bluuebunny/crossref_metadata_2025_split huggingface dataset:
Impact of malnutrition on the outcome and length of hospital stay in elective pediatric surgical patients: prospective cohort study at tertiary hospitals in Ethiopia
Authors: Wondemagegnehu Belachew D. , Aklilu Woubedel K. , Beyene Milliard D. , Nonyane Bareng A. Sanny 
Published: November 2023

Abstract
Background
Pediatric surgical patients in low and middle-income countries suffer from malnutrition on top of the surgical pathology and post-operative stress which increases post-operative morbidity and mortality. Malnutrition is highly prevalent in Africa and is expected to impact the outcome of surgical patients. The study was aimed at determining the impact of malnutrition on the outcome and length of hospital stay in elective pediatric surgical patients.

Methods
A prospective study was done on children, aged one month to fourteen years, who had undergone elective general surgery. Upon admission, nutritional assessment using an anthropometric indicator was undertaken and used to derive the WHO Anthro Z scores. Malnutrition was defined as a binary outcome: severely/moderately malnourished (Z < -2) versus well nourished (Z ≥ -2). After surgery, postoperative complications were documented. Chi-squared tests and t-tests were used to assess associations.

Results
Of the 109 enrolled children, 49 (45%) had malnutrition preoperatively. Infants had a higher prevalence of malnutrition (65% versus 35%, p-value = 0·028) compared to older children. Postoperative infection was relatively more common in malnourished children (27·1% versus 20%). The mean post-operative stays were 5·69 days (SD 0.46) for well-nourished children and 6.89 days (SD 0·9) for malnourished patients but the difference was not statistically significant.

Conclusion
We observed neither significant long hospital stays nor a higher incidence of postoperative infection among children with malnutrition. Further investigations with a larger sample size are warranted.
Persistent effects of intramammary ceftiofur treatment on the gut microbiome and antibiotic resistance in dairy cattle
Authors: Vasco Karla A. , Carbonell Samantha , Sloup Rebekah E. , Bowcutt Bailey , Colwell Rita R. , Graubics Karlis , Erskine Ronald , Norby Bo , Ruegg Pamela L. , Zhang Lixin , Manning Shannon D. 
Published: November 2023

Abstract
Background
Intramammary (IMM) ceftiofur treatment is commonly used in dairy farms to prevent mastitis, though its impact on the cattle gut microbiome and selection of antibiotic-resistant bacteria has not been elucidated. Herein, we enrolled 40 dairy (Holstein) cows at the end of the lactation phase for dry-cow therapy: 20 were treated with IMM ceftiofur (Spectramast®DC) and a non-antibiotic internal teat sealant (bismuth subnitrate) and 20 (controls) received only bismuth subnitrate. Fecal grab samples were collected before and after treatment (weeks 1, 2, 3, 5, 7, and 9) for bacterial quantification and metagenomic next-generation sequencing.

Results
Overall, 90% and 24% of the 278 samples had Gram-negative bacteria with resistance to ampicillin and ceftiofur, respectively. Most of the cows treated with ceftiofur did not have an increase in the number of resistant bacteria; however, a subset (25%) shed higher levels of ceftiofur-resistant bacteria for up to 2 weeks post-treatment. At week 5, the antibiotic-treated cows had lower microbiota abundance and richness, whereas a greater abundance of genes encoding extended-spectrum β-lactamases (ESBLs), CfxA, ACI-1, and CMY, was observed at weeks 1, 5 and 9. Moreover, the contig and network analyses detected associations between β-lactam resistance genes and phages, mobile genetic elements, and specific genera. Commensal bacterial populations belonging to Bacteroidetes most commonly possessed ESBL genes followed by members of Enterobacteriaceae.

