bluuebunny/crossref_metadata_2025_split huggingface dataset:
Late poor outcomes of Clostridioides difficile infections in oncological patients: A multicentre cohort study
Authors: Calbo Esther , Hernández Sergi , Sopena Nieves , Castellá Laia , Lopez-Contreras Joaquín , Cuquet Jordi , López-Sánchez Maria , Pérez Rafel , Gudiol Carlota , Coloma Ana , Marimón Mariló , Espinach Joan , Andres Marta , Martos Purificación , Carvalho Rodrigues Gonçalo , Limón Enric 
Published: March 2023

Background Cancer has been associated with an increased risk of in-hospital mortality in CDI patients. However, data on delayed mortality in cancer patients with CDI are scarce. Aim/Objective The aim of the present study was to compare outcomes between oncological patients and the general population with Clostridioides difficile infection (CDI) after 90 days of follow-up. Methods A multicenter prospective cohort study was conducted in 28 hospitals participating in the VINCat program. Cases were all consecutive adult patients who met the case definition of CDI. Sociodemographic, clinical, and epidemiological variables and evolution at discharge and after 90 days were recorded for each case. Findings/results The mortality rate was higher in oncological patients (OR = 1.70, 95% CI: 1.08–2.67). In addition, oncological patients receiving chemotherapy (CT) presented higher recurrence rates (18.5% vs 9.8%, p = 0.049). Among oncological patients treated with metronidazole, those with active CT showed a higher rate of recurrence (35.3% vs 8.0% p = 0.04). Discussion Oncological patients presented a higher risk of poor outcomes after CDI. Their early and late mortality rates were higher than in the general population, and in parallel, those undergoing chemotherapy (especially those receiving metronidazole) had higher rates of recurrence
Implementation and Evaluation of an Automated Text Message–Based Diabetes Prevention Program for Adults With Pre-diabetes
Authors: Arora Sanjay , Lam Chun Nok , Burner Elizabeth , Menchine Michael 
Published: March 2023

Background: Despite the efficacy of diabetes prevention programs, only an estimated 5% of people with pre-diabetes actually participate. Mobile health (mHealth) holds promise to engage patients with pre-diabetes into lifestyle modification programs by decreasing the referral burden, centralizing remote enrollment, removing the physical requirement of a brick-and-mortar location, lowering operating costs through automation, and reducing time and transportation barriers. Methods: Non-randomized implementation study enrolling patients with pre-diabetes from a large health care organization. Patients were exposed to a text message–based program combining live human coaching guidance and support with automated scheduled, interactive, data-driven, and on-demand messages. The primary analysis examined predicted weight outcomes at 6 and 12 months. Secondary outcomes included predicted changes in HbA1c and minutes of exercise at 6 and 12 months. Results: Of the 163 participants included in the primary analysis, participants had a mean predicted weight loss of 5.5% at six months ( P < .001) and of 4.3% at 12 months ( P < .001). We observed a decrease in predicted HbA1c from 6.1 at baseline to 5.8 at 6 and 12 months ( P < .001). Activity minutes were statistically similar from a baseline of 155.5 minutes to 146.0 minutes ( P = .567) and 142.1 minutes ( P = .522) at 6 and 12 months, respectively, for the overall cohort. Conclusions: In this real-world implementation of the myAgileLife Diabetes Prevention Program among patients with pre-diabetes, we observed significant decreases in weight and HbA1c at 6 and 12 months. mHealth may represent an effective and easily scalable potential solution to deliver impactful diabetes prevention curricula to large numbers of patients.
Rash, Facial Droop, and Multifocal Intracranial Stenosis Due to Varicella Zoster Virus Vasculitis
Authors: Bilodeau Philippe-Antoine , Aghajan Yasmin , Izzy Saef 
Published: March 2023

Background: This is a case of multifocal intracranial stenosis in a 74 year old male ultimately discovered to be due to Varicella Zoster Virus infection. Purpose: We highlight the importance of a broad differential diagnosis, even when the most likely etiology of intracranial stenosis is atherosclerosis. Our paper reviews the differential diagnosis as well as “red flags” for intracranial vasculopathy. Even though intracranial atherosclerotic disease is the most common cause of vasculopathy, infectious or inflammatory vasculitis should be considered on the differential. Conclusions: Before considering bypass surgery or other invasive neurosurgical procedures, ensure reversible causes of vasculopathy have been ruled out. The presence of cranial neuropathies, rash, and/or elevated inflammatory markers should be red flags for vasculitis in patients presenting with stroke.
Some Macrophages With High Expression of CHOP Undergo Necroptosis in Chronic Rhinosinusitis
Authors: Li Min , Fu Ziming , Qi Chenglin , Wang Qinying , Xie Hui , Li Huabin 
Published: March 2023

