. Among the newly proposed biomarkers of inflammation, authors developed a novel systemic immune-inflammation index (SII) based on lymphocyte, neutrophil, and platelet counts. Similarly, a recent study reported that a neutrophil-to-eosinophil ratio (NER) represents systemic inflammation.

Results
A 49-patient group with Peyronie’s disease as confronted with 50 well-matched for age and BMI controls. As laboratory evaluation of inflammation, SII, NER and the eosinophil to neutrophil ratio (ENR) were studied. As a likely risk factor for the presence of Peyronie’s disease, a higher prevalence of hypercholesterolemia, hyperglycemia and hypertension was discovered in the patients compared to controls. A significant difference was found in the median values of the NER between the two selected groups, i.e., 32.5 versus 17.3 (p = 0.0021). As expected, also ENR was significantly different. The receiver operating characteristic curves for SII, ENR and NER were 0.55, 0.32 and 0.67, respectively, highlighting the best performance of NER. The cut-off for NER was 12.1, according to the Youden test.

Conclusions
According to our results, any evaluation of circulating eosinophil, evaluated as NER, beyond being a signature of immuno-inflammatory response, help assess tissue homeostasis, since eosinophils are now considered multifunctional leukocytes and give a picture of the inflammatory process and repair process belonging to Peyronie’s disease.
Natural clines and human management impact the genetic structure of Algerian honey bee populations
Authors: Salvatore Giovanna , Chibani Bahi Amar Amira , Canale-Tabet Kamila , Fridi Riad , Tabet Aoul Nacera , Saci Soumia , Labarthe Emmanuelle , Palombo Valentino , D’Andrea Mariasilvia , Vignal Alain , Faux Pierre 
Published: December 2023

Abstract
Background
The Algerian honey bee population is composed of two described subspecies A. m. intermissa and A. m. sahariensis, of which little is known regarding population genomics, both in terms of genetic differentiation and of possible contamination by exogenous stock. Moreover, the phenotypic differences between the two subspecies are expected to translate into genetic differences and possible adaptation to heat and drought in A. m. sahariensis. To shed light on the structure of this population and to integrate these two subspecies in the growing dataset of available haploid drone sequences, we performed whole-genome sequencing of 151 haploid drones.

Results
Integrated analysis of our drone sequences with a similar dataset of European reference populations did not detect any significant admixture in the Algerian honey bees. Interestingly, most of the genetic variation was not found between the A. m. intermissa and A. m. sahariensis subspecies; instead, two main genetic clusters were found along an East–West axis. We found that the correlation between genetic and geographic distances was higher in the Western cluster and that close-family relationships were mostly detected in the Eastern cluster, sometimes at long distances. In addition, we selected a panel of 96 ancestry-informative markers to decide whether a sampled bee is Algerian or not, and tested this panel in simulated cases of admixture.

Conclusions
The differences between the two main genetic clusters suggest differential breeding management between eastern and western Algeria, with greater exchange of genetic material over long distances in the east. The lack of detected admixture events suggests that, unlike what is seen in many places worldwide, imports of queens from foreign countries do not seem to have occurred on a large scale in Algeria, a finding that is relevant for conservation purposes. In addition, the proposed panel of 96 markers was found effective to distinguish Algerian from European honey bees. Therefore, we conclude that applying this approach to other taxa is promising, in particular when genetic differentiation is difficult to capture.
PAPerFly: Partial Assembly-based Peak Finder for ab initio binding site reconstruction
Authors: Faltejsková Kateřina , Vondrášek Jiří 
Published: December 2023

Abstract
Background
The specific recognition of a DNA locus by a given transcription factor is a widely studied issue. It is generally agreed that the recognition can be influenced not only by the binding motif but by the larger context of the binding site. In this work, we present a novel heuristic algorithm that can reconstruct the unique binding sites captured in a sequencing experiment without using the reference genome.

