bluuebunny/crossref_metadata_2025_split huggingface dataset:
Czech dysplasia mimicking rheumatoid arthritis: Case series and literature review
Authors: Moreira Larissa Aniceto , Carvalho Daniel Rocha , Santos Savana Camilla Lima , Silva Cynthia Costa E , Ferreira Bruno Silva Araujo , Cunha Bernardo Matos da , Silveira Karina Costa , Lacarrubba-Flores Maria Dora Jazmin , Cavalcanti Denise Pontes , Mota Licia Maria Henrique da 
Published: July 2023

ABSTRACT

Objective
This study reported a family with most members affected by Czech dysplasia. We examined the patients’ clinical, laboratory, and imaging characteristics and evaluated their functional capacity using the Stanford Health Assessment Questionnaire-Disability Index.

Methods
The method used was case series description and literature review.

Results
This study showed that the pathogenic variant c.823C&gt;T in the COL2A1 gene, which is a characteristic of Czech dysplasia, was found in 12 Brazilian individuals. Half of the patients in this family met the criteria for rheumatoid arthritis (RA) based on the 2010 American College of Rheumatology/European League Against Rheumatism classification criteria. Patients had arthritis in their hand joints, synovitis detected by ultrasound, and alterations in inflammatory tests. The Stanford Health Assessment Questionnaire-Disability Index assessment revealed that all patients exhibited moderate-to-severe functional disability. What distinguish Czech dysplasia from RA are an autosomal dominant inheritance pattern, platyspondyly, sensorineural hearing loss, and shortening of the metatarsal bones.

Conclusions
It is important to consider Czech dysplasia as a potential differential diagnosis for RA. This autosomal dominant skeletal dysplasia is associated with normal height, short metatarsals, platyspondyly, hearing loss, enlarged epiphyses, and precocious osteoarthritis. Inflammatory findings such as arthritis, synovitis, and alteration of inflammatory markers may also be present in individuals with Czech dysplasia.
Reducing perinatal infection risk in newborns of mothers who received inadequate prenatal care
Authors: Bitnun Ari , Sauvé Laura , Fanella Sergio 
Published: July 2023

Abstract
Inadequate prenatal care increases risk for maternal infections going undetected and untreated, putting both the mother’s health and that of her infant at risk. When pregnant women present late to care, routine testing that impacts infant management should include: hepatitis B surface antigen (HBsAg); serology for hepatitis C virus (HCV), human immunodeficiency virus (HIV), and syphilis; and testing for Chlamydia trachomatis and Neisseria gonorrhoeae. If the mother was not tested before or after delivery and is not available for testing, the infant should undergo testing for HIV, HBV, HCV, and syphilis. Testing for C. trachomatis and N. gonorrhoeae should be undertaken if the infant develops compatible clinical manifestations. Rapid turnaround of test results for HIV, HBV, and syphilis is optimal because preventive treatment decisions are time-sensitive. Early and effective preventive interventions are available for newborns at risk for HIV, HBV, syphilis, or gonorrhea. Close clinical follow-up and follow-up testing of infants born to mothers with inadequate prenatal care are warranted, as not all infections can be fully excluded perinatally.
Drivers that decrease hospital-delivered care in children with medical complexity: Parental perspectives
Authors: Thibault Louis-Philippe , Bourque Claude Julie , Gaucher Nathalie , Marano Maria , Couture Karine , Saad Lydia , Chartrand Caroline , Frégeau Sandra , Doré-Bergeron Marie-Joëlle , Fiscaletti Melissa , Kleiber Niina 
Published: July 2023

Abstract

Background and objective
Children with medical complexity (CMC) have chronic and severe conditions leading to medical fragility. CMC represent less than 1% of children but account for one-third of paediatric healthcare expenditures. Enrollment to a complex care program (CCP) decreases health care resource utilization while improving parental satisfaction. An in-depth understanding of how these changes operate in real-world setting is needed to further support CMC and their families. This study aimed at assessing the possible reasons for a decrease in emergency department (ED) visits and hospitalization length of stay related to enrollment to a CCP, based on parental perspectives.

