bluuebunny/crossref_metadata_2025_split huggingface dataset:
Acute obstructive pyelonephritis due to pyosalpinx: a case report
Authors: Chaker Kays , Ouanes Yassine , Azouz Eya , Trigui Mohamed , Madani Anouar , Mosbahi Boutheina , Elabed Wiem , Chbeb Oumayma , Bibi Mokhtar , Dali Kheireddine Mrad , Ammous Adel , Nouira Yassine 
Published: April 2023

Abstract
Background
A pyosalpinx is the acute inflammation of the fallopian tube, which fills up and swells with pus. It commonly results from inadequate or delayed treatment of pelvic inflammatory disease.

Case presentation
We report the case of a 54-year-old Africain female patient, who presented with sustained high-grade fever, right flank pain, and severe acute storage low-urinary-tract symptoms. Computed tomography showed signs of acute obstructive pyelonephritis with a right tubular juxtauterine mass with complex internal fluid and thick enhancing walls exerting a mass effect on the right ureter. A drainage of the right excretory cavities by a JJ stent was performed. An ultrasound-guided aspiration of the collection was also performed.

Conclusion
A pyosalpinx can then exert a mass effect on the excretory cavities, thus causing an acute obstructive pyelonephritis. A double drainage coupled with an effective antibiotic therapy is then necessary.
Prospective paired crossover evaluation of potential impact of investigator gender on perceived pain intensity early after acute or scheduled surgery
Authors: Engskov Anna Sellgren , Ydrefors Andreas , el-Jaleb Karolin , Åkeson Jonas 
Published: April 2023

Abstract
Background
Postoperative pain is common but often difficult to assess, and there are many potential confounders. Over the last decades, the gender of investigator as well as participant has been found to influence pain perception in both preclinical and clinical studies. However, to our knowledge this has not been studied in various postoperative patients. Objectives of this study were to test the hypotheses that pain intensity levels early after acute or scheduled in- or out-hospital surgery are lower when evaluated by a female investigator, and higher when reported by a female patient.

Methods
In this prospective observational paired crossover study, two investigators of opposite genders independently obtained individually reported pain intensity levels with a visual analogue scale in a mixed cohort of adult postoperative study patients at Skåne University Hospital in Malmö, Sweden.

Results
In total, 245 (129 female) study patients were included and then one female excluded. The study patients rated their intensity of postoperative pain lower when evaluated by a female than by a male investigator (P = 0.006), where the male patients constituted the significant difference (P < 0.001). Pain intensity levels did not differ between female and male study patients (P = 0.210).

Conclusions
Main findings of lower pain intensity reported by males to a female than to a male investigator early after surgery in this paired crossover study in mixed postoperative patients, indicate that potential impact of investigator gender on pain perception should be considered and further evaluated in clinical bedside practice.
Trial registration Retrospectively registered in the ClinicalTrials.gov research database on 24th June 2019 with TRN number NCT03968497.
The oldest Gondwanan record of the extinct durophagous hybodontiform chondrichthyan, Strophodus from the Bajocian of Morocco
Authors: Stumpf Sebastian , Kettler Christoph , Kindlimann René , Cuny Gilles , Kriwet Jürgen 
Published: April 2023

AbstractStrophodusis a speciose and geographically widespread taxon of large durophagous hybodontiform chondrichthyan, with a stratigraphic range extending from Middle Triassic to the Early Cretaceous. Here, we describe a new species ofStrophodus,S.atlasensissp. nov., based on an incomplete articulated dentition recovered from marine Bajocian deposits of the eastern High Atlas Mountains in Morocco. The new species is diagnosed by a unique combination of dental characters that includes, among others, the presence of triangular first lateral teeth, mesio-distally wide and bulbous second lateral teeth without an occlusal crest or dome and uniquely shaped first posterior teeth that are shorter mesio-distally than being labio-lingually long, as well as small second posterior teeth whose roots protrude below the crowns to meet each other in an efficient interlocking manner. The holotype and only specimen ofStrophodus atlasensissp. nov. represents the hitherto oldest known record ofStrophodusfrom Gondwana and the first record of that genus from the Bajocian, thus adding valuable novel information to our incomplete understanding of the evolutionary history of extinct hybodontiform chondrichthyans.
Risk factors for severe COVID-19 in the young—before and after ICU admission
Authors: Kämpe Johanna , Bohlin Olof , Jonsson Martin , Hofmann Robin , Hollenberg Jacob , Wahlin Rebecka Rubenson , Svensson Per , Nordberg Per 
Published: April 2023

Abstract
Background
Factors associated with severe COVID-19 and death among young adults are not fully understood, including differences between the sexes. The aim of this study was to identify factors associated with severe COVID-19 requiring intensive care and 90-day mortality among women and men below 50 years of age.

