bluuebunny/crossref_metadata_2025_split huggingface dataset:
Nationwide experiences with trough levels, durability, and disease activity among inflammatory bowel disease patients following COVID-19 vaccination
Authors: Resál Tamás , Bacsur Péter , Horváth Miklós , Szántó Kata , Rutka Mariann , Bálint Anita , Fábián Anna , Bor Renáta , Szepes Zoltán , Fekete János , Farkas Klaudia , Miheller Pál , Molnár Tamás 
Published: July 2023

Background: The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic has complicated the management of inflammatory bowel diseases (IBD). Objectives: This study aimed to assess the efficacy of different anti-SARS-CoV-2 vaccines under different treatments in IBD patients and identify predictive factors associated with lower serological response, including anti-tumor necrosis factor (anti-TNF) drug levels. Design: A prospective, double-center study of IBD patients was conducted following messenger ribonucleotide acid (mRNA) and non-mRNA anti-SARS-CoV-2 vaccination. Methods: Healthy control (HC) patients were enrolled to reduce bias. Baseline and control samples were obtained 14 days after the second dose to assess the impact of conventional and biological treatments. Clinical and biochemical activity, serological response level, and anti-TNF drug levels were measured. Results: This study included 199 IBD (mean age, 40.9 ± 12.72 years) and 77 HC participants (mean age, 50.3 ± 12.36 years). Most patients (76.9%) and all HCs received mRNA vaccines. Half of the IBD patients were on biological treatment (anti-TNF 68.7%). Biological and thiopurine combined immunomodulation and biological treatment were associated with lower serological response ( p < 0.001), and mRNA vaccination promoted better antibody levels ( p < 0.001). Higher adalimumab levels caused lower serological response ( p = 0.006). W8 persistence of anti-SARS-CoV-2 level was equal in IBD and HC groups. Vaccination did not aggravate clinical disease activity ( p = 0.65). Conclusion: Anti-SARS-CoV-2 vaccination is considerably efficacious in IBD patients, with mRNA vaccines promoting better antibody levels. The negative impact of combined biological treatment, especially with high adalimumab drug levels, on serological response to vaccination should be considered. Although midterm durability of vaccination is encouraging, more data are needed to expand the existing understanding on this issue.
Prolonged Use of an Automated Insulin Delivery System Improves Sleep in Long-Standing Type 1 Diabetes Complicated by Impaired Awareness of Hypoglycemia
Authors: Malone Susan Kohl , Matus Austin M. , Flatt Anneliese J. , Peleckis Amy J. , Grunin Laura , Yu Gary , Jang Sooyong , Weimer James , Lee Insup , Rickels Michael R. , Goel Namni 
Published: July 2023

Background: This study assessed changes in actigraphy-estimated sleep and glycemic outcomes after initiating automated insulin delivery (AID). Methods: Ten adults with long-standing type 1 diabetes and impaired awareness of hypoglycemia (IAH) participated in an 18-month clinical trial assessing an AID intervention on hypoglycemia and counter-regulatory mechanisms. Data from eight participants (median age = 58 years) with concurrent wrist actigraph and continuous glucose monitoring (CGM) data were used in the present analyses. Actigraphs and CGM measured sleep and glycemic control at baseline (one week) and months 3, 6, 9, 12, 15, and 18 (three weeks) following AID initiation. HypoCount software integrated actigraphy with CGM data to separate wake and sleep-associated glycemic measures. Paired sample t-tests and Cohen’s d effect sizes modeled changes and their magnitude in sleep, glycemic control, IAH (Clarke score), hypoglycemia severity (HYPO score), hypoglycemia exposure (CGM), and glycemic variability (lability index [LI]; CGM coefficient-of-variation [CV]) from baseline to 18 months. Results: Sleep improved from baseline to 18 months (shorter sleep latency [ P < .05, d = 1.74], later sleep offset [ P < .05, d = 0.90], less wake after sleep onset [ P < .01, d = 1.43]). Later sleep onset ( d = 0.74) and sleep midpoint ( d = 0.77) showed medium effect sizes. Sleep improvements were evident from 12 to 15 months after AID initiation and were preceded by improved hypoglycemia awareness (Clarke score [ d = 1.18]), reduced hypoglycemia severity (HYPO score [ d = 2.13]), reduced sleep-associated hypoglycemia (percent time glucose was < 54 mg/dL, < 60 mg/dL,< 70 mg/dL; d = 0.66-0.81), and reduced glucose variability (LI, d = 0.86; CV, d = 0.62). Conclusion: AID improved sleep initiation and maintenance. Improved awareness of hypoglycemia, reduced hypoglycemia severity, hypoglycemia exposure, and glucose variability preceded sleep improvements. This trial is registered with ClinicalTrials.gov NCT03215914 https://clinicaltrials.gov/ct2/show/NCT03215914 .
Location Factors Impact the Career Choice of German Dental Practitioners – An Empirical Analytical Approach to Multi-Criteria Decision-Making
Authors: Stein David 
Published: July 2023

