bluuebunny/crossref_metadata_2025_split huggingface dataset:
Comparison of clinician diagnosis of COVID-19 with real time polymerase chain reaction in an adult-representative population in Sweden
Authors: Quraishi Eman , Jibuaku Chiamaka , Lisik Daniil , Wennergren Göran , Lötvall Jan , Nyberg Fredrik , Ekerljung Linda , Rådinger Madeleine , Kankaanranta Hannu , Nwaru Bright I. 
Published: January 2023

Abstract
Background
Due to the high transmissibility of SARS-CoV-2, accurate diagnosis is essential for effective infection control, but the gold standard, real-time reverse transcriptase-polymerase chain reaction (RT-PCR), is costly, slow, and test capacity has at times been insufficient. We compared the accuracy of clinician diagnosis of COVID-19 against RT-PCR in a general adult population.

Methods
COVID-19 diagnosis data by 30th September 2021 for participants in an ongoing population-based cohort study of adults in Western Sweden were retrieved from registers, based on positive RT-PCR and clinician diagnosis using recommended ICD-10 codes. We calculated accuracy measures of clinician diagnosis using RT-PCR as reference for all subjects and stratified by age, gender, BMI, and comorbidity collected pre-COVID-19.

Results
Of 42,621 subjects, 3,936 (9.2%) and 5705 (13.4%) had had COVID-19 identified by RT-PCR and clinician diagnosis, respectively. Sensitivity and specificity of clinician diagnosis against RT-PCR were 78% (95%CI 77–80%) and 93% (95%CI 93–93%), respectively. Positive predictive value (PPV) was 54% (95%CI 53–55%), while negative predictive value (NPV) was 98% (95%CI 98–98%) and Youden’s index 71% (95%CI 70–72%). These estimates were similar between men and women, across age groups, BMI categories, and between patients with and without asthma. However, while specificity, NPV, and Youden’s index were similar between patients with and without chronic obstructive pulmonary disease (COPD), sensitivity was slightly higher in patients with (84% [95%CI 74–90%]) than those without (78% [95%CI 77–79%]) COPD.

Conclusions
The accuracy of clinician diagnosis for COVID-19 is adequate, regardless of gender, age, BMI, and asthma, and thus can be used for screening purposes to supplement RT-PCR.
Durable wall lining for malaria control in Liberia: results of a cluster randomized trial
Authors: Giesbrecht David , Belleh Tuwuyor G. , Pontarollo Julie , Hinneh Victor S. , Pratt Oliver , Kamal Sajid , Allan Richard 
Published: January 2023

Abstract
Background
Malaria control in Liberia depends upon universal coverage with pyrethroid-impregnated long-lasting insecticidal nets (LLINs). Despite regular mass distribution, LLIN coverage and usage is patchy. Pyrethroid resistance in malaria vectors may further reduce LLIN efficacy. Durable Wall Lining (DWL), a novel material treated with two non-pyrethroid class insecticides, was designed to be installed onto the surface of inner walls, and cover openings and ceiling surfaces of rural houses.

Objectives

Aim
To determine the malaria control efficacy of DWL.

Primary objective
To determine if DWL has an additional protective effect in an area of pyrethroid resistance.

Secondary objectives
To compare surface bio-availability of insecticides and entomological effectiveness over the study duration.

Design
A cluster randomized trial.

Participants
Children aged 2–59 months.

Control arm
50 houses per 20 clusters, all of which received LLIN within the previous 12 months.

Active arm
50 houses per 20 experimental clusters, all of which received LLINs with the previous 12 months, and had internal walls and ceilings lined with DWL.

Randomisation
Cluster villages were randomly allocated to control or active arms, and paired on 4 covariates.

Main outcome measures

Primary measure
Prevalence of infection with P. falciparum in children aged 2 to 59 months.

Secondary measure
Surface bioavailability and entomological effectiveness of DWL active ingredients.

Results
Plasmodium falciparum prevalence in active clusters after 12 months was 34.6% compared to 40.1% in control clusters (p = 0.052). The effect varied with elevation and was significant (RR = 1.3, p = 0.022) in 14 pairs of upland villages. It was not significant (RR = 1.3, p = 0.344) in 6 pairs of coastal villages. Pooled risk ratio (RR) was calculated in SAS (Cary, NC, USA) using the Cochran–Mantel–Haenszel (CMH) test for upland and coastal cluster pairs. DWL efficacy was sustained at almost 100% for 12 months.