Methods
A register-based study using data from mandatory national registers, where patients with severe COVID-19 admitted to the ICU with need for mechanical ventilation (cases) between March 2020 and June 2021 were matched regarding age, sex, and district of residence with 10 population-based controls. Both the study population and the controls were divided into groups based on age (< 50 years, 50–64, and ≥ 65 years) and sex. Multivariate logistic regression models including socioeconomic factors were used to calculate odds ratios (OR) with 95% confidence intervals (CIs) for associations between severe COVID-19 in the population to compare the magnitude of the risk associations for co-morbidities in the different age categories, and subsequently factors associated with 90-day mortality among patients admitted to ICU.

Results
In total, 4921 cases and 49,210 controls (median age 63 years, 71% men) were included.
The co-morbidities with the strongest associations with severe COVID-19 for the young population compared to older patients were chronic kidney disease (OR 6.80 [3.61–12.83]), type 2 diabetes (OR 6.31 [4.48–8.88]), hypertension (OR 5.09 [3.79–6.84]), rheumatoid arthritis (OR 4.76 [2.29–9.89]), obesity (OR 3.76 [2.88–4.92]), heart failure (OR 3.06 [1.36–6.89]), and asthma (OR 3.04 [2.22–4.16]).
When comparing women vs. men < 50 years of age, stronger associations were seen for women regarding type 2 diabetes (OR 11.25 [6.00–21.08] vs OR 4.97 [3.25–7.60]) and hypertension (OR 8.76 [5.10–15.01] vs OR 4.09 [2.86–5.86]).
The factors associated with 90-day mortality in the young were previous venous thromboembolism (OR 5.50 [2.13–14.22]), chronic kidney disease (OR 4.40 [1.64–11.78]) and type 2 diabetes (OR 2.71 [1.39–5.29]). These associations with 90-day mortality were foremost driven by the female population.

Conclusion
Chronic kidney failure, type 2 diabetes, hypertension, rheumatoid arthritis, obesity, heart failure, and asthma were the strongest risk factors associated with severe COVID-19 requiring ICU-care in individuals < 50 years compared to the older population. However, after ICU admission, previous thromboembolism, chronic kidney failure, and type 2 diabetes were associated with increased 90-day mortality. The risk associations for co-morbidities were generally stronger among younger individuals compared to older and in women compared to men.
Comparing the incidence of SARS-CoV-2 across age groups considering sampling biases - use of testing data of autumn 2021 in Belgium
Authors: Lajot Adrien , Cornelissen Laura , Van Cauteren Dieter , Meurisse Marjan , Brondeel Ruben , Dupont-Gillain Christine 
Published: April 2023

Abstract
Background
To design efficient mitigation measures against COVID-19, understanding the transmission dynamics between different age groups was crucial. The role of children in the pandemic has been intensely debated and involves both scientific and ethical questions. To design efficient age-targeted non-pharmaceutical interventions (NPI), a good view of the incidence of the different age groups was needed. However, using Belgian testing data to infer real incidence (RI) from observed incidence (OI) or positivity ratio (PR) was not trivial.

Methods
Based on Belgian testing data collected during the Delta wave of Autumn 2021, we compared the use of different estimators of RI and analyzed their effect on comparisons between age groups.

Results
We found that the RI estimator’s choice strongly influences the comparison between age groups.

Conclusion
The widespread implementation of testing campaigns using representative population samples could help to avoid pitfalls related to the current testing strategy in Belgium and worldwide. This approach would also allow a better comparison of the data from different countries while reducing biases arising from the specificities of each surveillance system.
A meta-analysis on the prevalence of resistance of Staphylococcus aureus to different antibiotics in Nigeria
Authors: Ezeh Christian Kelechi , Eze Chibuzor Nwadibe , Dibua Marie Esther Uju , Emencheta Stephen Chijioke 
Published: April 2023

Abstract
Background
Rapid emergence of multidrug resistant Staphylococcus aureus has resulted to difficulty in treatment of infections caused by such strains. The aim of this meta-analysis study was to determine the pooled prevalence of resistance of S. aureus to different antibiotics in Nigeria.