Conclusion
This study highlights variable, persistent effects of IMM ceftiofur treatment on the gut microbiome and resistome in dairy cattle. Antibiotic-treated cattle had an increased abundance of specific taxa and genes encoding ESBL production that persisted for 9 weeks. Fecal shedding of ESBL-producing Enterobacteriaceae, which was classified as a serious public health threat, varied across animals. Together, these findings highlight the need for additional studies aimed at identifying factors associated with shedding levels and the dissemination and persistence of antibiotic resistance determinants on dairy farms across geographic locations.
Survival After Diagnosis of Esophageal Squamous Cell Carcinoma in Malawi
Authors: Kaimila Bongani , Chen Yingxi , Mulima Gift , Kajombo Chifundo , Salima Ande , Yano Yukiko , Gopal Satish , Dawsey Sanford M. , Abnet Christian C. 
Published: November 2023

PURPOSE Esophageal cancer (EC) is the second most common cancer in Malawi, with esophageal squamous cell carcinoma (ESCC) representing >90% of all ECs. Despite significant morbidity and mortality, little is known about disease outcomes. In this study, we assess survival after ESCC diagnosis in Malawi. METHODS We report on ESCC cases enrolled in a case-control study at Kamuzu Central Hospital in Lilongwe from August 2017 to April 2020. Suspected cases completed a questionnaire interview; provided blood, urine, and saliva specimens; and underwent a tumor biopsy for histologic confirmation. Cases were followed up by phone biweekly from enrollment to the study end date (December 31, 2020), date of death, or loss to follow-up. Survival was assessed using Kaplan-Meier analysis with the log-rank test. We also examined associations between treatment and ESCC mortality using Cox regression models. RESULTS There were 300 patients with ESCC enrolled in this study, of whom 290 (97%) had known vital status at the end of follow-up and 10 (3%) were lost to follow-up. Among the 290 patients, 282 (97%) died during follow-up. The median age at enrollment was 55 years (IQR, 48-66), and the median time to death was 106 days (95% CI, 92 to 127). The 1-year, 2-year, and 3-year survival rates were 11% (95% CI, 8 to 15), 3% (95% CI, 1 to 6), and 0.9% (95% CI, 0.8 to 4), respectively. Palliative chemotherapy significantly improved the overall survival of patients with ESCC ( Plog-rank = .038) and was significantly associated with reduced mortality (adjusted hazard ratio, 0.71 [95% CI, 0.51 to 0.99]). No significant association was observed between tobacco use, alcohol consumption, or HIV status and mortality. CONCLUSION Survival after diagnosis of ESCC was poor in Malawi. Although palliative chemotherapy was associated with improved survival, prevention and earlier detection remain key priorities to improve ESCC mortality at a population level.
Classical Estrogen Signaling in Ciliated Epithelial Cells of the Oviduct Is Nonessential for Fertility in Female Mice
Authors: McGlade Emily A , Stephens Kalli K , Winuthayanon Sarayut , Anamthathmakula Prashanth , Holtzman Michael J , Winuthayanon Wipawee 
Published: November 2023

Abstract
Ciliary action performs a critical role in the oviduct (Fallopian tube) during pregnancy establishment through sperm and egg transport. The disruption of normal ciliary function in the oviduct affects oocyte pick-up and is a contributing factor to female infertility. Estrogen is an important regulator of ciliary action in the oviduct and promotes ciliogenesis in several species. Global loss of estrogen receptor α (ESR1) leads to infertility. We have previously shown that ESR1 in the oviductal epithelial cell layer is required for female fertility. Here, we assessed the role of estrogen on transcriptional regulation of ciliated epithelial cells of the oviduct using single-cell RNA-sequencing analysis. We observed minor variations in ciliated cell genes in the proximal region (isthmus and uterotubal junction) of the oviduct. However, 17β-estradiol treatment had little impact on the gene expression profile of ciliated epithelial cells. We also conditionally ablated Esr1 from ciliated epithelial cells of the oviduct (called ciliated Esr1d/d mice). Our studies showed that ciliated Esr1d/d females had fertility rates comparable to control females, did not display any disruptions in preimplantation embryo development or embryo transport to the uterus, and had comparable cilia formation to control females. However, we observed some incomplete deletion of Esr1 in the ciliated epithelial cells, especially in the ampulla region. Nevertheless, our data suggest that ESR1 expression in ciliated cells of the oviduct is dispensable for ciliogenesis and nonessential for female fertility in mice.
The dual function of prokinesis in the feeding and locomotor systems of parrots
Authors: Young Melody W. , Wilken Alec T. , Manafzadeh Armita R. , Schurr Alissa F. , Bastian Aaron , Dickinson Edwin , Granatosky Michael C. 
Published: November 2023