Background Endoplasmic reticulum stress (ER stress) is activated in chronic sinusitis with nasal polyps (CRSwNP) and leads to increased expression of C/EBP homologous protein (CHOP). However, the role of CHOP in the pathogenesis of CRSwNP remains unclear. Methods CHOP expression was detected by immunohistochemistry staining in nasal mucosa of control and CRSwNP patients. Co-localization of CHOP and cleaved caspase3, p-MLKL, and CD68 was detected by immunofluorescence staining in CRSwNP patients. TNFα, IFNγ, IL1β, LPS, and tunicamycin were added to primary dispersed nasal polyp cells (DNPCs) to explore their roles in cell death. Western blot, CCK8 assay, and flow cytometry were employed to detect cell death. Results CHOP was specifically activated in CRSwNP compared to controls. It was mainly macrophages that highly expressed CHOP, some of which underwent apoptosis and the other underwent necroptosis. IL1β induced increased CHOP and apoptosis, and a slight p-MLKL. In addition, ER stress could also promote p-MLKL expression. Whereas classical TNFα plus IFNγ and LPS did not induce increased necroptosis in DNPCs. Conclusion IL1β induced the apoptotic pathway and minor necroptosis. And ER stress also plays a role in the occurrence of necroptosis in CRSwNP.
Seroprevalence of Hepatitis B Virus Infection and Associated Factors Among Pregnant Women Attending Antenatal Care At Public Hospitals in Borena Zone, Southern Ethiopia
Authors: Kampe Abdo , Kannaiyan Abbai Moorthy , Tilahun Dagnamyelew , Daka Deresse , Aliyo Alqeer , Dedecha Wako , Edin Alo 
Published: March 2023

Background Hepatitis B virus (HBV) is one of the major threats to global health, affecting millions of people each year and causing morbidity and mortality. The risk of acquiring chronic HVV infection varies with age, with 90% of infections acquired during the perinatal period. Despite many studies, there is little evidence of this virus in the Borena Zone. Objectives This study was done to assess seroprevalence HBVinfection and associated factors among pregnant women attending antenatal care at selected Borena Zone public hospitals from June 1 to September 30, 2022. Methods A cross-institutional study was conducted on 368 randomly selected pregnant women who received antenatal care at Yabelo General Hospital and Moyale Primary Hospital. Data on sociodemographic and HBV-related factors were collected using a structured questionnaire. A 5 mL blood sample is then taken and tested using a diagnostic method, the enzyme-linked immunosorbent assay. Finally, data were entered using Epidata version 3.1 and exported to SPSS version 25 and Stata version 14 for analysis. Independent predictors were identified using logistic regression analysis and P < .05 was considered statistically significant. Results The prevalence of HBV infection was 21 (5.7%) (95% confidence interval [CI], 3.74-8.61). History of hospitalization (adjusted odds ratio [AOR] =  3.44, 95% CI, 1.07-11.09), traditional tonsillectomy (AOR =  4.16, 95% CI, 1.29-13.40), history of sexually transmitted infection (AOR = 5.99, 95% CI, 1.81-19.85), human immunodeficiency virus (HIV) (AOR = 8.28, 95% CI, 1.66-41.41), and alcohol drinking (AOR = 5.08, 95% CI, 1.49-17.31) were independent predictors of HBV infection. Conclusions The results of this study indicate a moderate prevalence of HBV in selected public hospitals in the Borena Zone. History of hospitalization, traditional tonsillectomy, sexually transmitted infections, HIV, and alcohol use was significantly associated with HBV infection. Therefore, there is a need to conduct health education and more community-based research on disease transmission routes.
Application of Frailty Quantile Regression Model to Investigate of Factors Survival Time in Breast Cancer: A Multi-Center Study
Authors: Yazdani Akram , Zeraati Hojjat , Haghighat Shahpar , Kaviani Ahmad , Yaseri Mehdi 
Published: March 2023