Study design
Using a qualitative approach, data were collected using in-depth, semi-structured interviews with parents of CMC enrolled in a CCP from a university hospital centre in Montreal, Canada. The interview guide was co-constructed by an interdisciplinary team, including a parent partner and a clinical nurse coordinator. Themes have been identified inductively, using thematic analysis.

Results
Parents identified personalized care, family empowerment and guidance as enablers arising from the CCP that contributed to the decrease in hospital-delivered care utilization. Improvement in medical baseline condition was also identified as a contributing factor, while not necessarily related to program’s support.

Conclusions
In this study, we identified personalized care, parental empowerment, and guidance as three strategies for a CCP to potentially decrease ED visits and hospital length of stay, from the parents’ perspective. Parents identified the clinical nurse coordinator as playing a central role in supporting the implementation of these strategies.
Mapping Aedes aegypti indoor resting behavior reveals a preference vulnerable to householder-led vector control
Authors: Facchinelli Luca , Alsharif Bashir , Jones Jeff D , Matope Agnes , Barbosa Rôsangela M R , Ayres Constância F J , McCall Philip J 
Published: July 2023

Abstract
Many mosquito vectors rest inside human habitations, a behavioral trait that is exploited for vector control by indoor residual spraying (IRS) of interior walls with insecticide. Although IRS and its refined version targeted IRS are very effective against Aedes aegypti, they are expensive and logistically challenging to deliver in densely populated urban areas where outbreaks of dengue and other arboviruses are the greatest challenge. In experiments in Recife, Brazil, we set out to quantify the indoor resting behavior of Ae. aegypti at a level beyond that previously reported. We found that significantly more Ae. aegypti males, unfed and fed females visited the base of walls (height 0–20 cm, corresponding to 12.3% of the total wall surface) more frequently than upper wall areas, with the difference more pronounced at higher temperatures. When the lowest 20 cm of the walls was treated with an appropriate insecticide and colored black, we recorded up to 85% cumulative mortality after 24-h exposure in the experimental room. The findings are significant because feasibly, householders could treat this small and accessible target zone manually, without the need for visits by costly IRS teams or equipment, reducing insecticide use and enabling communities to actively protect their own indoor environment.
TNF inhibitors significantly attenuate the humoral immune response to COVID-19 vaccination in patients with rheumatoid arthritis
Authors: Schäfer Arne , Kovacs Magdolna S , Eder Anna , Nigg Axel , Feuchtenberger Martin 
Published: July 2023

Abstract

Objective
Several studies on the immunogenicity of vaccination against coronavirus disease 2019 (COVID-19) in patients with immune-mediated inflammatory diseases have evaluated the influence of DMARDs. The aim of the work presented here was to compare the humoral vaccine response after two vaccinations between patients with RA undergoing TNF inhibitor therapy and healthy controls.

Methods
We assessed the humoral immune response, as measured by titres of neutralizing antibodies against the S1 antigen of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), in patients with RA and anti-TNF treatment vs. controls without immunomodulatory medication. One hundred and seven fully vaccinated individuals were included at 6 ± 1 weeks after the second vaccination [BioNTech/Pfizer (72.9%), AstraZeneca (17.8%) and Moderna (9.3%)]. Immune responses in terms of antibody titres were compared between both subgroups with (n = 45) and without (n = 62) exposure to anti-TNF medication. The comparison was performed as a cross-sectional, single-centre study approach using non-parametric tests for central tendency.

Results
Anti-TNF medication produced a significantly impaired humoral immune response to vaccination against COVID-19. The maximum immune response was detected in 77.4% of control patients, whereas this decreased to 62.2% in participants treated with TNF inhibitors (P = 0.045; effect size, d = 0.194). Patients on combination treatment (anti-TNF medication and MTX, 17 of 45 subjects in the treatment group) did not differ significantly regarding humoral immune response compared with patients on monotherapy with TNF inhibitors only (P = 0.214).