ABSTRACT
Prokinesis, a mode of avian cranial kinesis involving motion between the neurocranium and upper beak, has long been investigated in biomechanical analyses of avian feeding and drinking. However, the modern avian beak is also used for non-feeding functions. Here, we investigate the dual function of prokinesis in the feeding and locomotor systems of the rosy-faced lovebird (Agapornis roseicollis). Lovebirds and other parrots utilize their beak both during feeding and as a third limb during vertical climbing. Thus, we experimentally measured both force-generating potential and movement of the rosy-faced lovebird mandible and maxilla (via prokinetic flexion of the craniofacial hinge) during tripedal climbing and mandibular/maxillary adduction. We found that whereas the maxilla is primarily responsible for generating force during locomotion, the mandible is primarily responsible for generating force during forceful jaw adduction, hinting at a remarkable capacity to alter prokinetic function with differing neuromuscular control. The ability of the prokinetic apparatus to perform functions with competing optimality criteria via modulation of motor control illustrates the functional plasticity of the avian cranial kinesis and sheds new light on the adaptive significance of cranial mobility.
Morbidity profile and physical health status of orphans and vulnerable children in selected orphanages in Ibadan, Nigeria
Authors: Olowokere Adekemi E. , Aladegboye Mercy K , Komolafe Abiola O , Adedeji Ademidun O , Irinoye Omolola 
Published: November 2023

Background: Orphans and vulnerable children (OVC) are prone to poor health outcomes when compared to other children in society. Aims: This study assessed the morbidity profile and physical health status of OVC in orphanages. Methods: A descriptive cross-sectional design was employed and multistage sampling technique was used to select 384 OVC from the orphanages. A structured questionnaire was used to collect data on morbidity profile while a head-to-toe assessment checklist and the body mass index (BMI) were used to assess their physical health status. Analysis was done using descriptive and inferential statistics at a significant level of 0.05. Results: Results showed that the most prevalent health problems experienced by OVC were headaches, respiratory infections, and malaria. The study further revealed that 44.8%, 29.9% and 25.3% of respondents had respectively fair, poor and good physical health. Conclusions: A substantial proportion of OVC have a fair and poor physical health status and the majority are underweight.
Time to Shine: The child that is fully seen, heard, and supported
Authors: Livsey Rachel 
Published: November 2023

Children and young people would like school nurses to be visible, accessible and confidential. In a time of cuts and high waiting lists, especially in CAMHS services, school nurses can offer valuable evidence-based support. However, when reports suggest that school nurses spend too much time on bureaucratic child protection duties and paperwork and with depleted school nurse numbers nationally, how can this gap be bridged? In this article, Rachel Livsey shares a new way of working where school nurses conduct a holistic health needs assessment, which considers all aspects of a child or young person's life has been suggested and created by the author. This work has been done in conjunction with a new robust safeguarding policy to allows school nurses to immerse themselves in the public health aspect of their work while participating in safeguarding duties in a proportionate and appropriate manner, with the aim of truly making every contact matter.
Development of an all-solid-state air-cooled high-power blue diode laser for metal processing
Authors: Devara Jayant S. , Jakhar Sandeep , Sihag Yateendra , Panda Biswajit , Venkatesan Ananth , Singh Kamal P. 
Published: November 2023

We present the design and development of an all-solid-state
(fluid/refrigerant-free) 100 W scale blue-laser system and show its
applications in precision copper works. We combine powerful
laser-diode arrays with Peltier chips on a compact laser head to
achieve stable thermal and optical performance. Good agreement between
the thermal simulation of the 3D laser head and experiments validates
stable thermal performance. The laser system emits 40–100 W
continuous wave at λ = 452.2 ± 2.5 nm
with 98% power stability and ∼24% wall-plug efficiency inside a
portable enclosure. This is the first, to the best of our knowledge,
all-solid-state air-cooled laser with a 100 W class output. We
achieved kW/cm2 intensity level on an mm-size focus with
this source and demonstrated cutting, bending, and soldering copper on
a battery pack. Furthermore, the copper–solder joints have nanoscale
adhesion without cracks. Additionally, we unveil that 0.5–4
kW/cm2 intensity laser annealing scan makes copper strips
mechanically resilient to withstand extreme loading cycles without
nanoscale cracks.
Prevalence and clinical characteristics of increased pancreatic enzymes in patients with severe fever with thrombocytopenia syndrome
Authors: Zhang Zhongwei , Hu Xue , Jiang Qunqun , Du Qian , Liu Jie , Luo Mingqi , Deng Liping , Xiong Yong 
Published: November 2023