Background The prognostic factors of survival can be accurately identified using data from different health centers, but the structure of multi-center data is heterogeneous due to the treatment of patients in different centers or similar reasons. In survival analysis, the shared frailty model is a common way to analyze multi-center data that assumes all covariates have homogenous effects. We used a censored quantile regression model for clustered survival data to study the impact of prognostic factors on survival time. Methods This multi-center historical cohort study included 1785 participants with breast cancer from four different medical centers. A censored quantile regression model with a gamma distribution for the frailty term was used, and p-value less than 0.05 considered significant. Results The 10th and 50th percentiles (95% confidence interval) of survival time were 26.22 (23–28.77) and 235.07 (130–236.55) months, respectively. The effect of metastasis on the 10th and 50th percentiles of survival time was 20.67 and 69.73 months, respectively (all p-value < 0.05). In the examination of the tumor grade, the effect of grades 2 and 3 tumors compare with the grade 1 tumor on the 50th percentile of survival time were 22.84 and 35.89 months, respectively (all p-value < 0.05). The frailty variance was significant, which confirmed that, there was significant variability between the centers. Conclusions This study confirmed the usefulness of a censored quantile regression model for cluster data in studying the impact of prognostic factors on survival time and the control effect of heterogeneity due to the treatment of patients in different centers.
“Teaching Through Your Fingertips”: A Descriptive Study to Understand the Experiences and Needs of Online Educators in Postgraduate Nursing Education in Australia
Authors: Biedermann Narelle , Ahern Tracey 
Published: March 2023

Introduction Even before COVID-19, enrolments in online postgraduate nursing and midwifery courses were growing globally. Teaching into planned online courses requires pedagogical considerations unique to the context. Objective The objective of this descriptive mixed methods study was to understand the experiences and needs of Australian online educators who taught into planned online postgraduate nursing or midwifery courses. Methods A 55-item online survey captured the experiences and needs of participants. This paper reports on the analysis of participants’ qualitative responses in this survey, analyzed using a thematic analysis approach. Forty-nine postgraduate educators participated in this study. Results Five core themes were identified: time is precious; redefining the educator role; understanding the pedagogical shift; online and alone; and learning to teach online. Many educators report lacking the skills and confidence to deliver high-quality education to postgraduate students through their fingertips. Conclusion This research highlighted that online educators need support through resources, education, and professional development.
Utility of targeted gene sequencing to differentiate myeloid malignancies from other cytopenic conditions
Authors: DeZern Amy E. , Goll Johannes B. , Lindsley R. Coleman , Bejar Rafael , Wilson Steffanie H. , Hebert Donnie , Deeg Joachim , Zhang Ling , Gore Steven , Al Baghdadi Tareq , Maciejewski Jaroslaw , Liu Jane , Padron Eric , Komrojki Rami , Saber Wael , Abel Gregory , Kroft Steven H. , Harrington Alexandra , Grimes Tyler , Reed Harrison , Fulton Robert S. , DiFronzo Nancy L. , Gillis Nancy , Sekeres Mikkael A. , Walter Matthew J. 
Published: March 2023

Abstract
The National Heart, Lung, and Blood Institute–funded National MDS Natural History Study (NCT02775383) is a prospective cohort study enrolling patients with cytopenia with suspected myelodysplastic syndromes (MDS) to evaluate factors associated with disease. Here, we sequenced 53 genes in bone marrow samples harvested from 1298 patients diagnosed with myeloid malignancy, including MDS and non-MDS myeloid malignancy or alternative marrow conditions with cytopenia based on concordance between independent histopathologic reviews (local, centralized, and tertiary to adjudicate disagreements when needed). We developed a novel 2-stage diagnostic classifier based on mutational profiles in 18 of 53 sequenced genes that were sufficient to best predict a diagnosis of myeloid malignancy and among those with a predicted myeloid malignancy, predict whether they had MDS. The classifier achieved a positive predictive value (PPV) of 0.84 and negative predictive value (NPV) of 0.8 with an area under the receiver operating characteristic curve (AUROC) of 0.85 when classifying patients as having myeloid vs no myeloid malignancy based on variant allele frequencies (VAFs) in 17 genes and a PPV of 0.71 and NPV of 0.64 with an AUROC of 0.73 when classifying patients as having MDS vs non-MDS malignancy based on VAFs in 10 genes. We next assessed how this approach could complement histopathology to improve diagnostic accuracy. For 99 of 139 (71%) patients (PPV of 0.83 and NPV of 0.65) with local and centralized histopathologic disagreement in myeloid vs no myeloid malignancy, the classifier-predicted diagnosis agreed with the tertiary pathology review (considered the internal gold standard).
Improvement of vaginal probiotics Lactobacillus crispatus on intrauterine adhesion in mice model and in clinical practice
Authors: Wu Fei , Kong Yao , Chen Wenjie , Liang Dingfa , Xiao Qin , Hu Lijuan , Tan Xiao , Wei Jing , Liu Yujuan , Deng Xiaorong , Liu Zhaoxia , Chen Tingtao 
Published: March 2023