Conclusions
Findings indicate that DWL is a scalable and effective malaria control intervention in stable transmission areas with pyrethroid-resistant vectors, where LLIN usage is difficult to achieve, and where local housing designs include large gable and eve openings.
Trial registration ClinicalTrials.gov identifier: NCT02448745 (19 May 2015): https://clinicaltrials.gov/ct2/show/NCT02448745
Automated wearable cameras for improving recall of diet and time use in Uganda: a cross-sectional feasibility study
Authors: Bulungu Andrea L. S. , Palla Luigi , Nambooze Joweria , Priebe Jan , Forsythe Lora , Katic Pamela , Varley Gwen , Galinda Bernice D. , Sarah Nakimuli , Wellard Kate , Ferguson Elaine L. 
Published: January 2023

Abstract
Background
Traditional recall approaches of data collection for assessing dietary intake and time use are prone to recall bias. Studies in high- and middle-income countries show that automated wearable cameras are a promising method for collecting objective health behavior data and may improve study participants’ recall of foods consumed and daily activities performed. This study aimed to evaluate the feasibility of using automated wearable cameras in rural Eastern Ugandan to collect dietary and time use data.

Methods
Mothers of young children (n = 211) wore an automated wearable camera on 2 non-consecutive days while continuing their usual activities. The day after wearing the camera, participants’ dietary diversity and time use was assessed using an image-assisted recall. Their experiences of the method were assessed via a questionnaire.

Results
Most study participants reported their experiences with the automated wearable camera and image-assisted recall to be good (36%) or very good (56%) and would participate in a similar study in the future (97%). None of the eight study withdrawals could be definitively attributed to the camera. Fifteen percent of data was lost due to device malfunction, and twelve percent of the images were "uncodable" due to insufficient lighting. Processing and analyzing the images were labor-intensive, time-consuming, and prone to human error. Half (53%) of participants had difficulty interpreting the images captured by the camera.

Conclusions
Using an automated wearable camera in rural Eastern Uganda was feasible, although improvements are needed to overcome the challenges common to rural, low-income country contexts and reduce the burdens posed on both participants and researchers. To improve the quality of data obtained, future automated wearable camera-based image assisted recall studies should use a structured data format to reduce image coding time; electronically code the data in the field, as an output of the image review process, to eliminate ex post facto data entry; and, ideally, use computer-assisted personal interviews software to ensure completion and reduce errors. In-depth formative work in partnership with key local stakeholders (e.g., researchers from low-income countries, representatives from government and/or other institutional review boards, and community representatives and local leaders) is also needed to identify practical approaches to ensuring that the ethical rights of automated wearable camera study participants in low-income countries are adequately protected.
Application of probabilistic methods to address variability and uncertainty in estimating risks for non-cancer health effects
Authors: Nielsen Greylin H. , Heiger-Bernays Wendy J. , Levy Jonathan I. , White Roberta F. , Axelrad Daniel A. , Lam Juleen , Chartres Nicholas , Abrahamsson Dimitri Panagopoulos , Rayasam Swati D. G. , Shaffer Rachel M. , Zeise Lauren , Woodruff Tracey J. , Ginsberg Gary L. 
Published: January 2023