Methods
Literature search for studies was done using Google scholar, PubMed, Science direct, and African Journal Online. The prevalence of S. aureus resistance to different antibiotics was evaluated using the meta-analysis proportion command in MedCalc software version 20.0 adopting a rand effect model. I2 statistic and Egger test in MedCalc was used to evaluate the heterogeneity and the presence of publication bias among studies respectively.

Results
A total of 40, 682 studies were retrieved through the database search of which 98 studies met the study inclusion criteria. Prevalence of resistance of S. aureus to different antibiotics ranges from 13 to 82%. Results showed a very high degree of resistance to penicillin G (82% [95% confidence interval (CI) 61%, 0.96%]), cloxacillin (77% [95% CI 64%, 88%]), amoxacillin (74% [95% CI 66%, 81%]), cefuroxime (69% [95% CI 51%, 85%]), ampicillin (68% [95% CI 53%, 81%]). Moderately resistance to erythromycin (47% [95% CI 40%, 53%]), chloramphenicol (47% [95% CI 37%, 56%]), methicillin (46% [95% CI 37%, 56%]), ofloxacin (24% [95% CI 18%, 31%]) and rifampicin 24% [95% CI 6%, 48%]). Low resistance was observed in vancomycin 13% (95% CI 7%, 21%). For each individual meta-analysis, high heterogeneity was observed with I2 range (79.36–98.60%) at p-values ≤ 0.01). Egger’s tests for regression intercept in funnel plots indicated no evidence of publication bias.

Conclusion
This meta-analysis study established that S. aureus in Nigeria has developed resistance to commonly used antibiotics such as the beta-lactam class antibiotics, sulphonamides, tetracyclines, chloramphenicol, and vancomycin. Hence it is imperative to develop programs to promote rational use of antimicrobial agents, infection prevention and control to reduce the incidence of antimicrobial resistance.
Qualitative assessment of the national initiative to implement antimicrobial stewardship centres in French administrative regions
Authors: Conlin Michèle , Leroy Anne-Gaëlle , Asquier-Khati Antoine , Boutoille David , Birgand Gabriel 
Published: April 2023

Abstract
Background
In May 2020, the French Ministry of Health funded the creation of regional antimicrobial stewardship (AMS) coordination centres (CRAtb) in preparation for the new national framework for the prevention of antimicrobial resistance. This study aimed to assess through qualitative methods the implementation process, the activities carried out, and the interactions with other regional stakeholders of the newly created CRAtb.

Methods
We conducted a mixed-method study based on a cross-sectional survey and semi-structured interviews by French regions among implemented CRAtb. Of the eight eligible French regions with an existing CRAtb, seven participated to the online survey. Regional partners involved in AMS from the eight regions were interviewed between September 2021 and April 2022. The survey questionnaire addressed, through closed questions, the organization of the CRAtb, articulation with other regional actors involved in AMS and infection prevention and control (IPC), and AMS activities. The semi-structured interviews approached the implementation and the role of CRAtb, and the collaboration of other AMS and IPC stakeholders. Interview transcripts were analysed using thematic content analysis methodology.

Results
AMS activities carried out by CRAtb were mainly focusing on hospitals (n = 3), primary care (n = 2) and nursing homes (n = 1). Education mostly relied on training days and AMS help lines, communication on websites and newsletters. CRAtb members reported still being more engaged in providing advice to professionals for individual antibiotic treatments rather than collective-level AMS activities. Interactions were frequent between CRAtb, IPC regional centres and health authorities, but rarely involved other stakeholders. Interviews were performed with 28 professionals involved in AMS from eight regions. Pre-existing networks and working relationships in AMS and more broadly facilitated the implementation of CRAtb. Streamlining and decompartmentalizing IPC and AMS regional activities were considered a way to optimise the prevention of antimicrobial resistance across sectors. The engagement with liberal health professionals was identified as a significant obstacle for CRAtb.