Background and aim
The increased pancreatic enzymes have recently been reported in patients with severe fever with thrombocytopenia syndrome (SFTS). However, its significance has not been elucidated clearly. The aim of this study was to explore the prevalence, clinical characteristics of elevated pancreatic enzymes (amylase and lipase) and its association with AP in patients with SFTS.

Methods
Data of demographics, comorbid conditions, clinical symptoms, laboratory parameters and survival time of patients with SFTS were collected. Patients were assigned into the non-AP and AP groups according to the diagnostic criteria of AP. Patients in the non-AP group were divided into the normal (<upper limit of normal [ULN]), elevated pancreatic enzymes (EPE) (1–3×ULN) and high pancreatic enzymes (HPE) (>3×ULN) groups according to the serum amylase and lipase levels, and then their clinical data were compared.

Results
A total of 284 patients diagnosed with SFTS were retrospectively enrolled, including 248 patients in the non-AP group and 36 patients in the AP group. Patients in the non-AP group were composed of 48, 116 and 84 patients in the normal, EPE and HPE groups, respectively. Compared with patients in the normal and EPE groups, patients in the HPE group had higher serum levels of laboratory parameters referring to liver, kidney, heart and coagulation system injury, as well as higher viral load. The cumulative survival rate of patients in the HPE group was significantly lower than that of patients in the normal group. In addition, patients in the AP group also had higher serum levels of laboratory variables reflecting liver, heart, coagulation dysfunction and viral load than patients in the HPE group. The cumulative survival rate of patients in the AP group was significantly lower than that of patients in the HPE group.

Conclusion
The increased pancreatic enzymes are very common in patients with SFTS, but they are not always associated with AP. Though AP accounts for the majority of deaths for patients with elevated pancreatic enzymes, patients with pancreatic enzymes >3×ULN except for AP also have a high in-hospital mortality rate.
Association between hearing loss and cognitive decline in the elderly: A systematic review with meta-analysis study
Authors: Conceição Santos de Oliveira Débora , Gomes-Filho Isaac Suzart , Araújo Edna Maria , Xavier Ramos Michelle de Santana , Freitas Coelho Julita Maria , Marques Adan Araújo , Hintz Alexandre Marcelo , Firmino Rabelo Dóris , Figueiredo Ana Claudia Morais Godoy , da Cruz Simone Seixas 
Published: November 2023

Objective
Hearing loss has been pointed out as a potential predictor for cognitive decline. This study conducted a systematic review to evaluate the scientific evidence on the association between hearing loss in the elderly and cognitive decline, as well as whether race/color influences this relationship.

Method
The search for studies was performed in the following electronic databases: MedLine/PubMed Web of Science, Scopus and Virtual Health Library, and MedRkiv up to August 2022. Studies with epidemiological designs that assess the association between hearing loss and cognitive decline in the elderly were eligible for inclusion. Three independent reviewers performed the selection, data extraction and evaluation of the quality of the studies using the Newcastle-Ottawa Scale. A meta-analysis using a random effects model estimated the global association measurements (Beta coefficient: β) and their 95% confidence intervals (95%CI), and the Higgins and Thompson indicator (I2) was also estimated to assess statistical heterogeneity among the studies.

Results
5,207 records were identified in the database surveys, of which only 18 were eligible studies, totaling 19,551 individuals. Hearing loss was associated with cognitive decline in the elderly, with statistical significance: β = -0.13; 95%CI = -0.23 to -0.04; I2 = 98.70%). For black individuals, the magnitude of the association increased: β = -0.64; 95%CI = -3.36 to 2.07; I2 = 95.65%, but it was not statistically significant.