AbstractHuman health risk assessment currently uses the reference dose or reference concentration (RfD, RfC) approach to describe the level of exposure to chemical hazards without appreciable risk for non-cancer health effects in people. However, this “bright line” approach assumes that there is minimal risk below the RfD/RfC with some undefined level of increased risk at exposures above the RfD/RfC and has limited utility for decision-making. Rather than this dichotomous approach, non-cancer risk assessment can benefit from incorporating probabilistic methods to estimate the amount of risk across a wide range of exposures and define a risk-specific dose. We identify and review existing approaches for conducting probabilistic non-cancer risk assessments. Using perchloroethylene (PCE), a priority chemical for the U.S. Environmental Protection Agency under the Toxic Substances Control Act, we calculate risk-specific doses for the effects on cognitive deficits using probabilistic risk assessment approaches. Our probabilistic risk assessment shows that chronic exposure to 0.004 ppm PCE is associated with approximately 1-in-1,000 risk for a 5% reduced performance on the Wechsler Memory Scale Visual Reproduction subtest with 95% confidence. This exposure level associated with a 1-in-1000 risk for non-cancer neurocognitive deficits is lower than the current RfC for PCE of 0.0059 ppm, which is based on standard point of departure and uncertainty factor approaches for the same neurotoxic effects in occupationally exposed adults. We found that the population-level risk of cognitive deficit (indicating central nervous system dysfunction) is estimated to be greater than the cancer risk level of 1-in-100,000 at a similar chronic exposure level. The extension of toxicological endpoints to more clinically relevant endpoints, along with consideration of magnitude and severity of effect, will help in the selection of acceptable risk targets for non-cancer effects. We find that probabilistic approaches can 1) provide greater context to existing RfDs and RfCs by describing the probability of effect across a range of exposure levels including the RfD/RfC in a diverse population for a given magnitude of effect and confidence level, 2) relate effects of chemical exposures to clinical disease risk so that the resulting risk assessments can better inform decision-makers and benefit-cost analysis, and 3) better reflect the underlying biology and uncertainties of population risks.
Advancing the science on chemical classes
Authors: Maffini Maricel V. , Rayasam Swati D. G. , Axelrad Daniel A. , Birnbaum Linda S. , Cooper Courtney , Franjevic Shari , MacRoy Patrick M. , Nachman Keeve E. , Patisaul Heather B. , Rodgers Kathryn M. , Rossi Mark S. , Schettler Ted , Solomon Gina M. , Woodruff Tracey J. 
Published: January 2023

AbstractBackgroundHazard identification, risk assessment, regulatory, and policy activity are usually conducted on a chemical-by-chemical basis. Grouping chemicals into categories or classes is an underutilized approach that could make risk assessment and management of chemicals more efficient for regulators.Objective and methodsWhile there are some available methods and regulatory frameworks that include the grouping of chemicals (e.g.,same molecular mechanism or similar chemical structure) there has not been a comprehensive evaluation of these different approaches nor a recommended course of action to better consider chemical classes in decision-making. This manuscript: 1) reviews current national and international approaches to grouping; 2) describes how groups could be defined based on the decision context (e.g., hazard/risk assessment, restrictions, prioritization, product development) and scientific considerations (e.g., intrinsic physical-chemical properties); 3) discusses advantages of developing a decision tree approach for grouping; 4) uses ortho-phthalates as a case study to identify and organize frameworks that could be used across agencies; and 5) discusses opportunities to advance the class concept within various regulatory decision-making scenarios.ResultsStructural similarity was the most common grouping approach for risk assessment among regulatory agencies (national and state level) and non-regulatory organizations, albeit with some variations in its definition. Toxicity to the same target organ or to the same biological function was also used in a few cases. The phthalates case study showed that a decision tree approach for grouping should include questions about uses regulated by other agencies to encourage more efficient, coherent, and protective chemical risk management.Discussion and conclusionOur evaluation of how classes of chemicals are defined and used identified commonalities and differences based on regulatory frameworks, risk assessments, and business strategies. We also identified that using a class-based approach could result in a more efficient process to reduce exposures to multiple hazardous chemicals and, ultimately, reduce health risks. We concluded that, in the absence of a prescribed method, a decision tree approach could facilitate the selection of chemicals belonging to a pre-defined class (e.g., chemicals with endocrine-disrupting activity; organohalogen flame retardants [OFR]) based on the decision-making context (e.g., regulatory risk management).
Photochemically-driven highly efficient intracellular delivery and light/hypoxia programmable triggered cancer photo-chemotherapy
Authors: Zhang Wei , Zhang Cuncheng , Yang Chao , Wang Xingyue , Liu Weiwei , Yang Mi , Cao Yang , Ran Haitao 
Published: January 2023

Abstract
Background
Using nanotechnology to improve the efficiency of tumor treatment represents a major research interest in recent years. However, there are paradoxes and obstacles in using a single nanoparticle to fulfill all the requirements of complex tumor treatment.

Results
In this paper, a programmed-triggered nanoplatform (APP NPs), which is sequentially responsive to light and hypoxia, is rationally integrated for photoacoustic (PA) imaging-guided synergistic cancer photo-chemotherapy. The nanoplatform is constructed by in situ hybridization of dopamine monomer in the skeleton of PCN-224 and loading prodrug banoxantrone (AQ4N). Upon first-stage irradiation with a 660 nm laser, cellular internalization was effectively promoted by a photosensitizer-mediated photochemical effect. Furthermore, under second-stage irradiation, APP NPs exhibit a notably high photothermal conversion efficiency and sufficient reactive oxygen species (ROS) production for photothermal therapy (PTT) and photodynamic therapy (PDT), respectively, which not only triggers rapid intercellular drug release but also consequently aggravates tumor hypoxia levels, and aggravated hypoxia can further active the cytotoxicity of AQ4N for chemotherapy. Both in vitro and in vivo studies confirm that the dual-stage light guided photo-chemotherapy strategy exhibits a greatly enhanced anticancer effects and superior therapeutic safety.