Objectives In light of the increasing number of employed dentists and the decreasing rate of self-employed dentists, the factors that impact the decision to set up a dental office in Germany were investigated. Central to this approach is the provision of comprehensive dental care. Methods Using a pairwise comparison technique, the analytic hierarchy process (AHP), location factors identified as relevant in a systematic literature review and then prioritized by the professionals were weighted and ranked. Results According to this, five factors generally dominate the decision to open a dental office. These are, in descending order: environment for the family, quality of life in the private environment, real income, perception of location, and good infrastructure. The strongest impact on the rank order of the influencing factors is the socio-demographic characteristic of gender. For female dentists, the family environment is in the first place (p  =  .3196/C.R.  =  0.1502). For male colleagues, this influence ranks third (p  =  .1550/C.R.  =  0.1468) and real income receives the first place (p  =  .244/C.R.  =  0.1468). For female dentists, the influence of income ranks fifth (p  =  .076/C.R.  =  0.1502). Female and male dentists who grew up in rural areas were less likely to prefer employment (13.6%) than subjects of urban origin (40.2%). Conclusion The method of AHP is a way to map a priority list of all relevant factors. It can successfully show variations related to specific personal attributes. Obviously, there are factors that are of greater importance for the decision-making process to set up a dental office.
Neonatal Jaundice Management: Knowledge, Attitude, and Practice Among Nurses and Midwives in the Northern Region, Ghana
Authors: Donkor Doreen Remember , Ziblim Shamsu-Deen , Dzantor Edem Kojo , Asumah Mubarick Nungbaso , Abdul-Mumin Alhassan 
Published: July 2023

Background Nurses and midwives play important role in managing neonatal jaundice and provide nursing health education to mothers on preventive and remedial measures to neonatal jaundice. However, the Knowledge, Attitudes, and Practices of nurses and midwives towards neonatal jaundice is not well understood in the Northern Region of Ghana. Aim of the study The study assessed the knowledge, attitudes, and practices of nurses and midwives towards the management of neonatal jaundice. Design and Method This is a hospital-based descriptive cross-sectional study, conducted between the periods of January 2021 to August 2021 in the Tamale Teaching Hospital, Northern Region, Ghana. Descriptive analysis such as mean, standard deviation, frequencies, and percentages were performed to give general description of the variables. Simple Pearson Chi-square test and logistic regression models were performed to test the level of associations between the outcome and independent variables and predictors for neonatal jaundice. A p-value of <.05 was considered statistically significant for the test of association. Results Among the 202 nurses and midwives, the mean age was 30.6 ± 3.8 years and majority were females (71.3%). The overall good knowledge, attitudes, and practices score towards neonatal jaundice was 69.30%, 64.90%, and 62.90%, respectively. After adjusting for other variables, good knowledge (adjusted odds ratio [AOR] = 22.41(10.21–49.18) p < .001) and good attitude (AOR = 25(11.86–55.07) p < .001) were positively associated with practices towards neonatal jaundice. Conclusion/Interpretation The participants demonstrated substantial knowledge, attitudes, and practices towards neonatal jaundice. However, there still exist some gaps in their knowledge, attitudes, and practices towards neonatal jaundice that need to be addressed to improve neonatal health outcomes in the study setting.
The Prevalence of Depression and its Predictors among International Postgraduate Students Studying Public Health at a UK University
Authors: Hosseinpur Hanieh , Parsa Ali Davod , Kabir Russell 
Published: July 2023