Conclusion
TNF inhibitors significantly reduce the humoral response following dual vaccination against COVID-19 in patients with RA.
Metformin and Aspirin: Anticancer effects on A549 and PC3 cancer cells and the mechanisms of action
Authors: Motafeghi Farzaneh , Shahsavari Romina , Mortazavi Parham , Babaei Aysan , Samadi Mojaveri Pouria , Khojasteh Omid Abed , Shokrzadeh Mohammad 
Published: July 2023

Abstract

Metformin exerts its anticancer effect through two mechanisms, directly affecting the tumor and indirectly reducing systemic insulin levels. The anticancer effects of aspirin occur by inhibiting Cyclooxygenase (COX)-2. COX-2 is absent in many cell types under normal conditions and increases under pathological conditions such as cancer. This study aims to investigate the effect of metformin and aspirin and their combination of them on A549 and PC3 cell lines. Metformin and aspirin were investigated separately and in combination on two cancer cell lines, A549 and PC3. The examined groups include the negative control of untreated cells and the positive control of cisplatin and drugs at concentrations of 15, 10, and 20 μg/ mL to investigate the mechanism of oxidative stress factors (reactive oxygen species, lipid peroxidation, Glutathione (GSH)) and apoptosis (lactate dehydrogenase). The results showed that aspirin, metformin, and their combination could affect cancer cell growth by damaging mitochondria, releasing reactive oxygen species, and activating the oxidative stress pathway. Also, these two drugs show the activation of the apoptotic pathway in cancer cells by increasing the lactate dehydrogenase factor and releasing it from the cells. By disrupting the balance of oxidants and antioxidants in the cell, metformin and aspirin cause an increase in the level of reactive oxygen species and a decrease in the level of glutathione reserves, followed by an increase in the level of lipid peroxidation and a decrease in cell viability. Unlike common chemotherapy drugs, these drugs have no known severe side effects; Therefore, in the not-so-distant future, these drugs can also be used as anticancer drugs.

Highlights
Comparison of in silico, in vitro, and in vivo toxicity benchmarks suggests a role for ToxCast data in ecological hazard assessment
Authors: Schaupp Christopher M , Maloney Erin M , Mattingly Kali Z , Olker Jennifer H , Villeneuve Daniel L 
Published: July 2023

Abstract
Large repositories of in vitro bioactivity data such as US EPA’s Toxicity Forecaster (ToxCast) provide a wealth of publicly accessible toxicity information for thousands of chemicals. These data can be used to calculate point-of-departure (POD) estimates via concentration-response modeling that may serve as lower bound, protective estimates of in vivo effects. However, the data are predominantly based on mammalian models and discussions to date about their utility have largely focused on potential integration into human hazard assessment, rather than application to ecological risk assessment. The goal of the present study was to compare PODs based on (1) quantitative structure-activity relationships (QSARs), (2) the 5th centile of the activity concentration at cutoff (ACC), and (3) lower-bound cytotoxic burst (LCB) from ToxCast, with the distribution of in vivo PODs compiled in the Ecotoxicology Knowledgebase (ECOTOX). While overall correlation between ToxCast ACC5 and ECOTOX PODs for 649 chemicals was weak, there were significant associations among PODs based on LCB and ECOTOX, LCB and QSARs, and ECOTOX and QSARs. Certain classes of compounds showed moderate correlation across datasets (eg, antimicrobials/disinfectants), while others, such as organophosphate insecticides, did not. Unsurprisingly, more precise classifications of the data based on ECOTOX effect and endpoint type (eg, apical vs biochemical; acute vs chronic) had a significant effect on overall relationships. Results of this research help to define appropriate roles for data from new approach methodologies in chemical prioritization and screening of ecological hazards.
Analysis of the availability, effectiveness and equity of deployment of resources in the health system response to COVID-19 in Nigeria
Authors: Ojielo Nwadiuto C , Uguru Nkolika P , Okeke Chinyere C , Onwujekwe Obinna E 
Published: July 2023

ABSTRACT

Background
Coronavirus disease 2019 (COVID-19) exposed weaknesses in the health systems of countries such as Nigeria, which affected the effectiveness of the health system response to the pandemic. This paper provides new knowledge on the level of the availability, effectiveness and equity of resources in response to COVID-19 in Nigeria. This is valuable information for improving the delivery of countermeasures against future pandemics.