AbstractBackgroundIntrauterine adhesion (IUA) is a frequent acquired endometrial condition, for which there is no effective preventive or treatment. Previous studies have found that vaginal microbiota dysregulation is closely related to endometrial fibrosis and IUA. Therefore, we wondered whether restoration of vaginal microbiota by vaginal administration ofL. crispatuscould prevent endometrial fibrosis and ameliorate IUA.ResultsFirst, we created a mechanically injured mouse model of IUA and restored the mice’s vaginal microbiota by the addition ofL. crispatusconvolvulus. The observations suggested that intrauterine injections ofL. crispatussignificantly decreased the degree of uterine fibrosis, the levels of IL-1β and TNF-α in blood, and downregulated the TGF-β1/SMADs signaling pathway in IUA mice. A therapy withL. crispatusconsiderably raised the abundance of the helpful bacteriaLactobacillusandOscillospiraand restored the balance of the vaginal microbiota in IUA mice, according to high-throughput sequencing. Then we conducted a randomized controlled trial to compare the therapeutic effect ofL. crispatuswith estrogen after transcervical resection of adhesion (TCRA). And the results showed that vaginal probiotics had a better potential to prevent intrauterine adhesion than estrogen.ConclusionsThis study confirmed thatL. crispatuscould restore vaginal microbiota after intrauterine surgery, inhibit endometrial fibrosis, and finally play a preventive and therapeutic role in IUA. At the same time, it is a new exploration for the treatment of gynecological diseases with vaginal probiotics.Clinical trial registration:http://www.chictr.org.cn/, identifier (ChiCTR1900022522), registration time: 15/04/2019.
A novel rubber tree PR-10 protein involved in host-defense response against the white root rot fungus Rigidoporus microporus
Authors: Longsaward Rawit , Pengnoo Ashara , Kongsawadworakul Panida , Viboonjun Unchera 
Published: March 2023

Abstract
Background
White root rot disease in rubber trees, caused by the pathogenic fungi Rigidoporus microporus, is currently considered a major problem in rubber tree plantations worldwide. Only a few reports have mentioned the response of rubber trees occurring at the non-infection sites, which is crucial for the disease understanding and protecting the yield losses.

Results
Through a comparative proteomic study using the two-dimensional polyacrylamide gel electrophoresis (2D-PAGE) technique, the present study reveals some distal-responsive proteins in rubber tree leaves during the plant-fungal pathogen interaction. From a total of 12 selected differentially expressed protein spots, several defense-related proteins such as molecular chaperones and ROS-detoxifying enzymes were identified. The expression of 6 candidate proteins was investigated at the transcript level by Reverse Transcription Quantitative PCR (RT-qPCR). In silico, a highly-expressed uncharacterized protein LOC110648447 found in rubber trees was predicted to be a protein in the pathogenesis-related protein 10 (PR-10) class. In silico promoter analysis and structural-related characterization of this novel PR-10 protein suggest that it plays a potential role in defending rubber trees against R. microporus infection. The promoter contains WRKY-, MYB-, and other defense-related cis-acting elements. The structural model of the novel PR-10 protein predicted by I-TASSER showed a topology of the Bet v 1 protein family, including a conserved active site and a ligand-binding hydrophobic cavity.

Conclusions
A novel protein in the PR-10 group increased sharply in rubber tree leaves during interaction with the white root rot pathogen, potentially contributing to host defense. The results of this study provide information useful for white root rot disease management of rubber trees in the future.
"SARCOPENIA MEASURED BY ULTRASOUND IN HOSPITALIZED OLDER ADULTS" (ECOSARC): multi-centre, prospective observational study protocol
Authors: López Jiménez Esther , Neira Álvarez Marta , Ramírez Martín Raquel , Alonso Bouzón Cristina , Amor Andrés María Solange , Bermejo Boixareu Cristina , Brañas Fátima , Menéndez Colino Rocío , Arias Muñana Estefanía , Checa López Marta , Grau Jiménez Concha , Pérez Rodríguez Patricia , Alcantud Ibáñez María , Vasquez Brolen Brian , Oliva Juan , Peña Longobardo Luz María , Alcantud Córcoles Rubén , Cortés Zamora Elisa Belén , Gómez Jiménez Elena , Romero Rizos Luis , Avendaño Céspedes Almudena , Hernández Socorro Carmen Rosa , Abizanda Pedro 
Published: March 2023

Abstract
Background
Measurement of muscle mass and function, and thereafter, screening and diagnosis of sarcopenia, is a challenge and a need in hospitalized older adults. However, it is difficult in complex real-world old patients, because usually they are unable to collaborate with clinical, functional, and imaging testing. Ultrasound measurement of quadriceps rectus femoris (QRF) provides a non-invasive, real-time assessment of muscle quantity and quality, and is highly acceptable to participants with excellent inter-rater and intra-rater variability. However, normative data, protocol standardization, and association with longitudinal outcomes, needs further research and consensus.