Results
We present PAPerFly, the Partial Assembly-based Peak Finder, a tool for the binding site and binding context reconstruction from the sequencing data without any prior knowledge. This tool operates without the need to know the reference genome of the respective organism. We employ algorithmic approaches that are used during genome assembly. The proposed algorithm constructs a de Bruijn graph from the sequencing data. Based on this graph, sequences and their enrichment are reconstructed using a novel heuristic algorithm. The reconstructed sequences are aligned and the peaks in the sequence enrichment are identified. Our approach was tested by processing several ChIP-seq experiments available in the ENCODE database and comparing the results of Paperfly and standard methods.

Conclusions
We show that PAPerFly, an algorithm tailored for experiment analysis without the reference genome, yields better results than an aggregation of ChIP-seq agnostic tools. Our tool is freely available at https://github.com/Caeph/paperfly/ or on Zenodo (https://doi.org/10.5281/zenodo.7116424).
Role of family factors in provision and perception of social support for older people in Iran: a cross-sectional survey
Authors: Tajvar Maryam , Grundy Emily , Fletcher Astrid , Allen Elizabeth , Karami Badriyeh 
Published: December 2023

Abstract
Background
Iran has experienced a very fast fertility transition. The process of demographic transition, coupled with modernization, has had considerable consequences for the structure and function of families. There is rising concern in Iran about a potential decline in family care and support for older people as a result of these changes. The main aim of this study was to provide a benchmark by examining current associations between family factors and older people’s social support, both perceived and received.

Methods
A cross-sectional survey of a random sample of 644 people aged 60 + years resident in Tehran was conducted using stratified cluster random sampling method in 2015. Outcome variables were perceived social support, as measured by Social Provision Scale, and received instrumental social support. Multilevel mixed-effects models were used to examine the hypotheses.

Results
The analyses showed that most of the family factors measured, including family size (p = 0.01), living arrangements (p = 0.05), and amount of contact with family members (p = 0.001) were associated with older people’s receipt of instrumental social support. Living arrangements and quality of relationships with family members were associated with older people’s perceptions of social support (p < 0.001). Also, a significant gender interaction was found in associations between family size and SPS (p = 0.03). Having a large size family was positively associated with higher SPS for women (Coef. = 3.9, p = 0.009) but not for men (Coef. = -0.4, p = 0.7).

Conclusion
findings of this study support the premise that most of family factors play an important role in provision and perception of social support for Iranian older people. Further policies should mostly be selective of those at higher risk of low support such as widowed, childless, those living alone, having poor relationship with their relatives and those with worse health status. The results of this study may be utilized to target older populations who are at higher risk of low support with innovative programs that focus on building social networks and enhancing social support.
Effectiveness and safety of adalimumab in patients with intestinal Behçet’s disease: a real-world prospective observational study in South Korea
Authors: Yu Jongwook , Shin Sung Jae , Park Yune-Jung , Kim Hyung Wook , Lee Bo-In , Ye Byong Duk , Kim Geun-Tae , Kim Sung Kook , Kim Joo Sung , Kim Young-Ho , Jeong Seonjeong , Cheon Jae Hee 
Published: December 2023

Abstract
Background
Intestinal Behçet’s disease (BD) is characterized by typical gastrointestinal ulcers in patients with BD followed by complications such as bleeding, perforation and fistula. Biologic agents are currently under active investigation to delay the disease course. Various data regarding infliximab are available, but there is relatively lack of data regarding adalimumab.

Methods
This was a multicenter, real-world prospective observational study to evaluate the effectiveness and safety of adalimumab in intestinal BD. The primary endpoint was disease activity at each follow up, including disease activity index for intestinal Behçet’s disease (DAIBD), serum C-reactive protein (CRP) level, and endoscopic findings. The secondary endpoint was the incidence of adverse drug reactions (ADRs).