Methods
The study was conducted at the federal level and in two states in Nigeria. The states were Lagos in the southwest and Enugu in the southeast. In-depth interviews were undertaken with 34 key informants. NVivo version 12 software was used for coding and thematic analysis.

Results
There were inadequate, inequitable and suboptimal resources (human, financial, equipment and materials) for the response. In some of the countermeasures, only people that were employed in the formal sector benefitted from the distribution of welfare materials and financial packages; the informal sector, which constitutes the majority of the poor population in Nigeria, was excluded.

Conclusions
Inequity and suboptimal availability of resources to control COVID-19 led to reduced effectiveness of the health system response to the disease in Nigeria. Such negative factors must be mitigated in future responses to pandemics in the country.
Assessment Practices in Continuing Professional Development Activities in Health Professions: A Scoping Review
Authors: Marceau Mélanie , Vachon Lachiver Élise , Lambert Danika , Daoust Julianne , Dion Vincent , Langlois Marie-France , McConnell Meghan , Thomas Aliki , St-Onge Christina 
Published: July 2023

Introduction:
In continuing professional development (CPD), educators face the need to develop and implement innovative assessment strategies to adhere to accreditation standards and support lifelong learning. However, little is known about the development and validation of these assessment practices. We aimed to document the breadth and depth of what is known about the development and implementation of assessment practices within CPD activities.

Methods:
We conducted a scoping review using the framework proposed by Arksey and O'Malley (2005) and updated in 2020. We examined five databases and identified 1733 abstracts. Two team members screened titles and abstracts for inclusion/exclusion. After data extraction, we conducted a descriptive analysis of quantitative data and a thematic analysis of qualitative data.

Results:
A total of 130 studies were retained for the full review. Most reported assessments are written assessments (n = 100), such as multiple-choice items (n = 79). In 99 studies, authors developed an assessment for research purpose rather than for the CPD activity itself. The assessment validation process was detailed in 105 articles. In most cases, the authors examined the content with experts (n = 57) or pilot-tested the assessment (n = 50). We identified three themes: 1-satisfaction with assessment choices; 2-difficulties experienced during the administration of the assessment; and 3-complexity of the validation process.

Discussion:
Building on the adage “assessment drives learning,” it is imperative that the CPD practices contribute to the intended learning and limit the unintended negative consequences of assessment. Our results suggest that validation processes must be considered and adapted within CPD contexts.
Development and verification of the Menopause Emotional Symptom Questionnaire
Authors: Kim Na Yeon , Yoo Seo-Koo , Jin Jae-Chan , Han Seunga , Hong Ji Sun , Kim Sun Mi 
Published: July 2023

Abstract

Objective
A detailed, well-validated scale for measuring emotional symptoms in menopausal women is lacking. We aimed to develop the Menopause Emotional Symptom Questionnaire (MESQ) and to confirm its reliability and validity among Koreans.

Methods
Eighteen primary items based on previous research results were selected using exploratory factor analysis and confirmatory factor analysis (CFA). New data, including answers to the novel MESQ, Menopause Rating Scale, Kupperman Index, Beck Depression Inventory-II, and Beck Anxiety Inventory, were collected from 200 perimenopausal women and 100 young men through a research company. Exploratory factor analysis and CFA were performed again to determine whether the MESQ accurately measures emotional symptoms in perimenopausal women. Receiver operating characteristic curve and k-means cluster analyses were used to identify the most appropriate cutoff value.

Results
The MESQ showed high internal consistency (Cronbach α = 0.926), and the CFA revealed that the factor structure comprised two subscales: nine items for mood/anxiety symptoms and four items for sleep symptoms. A high correlation between the total MESQ score and total scores of the existing scales was confirmed, indicating high convergence validity. Comparison of the mean MESQ scores between men and women showed significant sex difference, indicating secure known-group validity. The cutoff point of the total MESQ score between the high-risk and low-risk groups was 26.