Objective: This study examined the prevalence and existing predictors of depression in international postgraduate public health students at a university in England. Material and Methods: It was carried out as a descriptive cross-sectional survey. A total of 153 students enrolled in MSc in public health and community well-being and MPH in global public health courses were recruited using a convenience sampling technique. The Centre for Epidemiological Studies Depression 10-Item Scale (CES-D-10) and Chi-squared tests were utilized to assess the prevalence of depression and the association of encountered challenges with depressive symptoms, respectively. Outcomes: The prevalence of depression was 34.6% in this study. A link was found between depressive symptoms and several socio-demographic factors such as ethnicity, source of funding, and accommodation status in the United Kingdom. There was also a significant association between depression and all general problems faced by international students except housing. Finally, of all the challenges faced at the university, communicating with lecturers was the only one associated with this disorder. Conclusion: This study highlighted the important predictors of depression among international public health students, which reflect the need for a more collaborative strategy pursued by all teams within the university to compact this crisis.
Expectant management for umbilical artery thrombosis in monochorionic diamniotic twin pregnancies: a case report
Authors: Wang Qilin , Zhang Yanping , Zhou Rong 
Published: July 2023

Abstract
Background
Thrombosis of one of the umbilical arteries is a rare complication of pregnancy and is associated with adverse pregnancy outcomes, including stillbirth and intrauterine growth restriction. Although extremely rare, umbilical artery thrombosis (UAT) in monochorionic diamniotic twins is difficult to diagnose prenatally and manage. UAT has a poor prognosis and is associated with an increased perinatal mortality rate. In most previous cases, emergency cesarean section was performed or intrauterine fetal death occurred at the time of UAT diagnosis. Case presentation: Herein, we report an extremely rare case of sequential UAT in monochorionic diamniotic twins diagnosed via ultrasound at 29+ 5 weeks of gestation in a 34-year-old woman. Following expectant management with intensive monitoring for 16 days, two healthy infants were delivered through an emergency cesarean section. UAT in both fetuses was confirmed by pathological examination. The mother and twins described in this case underwent long-term follow-up and are currently in good health without any complications.

Conclusions
Based on our experience, we suggest that expectant management should be undertaken as long as the mother and infants are stable on ultrasonographic scans and are closely monitored. When UAT is suspected, we believe that the best delivery time should be determined by considering complaints of unusual fetal movements, non-stress test evidence, gestational age, amniotic fluid volume, and blood flow in the umbilical artery, middle cerebral artery, and ductus venosus. Obstetricians should ensure that the patients and their families are clearly informed about all potential risks of expectant management for UAT.
The acceptability of evidence-informed guidance for parents in talking to their children about weight
Authors: Baber Fran , Gillison Fiona B , Grey Elisabeth B 
Published: July 2023

Abstract
Background
Many parents express concern about the impact of talking to children about weight on their self-esteem and wellbeing. The aim of this study was to explore the perceived relevance, utility and acceptability of new guidance for parents on talking to children about weight, developed to apply theory, evidence and expert advice into practice.

Methods
For this qualitative study, parents and public health practitioners (PHPs) were recruited from ten local authorities in England, through the National Child Measurement Programme between June and September 2021. Participants were sent a copy of the guidance document and took part in an interview approximately one week later. Interviews were transcribed verbatim and explored using thematic analysis.

Results
12 parents and 15 PHPs took part, and were similar in their responses reporting the guidance to be acceptable, relevant and helpful. Theme 1 explored how the guidance reduced perceptions of stigma and blame through the perspective and tone that was adopted. Theme 2 explored how the guidance could provide reassurance and increase confidence as a result of case study examples, and specific tips and advice. Theme 3 explored the extent to which participants perceived the advice to be realistic and how it could fit with existing PHP practice. Suggestions for improvement included adapting for relevance for lower income families and providing separate advice for parents of older and younger children.