Conclusion
This work represents a versatile strategy to construct a dual-stage light induced PDT/PTT and hypoxia-activated chemotherapy nanoplatform and will be promising for the development of multistimuli-responsive nanosystems with programmable functions for precise cancer therapy.
Additional evidence for the role of chromosomal imbalances and SOX8, ZNRF3 and HHAT gene variants in early human testis development
Authors: Rjiba Khouloud , Mougou-Zerelli Soumaya , Hamida Imen hadj , Saad Ghada , Khadija Bochra , Jelloul Afef , Slimani Wafa , Hasni Yosra , Dimassi Sarra , khelifa Hela Ben , Sallem Amira , Kammoun Molka , Abdallah Hamza Hadj , Gribaa Moez , Bignon-Topalovic Joelle , Chelly Sami , Khairi Hédi , Bibi Mohamed , Kacem Maha , Saad Ali , Bashamboo Anu , McElreavey Kenneth 
Published: January 2023

AbstractBackgroundForty-six ,XY Differences/Disorders of Sex Development (DSD) are characterized by a broad phenotypic spectrum ranging from typical female to male with undervirilized external genitalia, or more rarely testicular regression with a typical male phenotype. Despite progress in the genetic diagnosis of DSD, most 46,XY DSD cases remain idiopathic.MethodsTo determine the genetic causes of 46,XY DSD, we studied 165 patients of Tunisian ancestry, who presented a wide range of DSD phenotypes. Karyotyping, candidate gene sequencing, and whole-exome sequencing (WES) were performed.ResultsCytogenetic abnormalities, including a high frequency of sex chromosomal anomalies (85.4%), explained the phenotype in 30.9% (51/165) of the cohort. Sanger sequencing of candidate genes identified a novel pathogenic variant in theSRYgene in a patient with 46,XY gonadal dysgenesis. An exome screen of a sub-group of 44 patients with 46,XY DSD revealed pathogenic or likely pathogenic variants in 38.6% (17/44) of patients.ConclusionRare or novel pathogenic variants were identified in theAR, SRD5A2, ZNRF3, SOX8, SOX9andHHATgenes. Overall our data indicate a genetic diagnosis rate of 41.2% (68/165) in the group of 46,XY DSD.
Raising the contraceptive prevalence rate to 50% by 2025 in Pakistan: an analysis of number of users and service delivery channels
Authors: Abdullah Mujahid , Bilal Faiq , Khan Romesa , Ahmed Azadeh , Khawaja Aamir Ashraf , Sultan Faisal , Khan Adnan Ahmad 
Published: January 2023

Abstract
Background
Pakistan is the fifth most populous country in the world, with a population that is growing at 2.4% annually. Despite considerable political will, including a national commitment that was endorsed by the president to raise the contraceptive prevalence rate (CPR) to 50% by 2025, it has stagnated at around 30–35%. Much of the dialogue on raising CPR is hypothetical and revolves around percentage point change rather than an actual number of women that must be served.

Methods
The Demographic and Health Survey 2017–18 (DHS 2017–18) provides information about the channels through which users receive family planning (FP) services and disaggregates this information at the provincial level. Proportions of users from each of these channels were multiplied by the Pakistan Census-2017 populations to arrive at the number of users. These users were compared with the total FP users and the number of women that had used any FP service in the past 12 months. Linear estimations of population were applied to calculate population numbers in 2025.

Results
The national target of 50% CPR by 2025 translates to a population of 20.02 million users. Currently, 11.26 million married women of reproductive age (MWRA) use any method, 8.22 million use a modern method and 4.94 million received this service in the past 12 months. Of these, 2.7 million did so from social marketing outlets, 0.76 million from public sector outreach through lady health workers (LHWs), 0.55 million from private sector and 0.88 million from public sector facilities. However, arriving at the CPR target means expanding annual service delivery from 4.94 to 13.7 million users. Since social marketing and LHW outreach may have become saturated, only public and private health facilities are the likely channels for such an expansion.