Conclusions
Two years after the launch of a new national framework, the implementation of CRAtb appeared complex in most regions. An integrative model joining IPC and AMS efforts, relying on existing networks, with engagement from liberal health profession organisations may be the next pivotal step.
Mediating effect of anxiety and depression between family function and hope in patients receiving maintenance hemodialysis: a cross-sectional study
Authors: Wang Xuefen , Xia Fuhai , Wang Guoqing 
Published: April 2023

Abstract
Objectives
This study aimed to explore the levels of hope in patients receiving maintenance hemodialysis (MHD), and whether anxiety and depression mediate the relationship between family function and hope.

Methods
The family APGAR index, hospital anxiety and depression scale, and Herth hope index were recorded using the self-reported questionnaires completed by 227 MHD patients.

Results
The family function can directly predict hope, positively predict hope through depression (β = 0.052, p = 0.001), and positively predict hope through the chain mediating of anxiety and depression (β = 0.087, p = 0.001), according to chain mediation analysis. The total effect size was 28.31%. The total indirect effect value was 0.139, and the total effect value was 0.491.

Conclusions
Our findings suggest that family function had a direct impact on MHD patients’ hope, and that lowering anxiety and depression can help to feel more hopeful.
Lupeol alleviates atopic dermatitis-like skin inflammation in 2,4-dinitrochlorobenzene/Dermatophagoides farinae extract-induced mice
Authors: Bae Sojung , Jeong Na-Hee , Choi Young-Ae , Lee Byungheon , Jang Yong Hyun , Lee Soyoung , Kim Sang-Hyun 
Published: April 2023

Abstract
Background
Atopic dermatitis (AD) is a chronic inflammatory skin disease that affects from children to adults widely, presenting symptoms such as pruritus, erythema, scaling, and dryness. Lupeol, a pentacyclic triterpenoid, has anti-inflammatory and antimicrobial activities. Based on these properties, the therapeutic effects of lupeol on skin disorders have been actively studied. In the present study, we aimed to determine the effectiveness of lupeol on AD.

Methods
We utilized tumor necrosis factor (TNF)-α/interferon (IFN)-γ-stimulated keratinocytes and 2, 4-dinitrochlorobenzene/Dermatophagoides farinae extract (DFE)-induced AD mice to confirm the action.

Results
Lupeol inhibited TNF-α/IFN-γ-stimulated keratinocytes activation by reducing the expressions of pro-inflammatory cytokines and chemokines which are mediated by the activation of signaling molecules such as signal transducer and activator of transcription 1, mitogen-activated protein kinases (p38 and ERK), and nuclear factor-κB. Oral administration of lupeol suppressed epidermal and dermal thickening and immune cell infiltration in ear tissue. Immunoglobulin (Ig) E (total and DFE-specific) and IgG2a levels in serum were also reduced by lupeol. The gene expression and protein secretion of T helper (Th) 2 cytokines, Th1 cytokines, and pro-inflammatory cytokine in ear tissue were decreased by lupeol.

Conclusions
These results suggest that lupeol has inhibitory effects on AD-related responses. Therefore, lupeol could be a promising therapeutic agent for AD.
Diagnostic performance of PET/CT in the detection of liver metastases in well-differentiated NETs
Authors: Grawe Freba , Rosenberger Natalie , Ingenerf Maria , Beyer Leonie , Eschbach Ralf , Todica Andrei , Seidensticker Ricarda , Schmid-Tannwald Christine , Cyran Clemens C. , Ricke Jens , Bartenstein Peter , Auernhammer Christoph. J. , Ruebenthaler Johannes , Fabritius Matthias P. 
Published: April 2023

Abstract
Background
The aim of this retrospective study was to compare the diagnostic accuracy of somatostatin receptor (SSR)-PET/CT to liver MRI as reference standard in the evaluation of hepatic involvement in neuroendocrine tumors (NET).

Methods
An institutional database was screened for “SSR” imaging studies between 2006 and 2021. 1000 NET Patients (grade 1/2) with 2383 SSR-PET/CT studies and matching liver MRI in an interval of +3 months were identified. Medical reports of SSR-PET/CT and MRI were retrospectively evaluated regarding hepatic involvement and either confirmed by both or observed in MRI but not in SSR-PET/CT (false-negative) or in SSR-PET but not in MRI (false-positive).