Methods
Prospective exploratory multicenter study in older adults admitted to Acute Geriatric Units (AGUs) for medical reasons. 157 subjects from 7 AGUs of Spain were recruited between May 2019 and January 2022. Muscle ultrasound measurements of the anterior vastus of the QRF were acquired on admission and on discharge, using a previously validated protocol, using a Chieson model ECO2 ultrasound system (Chieson Medical Technologies, Co. Ltd, Wimxu District Wuxi, Jiangsu, China). Measurements included the cross-sectional area, muscle thickness in longitudinal view, intramuscular central tendon thickness, echogenicity, and the presence or absence of edema and fasciculations. Functional, nutritional, and DXA measurements were provided. Clinical follow-up was completed at discharge, and 30 and 90 days after discharge. Variations between hospital admission and discharge ultrasound values, and the relationship with clinical variables, will be analyzed using paired t-tests, Wilcoxon tests, or Mc Nemar chi-square tests when necessary. Prevalence of sarcopenia will be calculated, as well as sensitivity and specificity of ultrasound measurements to determine sarcopenia. Kappa analysis will be used to analyze the concordance between measurements, and sensitivity analysis will be conducted for each participating center.

Discussion
The results obtained will be of great interest to the scientific geriatric community to assess the utility and validity of ultrasound measurements for the detection and follow-up of sarcopenia in hospitalized older adults, and its association with adverse outcomes.

Trial registration
NCT05113758. Registration date: November 9th 2021. Retrospectively registered.
Severe CMV pneumonitis and the resulting ARDS in a 28-year-old pregnant woman: a case report
Authors: Kalogeropoulos Sotirios , Zarogianni Evgenia , Adonakis Georgios , Kaponis Apostolos 
Published: March 2023

Abstract
Background
Cytomegalovirus (CMV) is a common virus. In pregnant women, CMV infection is usually mildly symptomatic or asymptomatic but can lead to fetal infection. Here we present a rare case of severe CMV pneumonitis and acute respiratory distress syndrome in a healthy immunocompetent pregnant woman.

Case presentation
A previous healthy 28-year-old woman with spontaneous conception, was admitted to the General University Hospital of Patras at 29 weeks of gestation with a day history of fever, fatigue, pharyngitis, and cough. She was diagnosed with acute CMV infection and CMV pneumonitis. During her hospitalization she developed acute distress syndrome (ARDS). The patient was intubated and underwent emergency caesarean delivery. She was admitted to the intensive care unit and received intravenous ganciclovir. She was discharged at 20th day postpartum in a good clinical condition.

Conclusions
This case highlights the infrequent yet potential complexity of CMV infection in immunocompetent patients and in pregnancy.
Complete excision of giant clavicular hydatid cyst: a case report
Authors: Wang Xin , Huang Jinyong , Su Liping , Ma Qian , Ma Chao , Xie Zengru 
Published: March 2023

Abstract
Background
Echinococcosis, also known as hydatid disease, is a zoonotic parasitic disease prevalent in pastoral areas, mainly involving the liver and lungs, and less frequently the bones and surrounding soft tissues. Diagnosis and treatment of bone hydatid disease is a challenge, and because of the insidious course of the disease, the lesions are often widely disseminated by the time patients seek medical attention.

Case presentation
A 29-year-old woman presented with a painless mass that was gradually increasing in size in the cervical thorax. Imaging revealed an enlarged clavicle with multiple bone cortical defects and the existence of cysts in the soft tissues surrounding the clavicle, for which complete excision of the clavicle and the attached cysts was performed. There was no recurrence of the cyst within one year after the operation, and the patient felt well and had normal shoulder joint movement.

Conclusions
Bone hydatid may appear in bones throughout the body, and cysts that leak from the bone into the surrounding soft tissues may spread at a relatively rapid rate. Prompt surgical removal of the affected bone and surrounding cysts is necessary for treatment.