Conclusions
The guidance was perceived as relevant and needed; it showed potential to reduce parents’ negative affect and concerns, and improve confidence around talking to children about weight.
Two microRNAs of plasma-derived small extracellular vesicles as biomarkers for metastatic non-small cell lung cancer
Authors: Geng Nan , Qi Yaopu , Qin Wenwen , Li Si , Jin Hao , Jiang Yifang , Wang Xiuhuan , Wei Shanna , Wang Ping 
Published: July 2023

Abstract
Background
MicroRNAs (miRNAs) of plasma-derived small extracellular vesicles (sEVs) have been proven to be associated with metastasis in several types of cancer. This study aimed to detect miRNAs of plasma-derived sEVs as potential biomarkers for metastatic non-small cell lung cancer (NSCLC).

Methods
We assessed the miRNA profiles of plasma-derived sEVs from healthy individuals as the control group (CT group), NSCLC patients without distant organ metastasis as the NM-NSCLC group and patients with distant organ metastasis as the M-NSCLC group. Next-generation sequencing (NGS) was performed on samples, and differentially expressed miRNAs (DEMs) of the three groups were screened. Kyoto Encyclopedia of Genes and Genomes (KEGG) and ClueGO were used to predict potential pathways of DEMs. MiRNA enrichment analysis and annotation tool (miEAA) was used to understand changes in the tumour microenvironment in NSCLC. Quantitative reverse transcription polymerase chain reaction (qRT‒PCR) analysis was used to validate target miRNAs.

Result
NGS was performed on 38 samples of miRNAs of plasma-derived sEVs, and DEMs were screened out between the above three groups. Regarding the distribution of DEMs in the NM-NSCLC and M-NSCLC groups, KEGG pathway analysis showed enrichment in focal adhesion and gap junctions and ClueGO in the Rap1 and Hippo signaling pathways; miEAA found that fibroblasts were over-represented. From our screening, miRNA-200c-3p and miRNA-4429 were found to be predictive DEMs among the CT, NM-NSCLC and M-NSCLC groups, and qRT‒PCR was applied to verify the results. Finally, it was revealed that expression levels of miR-200c-3p and miR-4429 were significantly upregulated in M-NSCLC patients.

Conclusion
This study identified miRNA-200c-3p and miRNA-4429 as potential biomarkers for NSCLC metastasis.
Laboratory services in the context of prevention of mother-to-child transmission of HIV testing requirements in Copperbelt Province, Zambia: a qualitative inquiry
Authors: Mwanza Jonathan , Doherty Tanya , Lubeya Mwansa Ketty , Gray Glenda E. , Mutale Wilbroad , Kawonga Mary 
Published: July 2023

AbstractIntroductionReliable and timely laboratory results are crucial for monitoring the Prevention of the Mother-to-Child Transmission (PMTCT) cascade, particularly to enable early HIV diagnosis and early intervention. We sought to explore whether and how laboratory services have been prepared to absorb new testing requirements following PMTCT Test-and-Treat policy changes in three districts of Zambia.MethodWe employed in-depth interviews and thematic data analysis, informed by the health system dynamic framework. Twenty-Six health workers were purposively selected and a document review of laboratory services in the context of PMTCT was undertaken. All face-to-face interviews were conducted in three local government areas in the Copperbelt Province (one urban and two rural) between February 2019 and July 2020. We extracted notes and markings from the transcripts for coding. Different codes were sorted into potential themes and the data extracted were put within the identified themes. Trustworthiness was confirmed by keeping records of all data field notes, transcripts, and reflexive journals.ResultsThe findings revealed that the health system inputs (infrastructure and supplies, human resources, knowledge, and information and finance) and service delivery were unequal between the rural and urban sites, and this affected the ability of health facilities to apply the new testing requirements, especially, in the rural-based health facilities. The major barriers identified include gaps in the capacity of the existing laboratory system to perform crucial PMTCT clinical and surveillance functions in a coordinated manner and insufficient skilled human resources to absorb the increased testing demands. The centralized laboratory system for HIV testing of mothers and exposed neonates meant facilities had to send specimens to other facilities and districts which resulted in high turnaround time and hence delayed HIV diagnosis.ConclusionNew guidelines implemented without sufficient capacitation of health system laboratory capacity severely limited the effectiveness of PMTCT program implementation. This study documented the areas relating to health system inputs and laboratory service delivery where greater support to enable the absorption of the new testing requirements is needed.
Polyhydroxybutyrate production by recombinant Escherichia coli based on genes related to synthesis pathway of PHB from Massilia sp. UMI-21
Authors: Jiang Nan , Wang Ming , Song Linxin , Yu Dengbin , Zhou Shuangzi , Li Yu , Li Haiyan , Han Xuerong 
Published: July 2023