Results
Metastatic hepatic involvement was reported in 1650 (69.2%) of the total 2383 SSR-PET/CT imaging studies, whereas MRI detected hepatic involvement in 1685 (70.7%) cases. There were 51 (2.1%) false-negative and 16 (0.7%) false-positive cases. In case of discrepant reports, MRI and PET/CT were reviewed side by side for consensus reading. SSR-PET/CT demonstrated a sensitivity of 97.0% (95%CI: 96.0%, 97.7%), a specificity of 97.7% (95%CI: 96.3%, 98.7%), a PPV of 99.0% (95%CI: 98.4%, 99.4%) and NPV of 93.0% (95%CI: 91.0, 94.8%) in identifying hepatic involvement. The most frequent reason for false-negative results was the small size of lesions with the majority < 0.6 cm.

Conclusion
This study confirms the high diagnostic accuracy of SSR-PET/CT in the detection of hepatic involvement in NET patients based on a patient-based analysis of metastatic hepatic involvement with a high sensitivity and specificity using liver MRI imaging as reference standard. However, one should be aware of possible pitfalls when a single imaging method is used in evaluating neuroendocrine liver metastases in patients.
Artificial intelligence in higher education: the state of the field
Authors: Crompton Helen , Burke Diane 
Published: April 2023

AbstractThis systematic review provides unique findings with an up-to-date examination of artificial intelligence (AI) in higher education (HE) from 2016 to 2022. Using PRISMA principles and protocol, 138 articles were identified for a full examination. Using a priori, and grounded coding, the data from the 138 articles were extracted, analyzed, and coded. The findings of this study show that in 2021 and 2022, publications rose nearly two to three times the number of previous years. With this rapid rise in the number of AIEd HE publications, new trends have emerged. The findings show that research was conducted in six of the seven continents of the world. The trend has shifted from the US to China leading in the number of publications. Another new trend is in the researcher affiliation as prior studies showed a lack of researchers from departments of education. This has now changed to be the most dominant department. Undergraduate students were the most studied students at 72%. Similar to the findings of other studies, language learning was the most common subject domain. This included writing, reading, and vocabulary acquisition. In examination of who the AIEd was intended for 72% of the studies focused on students, 17% instructors, and 11% managers. In answering the overarching question of how AIEd was used in HE, grounded coding was used. Five usage codes emerged from the data: (1) Assessment/Evaluation, (2) Predicting, (3) AI Assistant, (4) Intelligent Tutoring System (ITS), and (5) Managing Student Learning. This systematic review revealed gaps in the literature to be used as a springboard for future researchers, including new tools, such as Chat GPT.
EEG spectral and connectivity parameters as cognitive biomarkers in Parkinson disease
Authors: Elkholy Mostafa M. , Aboubakr Hossam H. , Abd ElMonem Noha A. , Soliman Rasha H. , Masoud Mohammed M. 
Published: April 2023

Abstract
Background
Cognitive decline is a common presentation of Parkinson’s disease (PD) and a continued search exists for a reliable biomarker for early identification and management of this clinical problem. The objective of this study is to select the most useful biomarker in assessment of PD-related cognitive decline. This cross-sectional study included 47 patients with PD and 47 matched healthy controls. All participants were assessed by quantitative electroencephalography (QEEG) spectral (relative power and background peak frequency) and connectivity measures (coherence and phase lag degree), in addition to clinical evaluation using Unified Parkinson’s Disease Rating Scale (UPDRS)and Modified Hoehn and Yahr staging scale and neuropsychological assessment of the patients using Montreal Cognitive Assessment (MoCA).

Results
PD patients showed significantly higher relative power in all frequency bands over the right temporal region with no significant changes in peak frequency, coherence and phase lag degree compared to healthy controls. PD patients with impaired cognition (MoCA < 26) had significantly lower global relative power, more marked in alpha and beta frequency bands compared to PD patients with normal cognition. Alpha and beta relative power in frontal and temporal regions showed significant correlation with different cognitive domains of MoCA score.

Conclusions
QEEG measures especially spectral relative power could be used as adjunct to neuropsychological assessment in evaluation of PD-related cognitive decline.