Results
A total of 58 patients were enrolled and 8 of them were excluded. Adverse events were reported in 72.0% of patients with 122 events. ADRs were reported in 24.0% with 28 events. For adverse events, arthralgia was most commonly reported (13.1%: 16/122) and only one experienced critical adverse event (0.82%, 1/122: death due to stroke). On multivariable regression analysis, a longer disease duration was significantly associated with decreased ADRs [Odds ratio 0.976 (0.953–0.999, 95% CI); p = 0.042]. Clinical response rates as assessed by DAIBD were 90.9% at Week 12 and 89.7% at Week 56, respectively. The mean serum CRP level at baseline was significantly decreased after 12 weeks (3.91 ± 4.93 to 1.26 ± 2.03 mg/dL; p = 0.0002).

Conclusion
Adalimumab was found to be safe and effective in Korean patients with intestinal BD. A longer disease duration was significantly associated with decreased ADRs.
An evolutionary game-based simulation study of a multi-agent governance system for smart senior care services in China
Authors: Shi Qiannan , Yang Shumian , Wang Na , Zhang Shu-e , Wang Yanping , Wu Bing , Lu Xinyuan , She Yining , Yue Zhihao , Gao Lei , Zhang Zhong 
Published: December 2023

Abstract
Background
The competing interests of the government, smart senior care technology service providers, and older adults have led to a serious fragmentation of governance in China. This study aims to identify the collaboration mechanisms and evolutionary stabilization strategies for these agents.

Methods
An evolutionary game model is developed to analyze the strategic decisions made by the government, smart senior care technology service providers, and older adults. A sensitivity analysis is conducted using data from Anhui Province, China, to verify the effects of relevant parameters on the strategy decisions of each agent.

Results
The results of the simulation and sensitivity analysis indicated that, first, despite changes in the initial willingness values of the tripartite agents, the system eventually converges on 1. Second, the collaboration mechanism of the tripartite agents in the smart senior care system is related to government incentives, penalties, and subsidies, smart senior care service costs, and the additional benefits provided to smart senior care technology service providers.

Conclusion
The strategy decisions of the government, providers, and older adults interact with each other. To promote collaboration among the tripartite agents and improve governance effectiveness, the government should strengthen the regulations for providers, increase penalties for providers that engage in a breach of trust, provide moderate incentives and subsidies, and control smart senior care service costs.
A case of TM infection with challenging differential diagnosis from lymphoma post-renal transplant
Authors: Luo Sulin , Wang Xingxia , Ren Xue , Cheng Yamei , Guo Luying , Yan Pengpeng , Lv Junhao , Su Xinhui , Shen Jia , Zhao Kui , Sun Ke , Chen Jianghua , Wang Rending 
Published: December 2023

Abstract
Background
Lymphomas involving the gastrointestinal tract may be manifested as anti-inflammatory tract bleeding, abdominal lymph node enlargement, or even perforation of the gastrointestinal tract. After organ transplantation, the likelihood of post-transplant lymphoproliferative disorders increases, and some rare infections may also appear.

Case presentation
Herein, we report a living transplant patient with talaromycosis marneffei (TSM) or Talaromyces marneffei (TM) infection with gastrointestinal hemorrhage and systemic lymph node enlargement, which presented clinically as lymphoma.

Conclusion
This case is TSM in a kidney transplant patient, confirmed by lymph node biopsy and blood culture. The patient discharged from hospital successfully under the treatment of antifungal therapy and immunosuppressive therapy. Physicians should be aware that TSM can mimic lymphoma, and early diagnosis and treatment can benefit the outcomes.
The Carolina hysterectomy cohort (CHC): a novel case series of reproductive-aged hysterectomy patients across 10 hospitals in the US south
Authors: Haji-Noor Zakiya M. , Mathias Joacy G. , Beltran Theo Gabriel , Anderson Lauren G. , Wood Mollie E. , Howard Annie Green , Hinton Sharon Peacock , Doll Kemi M. , Robinson Whitney R. 
Published: December 2023

Abstract
Background
Hysterectomy is a common surgery among reproductive-aged U.S. patients, with rates highest among Black patients in the South. There is limited insight on causes of these racial differences. In the U.S., electronic medical records (EMR) data can offer richer detail on factors driving surgical decision-making among reproductive-aged populations than insurance claims-based data. Our objective in this cohort profile paper is to describe the Carolina Hysterectomy Cohort (CHC), a large EMR-based case-series of premenopausal hysterectomy patients in the U.S. South, supplemented with census and surgeon licensing data. To demonstrate one strength of the data, we evaluate whether patient and surgeon characteristics differ by insurance payor type.