Conclusion
The findings of this systematic review showed the existence of a significant relationship between hearing loss and cognitive decline in the elderly, as well as signaling that among black individuals the magnitude of the association can be increased.
Potential contribution of PrEP uptake by adolescents 15–17 years old to achieving the “Ending the HIV Epidemic” incidence reduction goals in the US South
Authors: Hamilton Deven T. , Wang Li Yan , Hoover Karen W. , Smith Dawn K. , Delaney Kevin P. , Li Jingjing , Hoyte Tamika , Jenness Samuel M. , Goodreau Steven M. 
Published: November 2023

Background
The “Ending the HIV Epidemic” (EHE) initiative seeks to reduce new HIV infections in the U.S. by prioritizing federal resources towards highly impacted populations. Antiretroviral therapy (ART) and pre-exposure prophylaxis (PrEP) are essential for reaching EHE goals. Adolescents are often at increased risk for HIV because they may lack agency in negotiating their sexual partnerships and may not have the same access to treatment and prevention as adults. This study estimates the potential contribution of expanded PrEP coverage among adolescents ages 15–17 to achieving the EHE goals in the South.

Methods
An HIV-transmission model was built to simulate the HIV epidemic in the South. Increased ART and PrEP uptake were systematically varied with and without PrEP eligibility including individuals age<18.

Results
Prioritizing PrEP for adolescents had a negligible impact on incidence. At 50% uptake among eligible adolescents and 90% ART coverage, including adolescents only improved the percentage of infections averted from 80.1% to 80.3%. In 10 of 15 scenarios explored, there was no reduction in new infections when PrEP eligibility was expanded to include adolescents age<18. At 95% ART coverage at the population-level incidence among adolescents declined by over 80%, but PrEP uptake among adolescents did not contribute to additional declines in incidence among adolescents.

Conclusions
Prioritizing PrEP for adolescents did not significantly contribute to reaching EHE incidence reductions goal. Focusing resources to specific adolescent populations at risk, such sexual minority males in high incidence settings, will remain an important public health goal outside the context of EHE.
Clinical profile, prognosis and post COVID-19 syndrome among UNRWA staff in Jordan: A clinical case-series study
Authors: Aldahleh Haneen , Batieha Anwar , Elayyan Rasheed , Abdo Nour , Abuzayed Ishtaiwi , Albaik Shatha , Shahin Yousef , Seita Akihiro 
Published: November 2023

Background
The clinical manifestations of Corona Virus Disease of 2019 (COVID-19) varied from patient to patient with evidence of multi-organ involvement. Many patients continue to have a wide range of symptoms for variable periods of time. The long-term effects of COVID-19 infection (post COVID-19 illness or syndrome) are not yet fully explored. This study aims to shed light on the clinical manifestations of the acute COVID-19 infection as well as post COVID-19 syndrome among the United Nations Relief and Works Agency for Palestine Refugee (UNRWA) staff in Jordan.

Methods
A clinical case-series was conducted on a sample of COVID-19 positive employees of the UNRWA staff in Jordan. A structured questionnaire based mainly on World Health Organization (WHO) Case Report Form (CRF) verified tool for post COVID-19 was used. A sample of 366 out of a total of 1322 confirmed cases was systemically selected and included in the present study. Data were collected from UNRWA medical records and phone interviews. Data were analyzed using the Statistical Package for Social Sciences (SPSS) software.

Results
The calculated Case Fatality Ratio was 0.7%. The incidence of COVID-19 among UNRWA staff in Jordan during the period of our study was 20.1%. A total of 366 respondents, 220 (60.1%) females and 146 (39.9%) males were included in the study. The mean (SD) age was 44.2 (8.0) years. Most of the infected (97.8%) developed acute COVID-19 symptoms. Fatigue, fever, joint pain, loss of smell and taste, and cough were the most common symptoms. According to WHO clinical classification of acute illness severity, 65.0% had mild illness. Only 28.7% of all subjects fully recovered from the infection, while most of them (71.3%) continued to suffer from many symptoms. Persistent fatigue (39.7%), shortness of breath (SOB) with activity (18.8%), anxiety (17.4%), forgetfulness (16.9%), trouble in concentrating (16.7%), and depressed mood (15.8%) were the most frequently reported.

Conclusion
Post COVID-19 illness was very common (71.3%) calling for UNRWA to continue assessment of post COVID-19 syndrome and the medical and psychological needs of affected staff. Despite vaccination, only 2.2% of the infected were asymptomatic. Reinfection was unusually high (24%).