Conclusions
We demonstrate triangulation of the survey data with the census data as a simple policy analysis tool that can help decision-makers estimate the quantum of services they must provide. Such an analysis also allows an understanding of the utilization patterns of each of these channels. In Pakistan’s context, underutilization of funds and existing facilities suggests that increased funding or more providers will likely not be helpful. The policy changes that will likely be most effective include adding outreach to support existing public and private sector facilities while ensuring that procurement of commodities is prioritized.
Clinical and economic benefits of image-guided system in functional endoscopicsinus surgery: a retrospective chart review study in China
Authors: Wang Zaixing , Liu Chunling , Tan Baoying , Sun Guoqing , Pang Poucheok , lv Kangchen , Xie Hui , Ou Xiong , Zeng Xianhai , Xuan Jianwei 
Published: January 2023

Abstract
Background
Image-guided system (IGS) has been gradually applied in the field of rhinology, making functional endoscopic sinus surgery (FESS) a truly minimally invasive and precise surgery. This study was based on real-world data from China hospitals and aimed to evaluate the clinical and economic benefits of the IGS navigation system in FESS.

Methods
This was a two-center retrospective chart review of patients with chronic rhinosinusitis who underwent FESS, including open frontal sinus between July 1, 2018 and December 31, 2019 in China. The intervention group consisted of 100 patients who underwent FESS with the IGS navigation system (IGS group), and the control group consisted of 100 patients who underwent conventional FESS (Non-IGS group). Data were collected from surgical notes and hospital medical records. The primary endpoints for clinical effectiveness and safety were avoid rehospitalization due to bleeding, avoid reoperation due to bleeding, and avoid reoperation due to recurrence.

Results
There were no cases of rehospitalization due to bleeding, reoperation due to bleeding, and reoperation due to recurrence in the IGS group, with an avoidance rate of 100%. In the non-IGS group, there were four cases of rehospitalization and reoperation due to bleeding, with an avoidance rate 96.00% (P = 0.121). No cases of reoperation due to recurrence were in the non-IGS group. The total hospitalization cost was 17,391.51 CNY in the IGS group and 17,742.41 CNY in the non-IGS group per patient, with no statistical difference between the two groups (P = 0.715). Compared with the non-IGS group, the IGS group had an overall cost saving of 350.90 CNY per patient. Although the procedure-related medical costs of IGS group were increased by 1,286.12 CNY compared with the non-IGS group, this was more than offset by other costs.

Conclusion
The results of the study indicated that the IGS may avoid occurrence of rehospitalization and reoperation due to postoperative bleeding. Although the use of navigation technology increased the cost of surgery, its clinical effectiveness brought other medical cost savings, resulting in no significant difference in the overall cost of navigation surgery compared to conventional surgery. The IGS should be considered cost-effectiveness in the treatment of FESS.
Detrimental consequences after intimal disruption of subclavian artery during transcathether aortic valve implantation
Authors: Reuthebuch Oliver T. , Vasiloi Ion , Nestelberger Thomas , Wolff Thomas , Eckstein Friedrich S. 
Published: January 2023

AbstractBackgroundTAVI via the left subclavian artery is considered a bail-out strategy in cases where a transfemoral approach is not feasible. However, since this route is only scarcely used, major complications can arise. We describe such an adverse course and present our proceeding.Case presentationA 65-year-old man with severe aortic valve stenosis (AS) was referred for transcatheter aortic valve implantation (TAVI) via left subclavian artery. After uneventful deployment of the TAVI prosthesis, consequent valve assessment with transeosophageal echocardiography and angiography showed a highly mobile and tubular structure shifting within the valve. We went for a surgical extraction via sternotomy on cardiopulmonary bypass (CPB). A 6 cm longish intimal cylinder was hassle-free extracted. 4 days postoperatively the left sided radial pulse was missing. In a subsequent computed tomography angiography (CTA) scan a proximal dissection as well as an intimal flap, causing a subtotal stenosis of the left subclavian artery, was detected. Consecutively the intimal cylinder was removed using a Fogarty-balloon. Pre-discharge control revealed recurrence of peripheral radial pulse and an unimpeded function of the TAVI prosthesis. The patient presented no sequela at discharge.ConclusionThough TAVI is a well-advanced technique complications are not completely avertable. It is thus advisable to have patients discussed in the heart team encompassing all potentially involved specialties.