Conclusions
The novel MESQ has high validity and reliability, and this study confirmed that the MESQ is a valid tool for screening for and measuring emotional symptoms in menopausal women in Korea.
Indications for and Limitations of Reconstruction of Auricular Defects with the “Mid-moon Flap” and Evaluation of Outcome by the Aesthetic Numeric Analogue Score
Authors: Guarro Giuseppe , Fabrizio Tommaso 
Published: July 2023

Summary:
A variety of skin grafting techniques and local flaps have been described for medium-sized auricular defect reconstruction. Despite this, the reconstruction of a medium-sized auricular defect starting from the opposite surface is not yet reported in the literature. In the present article, the authors describe a novel surgical approach, the “mid-moon flap” technique, used for 87 patients in that kind of reconstruction. Eighty-seven patients presenting tumors located on the pinnal surface were enrolled in this study. The patient distribution included 68 men and 19 women, aged from 52 to 94 years, with a median age of 77.4 years. For all the patients, a customized cutaneous flap, named the mid-moon flap, was performed for auricular defect reconstruction. Histopathology reports confirmed the diagnosis of malignant tumors, with complete excision of the lesions in all cases. Follow-ups ranged from 6 to 36 months, with a mean of 18 months. There were no recurrences of the malignancy during the study, and the aesthetic outcome was globally considered good. The authors reported that the mid-moon flap technique is most appropriate for medium-sized auricular defects for two principal reasons: it covers the recipient area very well and, at the same time, leaves almost imperceptible relics on the donor area without causing any morphofunctional alteration of the ear.
Below-knee Amputation with Minimally Painful Injection of Tumescent Local Anesthesia
Authors: Admani Asif , Sherman Imraan , Jani Pankaj , Mwamuye Arnold , Sepehripour Sarvnaz , Lalonde Donald 
Published: July 2023

Summary:
We successfully performed minimally painful injection of tumescent local anesthesia to eliminate the need for the tourniquet and sedation for a below-knee amputation in a frail patient with multiple medical comorbidities in Mombasa, Kenya. Minimal pain injection of WALANT (wide awake local anesthesia no tourniquet) pure local anesthesia can be a good alternative for lower limb amputation in frail patients when safe sedation services are unavailable or unaffordable in many countries.
Artificial intelligence’s role in differentiating the origin for subretinal bleeding in pathologic myopia
Authors: Crincoli Emanuele , Servillo Andrea , Catania Fiammetta , Sacconi Riccardo , Mularoni Cecilia , Battista Marco , Querques Lea , Parravano Mariacristina , Costanzo Eliana , Polito Maria Sole , Bandello Francesco , Querques Giuseppe 
Published: July 2023

Abstract

Purpose:
To identify salient imaging features to support human-based differential diagnosis between subretinal hemorrhage(SH) due to choroidal neovascularization(CNV)onset and SH without CNV (simple bleeding,SB)in pathologic myopia eyes using a machine learning(ML)-based stepwise approach.

Materials and methods:
Four different methods for feature extraction were applied:GradCAM visualization,reverse engineering,image processing and human graders' measurements.GradCAM was performed on a deep learning(DL)model derived from Inception-ResNet-v2 trained with OCT B-scan images. Reverse engineering consisted in merging U-Net architecture with a deconvolutional network.Image processing consisted in the application of a local adaptive threshold. Available OCT B-scan images were divided in two groups: the first group was classified by graders before knowing the results of feature extraction; the second(different images)was classified after familiarization with the results of feature extraction.

Results:
Forty-seven(47)and 37 eyes were included in CNV group and SB group respectively.CNV eyes showed higher baseline central macular thickness(p=0.036).Image processing evidenced in CNV eyes an inhomogeneity of the subretinal material and an interruption of the Bruch membrane at the margins of the SH area.Graders’ classification performance improved from an accuracy of 76.9% without guidance to 83.3% with the guidance of the 3 methods(p=0.02). DL accuracy in the task was 86.0%.

Conclusions:
Artificial intelligence helps identifying imaging biomarkers suggestive of CNV in the context of SH in myopia,improving human ability to perform differential diagnosis on unprocessed baseline OCT B-scan images. DL can accurately distinguish between the 2 causes of SH.