Abstract
Background
Polyhydroxybutyrate (PHB) is currently the most common polymer produced by natural bacteria and alternative to conventional petrochemical-based plastics due to its similar material properties and biodegradability. Massilia sp. UMI-21, a newly found bacterium, could produce PHB from starch, maltotriose, or maltose, etc. and could serve as a candidate for seaweed-degrading bioplastic producers. However, the genes involved in PHB metabolism in Massilia sp. UMI-21 are still unclear.

Results
In the present study, we assembled and annotated the genome of Massilia sp. UMI-21, identified genes related to the metabolism of PHB, and successfully constructed recombinant Escherichia coli harboring PHB-related genes (phaA2, phaB1 and phaC1) of Massilia sp. UMI-21, which showed up to 139.41% more product. Also, the vgb gene (encoding Vitreoscilla hemoglobin) was introduced into the genetically engineered E. coli and gained up to 117.42% more cell dry weight, 213.30% more PHB-like production and 44.09% more product content. Fermentation products extracted from recombinant E. coli harboring pETDuet1-phaA2phaB1-phaC1 and pETDuet1-phaA2phaB1-phaC1-vgb were identified as PHB by Fourier Transform Infrared and Proton nuclear magnetic resonance spectroscopy analysis. Furthermore, the decomposition temperature at 10% weight loss of PHB extracted from Massilia sp. UMI-21, recombinant E. coli DH5α-pETDuet1-phaA2phaB1-phaC1 and DH5α-pETDuet1-phaA2phaB1-phaC1-vgb was 276.5, 278.7 and 286.3 °C, respectively, showing good thermal stability.

Conclusions
Herein, we presented the whole genome information of PHB-producing Massilia sp. UMI-21 and constructed novel recombinant strains using key genes in PHB synthesis of strain UMI-21 and the vgb gene. This genetically engineered E. coli strain can serve as an effective novel candidate in E. coli cell factory for PHB production by the rapid cell growth and high PHB production.
Unmasked immune reconstitution inflammatory syndrome towards B-cell non-Hodgkin lymphoma during treatment of esophageal actinomycosis in a patient with advanced HIV: a case report
Authors: Vargas-Garcia Elsa K. , Fernandez-Aristi Augusto R. , Cornejo-Venegas Gonzalo , Montenegro-Idrogo Juan José , Chirinos-Vega Juan , Chiappe-Gonzalez Alfredo 
Published: July 2023

AbstractBackgroundActinomycosis is an unusual chronic bacterial infection, even rarer in people living with HIV. It is not considered an AIDS-defining disease. However, the role in co-presentation or overlap with other opportunistic conditions of advanced HIV is unknown.Case presentationA 49-year-old Peruvian male presented with a 4-month history of dysphagia, odynophagia, hyporexia and wasting. He underwent an upper digestive endoscopy, in which ulcers with a necrotic center were observed, therefore, the initial diagnostic assumption was esophageal cancer. Subsequent pathology report excluded neoplasms and confirmed the diagnosis of actinomycosis. Serology for human immunodeficiency virus was requested, yielding a positive result. Antimicrobial treatment with amoxicillin and antiretroviral therapy were indicated, with slow clinical improvement. After 4 months, epigastric discomfort presented, for which a new upper digestive endoscopy was performed, revealing a deep gastric ulcer, which was compatible with diffuse large B-cell non-Hodgkin lymphoma.ConclusionEsophageal actinomycosis in people living with HIV is very rare. We suggest HIV-associated immunosuppression is not enough to allow for actinomycosis to develop, and masked underlying entities should be sought. The existence of such entities in people living with HIV should raise awareness of the possibility of unmasked immune reconstitution inflammatory syndrome once treatment has started.