Methods
We used structured and abstracted EMR data to identify and characterize patients aged 18–44 years who received hysterectomies for non-cancerous conditions between 10/02/2014–12/31/2017 in a large health care system comprised of 10 hospitals in North Carolina. We used Chi-squared and Kruskal Wallis tests to compare whether patients’ socio-demographic and relevant clinical characteristics, and surgeon characteristics differed by patient insurance payor (public, private, uninsured).

Results
Of 1857 patients (including 55% non-Hispanic White, 30% non-Hispanic Black, 9% Hispanic), 75% were privately-insured, 17% were publicly-insured, and 7% were uninsured. Menorrhagia was more prevalent among the publicly-insured (74% vs 68% overall). Fibroids were more prevalent among the privately-insured (62%) and the uninsured (68%). Most privately insured patients were treated at non-academic hospitals (65%) whereas most publicly insured and uninsured patients were treated at academic centers (66 and 86%, respectively). Publicly insured and uninsured patients had higher median bleeding (public: 7.0, uninsured: 9.0, private: 5.0) and pain (public: 6.0, uninsured: 6.0, private: 3.0) symptom scores than the privately insured. There were no statistical differences in surgeon characteristics by payor groups.

Conclusion
This novel study design, a large EMR-based case series of hysterectomies linked to physician licensing data and manually abstracted data from unstructured clinical notes, enabled identification and characterization of a diverse reproductive-aged patient population more comprehensively than claims data would allow. In subsequent phases of this research, the CHC will leverage these rich clinical data to investigate multilevel drivers of hysterectomy in an ethnoracially, economically, and clinically diverse series of hysterectomy patients.
Effect of empathy competence on moral sensitivity in Chinese student nurses: the mediating role of emotional intelligence
Authors: Liu Fang , Zhou Hengyu , Yuan Long , Cai Ying 
Published: December 2023

Abstract
Background
Ethical issues may pose challenges to nursing students entering clinical practice. Moral sensitivity can assist them in recognising existing moral situations and then taking adequate action. Identifying the variables associated with moral sensitivity may be useful in preparing to improve nursing students' moral sensitivity.

Objectives
This study investigated empathy, emotional intelligence, and moral sensitivity in Chinese student nurses to explore the association among these three factors and to verify the mediating function of emotional intelligence in determining the connection between empathy and moral sensitivity.

Design
This study used a cross-sectional correlational design.

Setting and participants
Through convenience sampling, 239 fourth-year nursing undergraduates at a university in Western China were enrolled in this study.

Methods
Nursing students who volunteered to participate in the study completed self-reported scales on empathy, emotional intelligence, and moral sensitivity between September and October 2022. The potential mediating effect was explored using the Process Macro and bootstrap method.

Results
The nursing students' average scores were 39.62 ± 5.27 on moral sensitivity, 108.21 ± 15.49 on empathy, and 124.41 ± 13.66 on EI. Moral sensitivity was positively correlated with emotional intelligence (r = 0.454, p < 0.001) and empathy (r = 0.545, p < 0.001). Furthermore, empathy exerted a substantial direct effect on nursing students' moral sensitivity (B = 0.1424, p < 0.001). Emotional intelligence could mediate the indirect path from empathy to moral sensitivity. (B = 0.0372, p < 0.001).

Conclusion
Emotional intelligence mediated the association between empathy and moral sensitivity. Thus, educational activities and programmes placing an emphasis on empathy and emotional intelligence may offer an alternative way to promote moral sensitivity in Chinese student nurses.

Implications
Nursing educators can organise programmes to improve nursing students' emotional competence and professional values. Early exposure to clinical practice benefits nursing students a lot in terms of building interactions with patients and increasing emotional resonance. In addition, nursing educators should develop situational teaching in nursing ethics courses to help students cope with ethical issues.