bluuebunny/crossref_metadata_2025_split huggingface dataset:
Diagnostic performance of two rapid tests for syphilis screening in people living with HIV in Cali, Colombia
Authors: García Luna Jonny Alejandro , Romero-Rosas Nelson , Silva Peña Sebastian Alejandro , Oviedo Sarmiento Oscar Javier , Galindo Orrego Ximena , Lenis Quintero William , Perea Luisa Consuelo , Martínez Buitrago Ernesto , Osorio Lyda , Salazar Juan Carlos , Smith Adrian D. , Alexander Neal 
Published: March 2023

Introduction
There is insufficient evidence supporting the use of rapid diagnostic tests (RDTs) for syphilis in people living with HIV (PLWH). We evaluated the diagnostic performance of two commercially available RDTs (Bioline and Determine) in PLWH in Cali, Colombia.

Methods
A cross-sectional field validation study on consecutive adults with confirmed HIV diagnosis attending three outpatient clinics. Both RDTs were performed on capillary blood (CB), obtained by finger prick, and sera, by venipuncture. A combination of treponemal enzyme linked immunosorbent assay (ELISA) and Treponema pallidum haemagglutination assay (TPHA) on serum samples was the reference standard. Rapid plasma reagin (RPR) and clinical criteria were added to define active syphilis. Sensitivity and specificity, predictive values and likelihood ratios (LR) of RDTs were estimated with their corresponding 95% confidence interval (95% CI). Stratified analyses by sample type, patient characteristics, non-treponemal titers, operator and re-training were performed.

Results
244 PLWH were enrolled, of whom 112 (46%) had positive treponemal reference tests and 26/234 (11.1%) had active syphilis. The sensitivities of Bioline on CB and sera were similar (96.4% vs 94.6%, p = 0.6). In contrast, Determine had a lower sensitivity on CB than sera (87.5% vs 99.1%, p<0.001). Sensitivities were lower in PLWH not receiving ART (Bioline 87.1% and Determine 64.5%, p<0.001) and for one of the operators (Bioline 85% and Determine 60%, p<0.001). Specificities of the RDTs were > 95% in most analyses. Predictive values were 90% or higher. For active syphilis, the RDTs showed a similar performance pattern but with decreased specificities.

Conclusion
The studied RDTs have an excellent performance in PLWH to screen for syphilis and potentially for active syphilis, yet Determine performs better on sera than CB. Patient characteristics and potential difficulties operators may face in acquiring enough blood volume from finger pricks should be considered for the implementation and the interpretation of RDTs.
Assessing the effects of therapeutic combinations on SARS-CoV-2 infected patient outcomes: A big data approach
Authors: Moradi Hamidreza , Bunnell H. Timothy , Price Bradley S. , Khodaverdi Maryam , Vest Michael T. , Porterfield James Z. , Anzalone Alfred J. , Santangelo Susan L. , Kimble Wesley , Harper Jeremy , Hillegass William B. , Hodder Sally L. ,   on behalf of the National COVID Cohort Collaborative (N3C) Consortium
Published: March 2023

Background
The COVID-19 pandemic has demonstrated the need for efficient and comprehensive, simultaneous assessment of multiple combined novel therapies for viral infection across the range of illness severity. Randomized Controlled Trials (RCT) are the gold standard by which efficacy of therapeutic agents is demonstrated. However, they rarely are designed to assess treatment combinations across all relevant subgroups. A big data approach to analyzing real-world impacts of therapies may confirm or supplement RCT evidence to further assess effectiveness of therapeutic options for rapidly evolving diseases such as COVID-19.

Methods
Gradient Boosted Decision Tree, Deep and Convolutional Neural Network classifiers were implemented and trained on the National COVID Cohort Collaborative (N3C) data repository to predict the patients’ outcome of death or discharge. Models leveraged the patients’ characteristics, the severity of COVID-19 at diagnosis, and the calculated proportion of days on different treatment combinations after diagnosis as features to predict the outcome. Then, the most accurate model is utilized by eXplainable Artificial Intelligence (XAI) algorithms to provide insights about the learned treatment combination impacts on the model’s final outcome prediction.

Results
Gradient Boosted Decision Tree classifiers present the highest prediction accuracy in identifying patient outcomes with area under the receiver operator characteristic curve of 0.90 and accuracy of 0.81 for the outcomes of death or sufficient improvement to be discharged. The resulting model predicts the treatment combinations of anticoagulants and steroids are associated with the highest probability of improvement, followed by combined anticoagulants and targeted antivirals. In contrast, monotherapies of single drugs, including use of anticoagulants without steroid or antivirals are associated with poorer outcomes.

Conclusions
This machine learning model by accurately predicting the mortality provides insights about the treatment combinations associated with clinical improvement in COVID-19 patients. Analysis of the model’s components suggests benefit to treatment with combination of steroids, antivirals, and anticoagulant medication. The approach also provides a framework for simultaneously evaluating multiple real-world therapeutic combinations in future research studies.
Enhancements in yield, agronomic, and zinc recovery efficiencies of rice-wheat system through bioactive zinc coated urea application in Aridisols
Authors: Shah Syed Shahid Hussain , Azhar Muhammad , Nadeem Faisal , Ali Muhammad Asif , Khan Muhammad Naeem , Ahmad Ijaz , Khurshid Muhammad Yasir , Hasnain Muhammad , Ali Zeeshan , Shaheen Ahmad Abu Al-Ala 
Published: March 2023

BackgroundZinc (Zn) deficiency and source-dependent Zn fertilization to achieve optimum Zn levels in rice and wheat grains remain global concern for human nutrition, especially in developing countries. To-date, little is known about the effectiveness of bioactive Zn-coated urea (BAZU) to enhance the concentration, uptake, and recovery of Zn in relation to agronomic efficiency in paddy and wheat grains.ResultsField experiments were carried out during 2020–21 on the rice-wheat system at Lahore, Faisalabad, Sahiwal, and Multan, Punjab, Pakistan using four treatmentsviz.T1(Urea 46% N @ 185 kg ha-1+ zero Zn), T2(Urea 46% N @ 185 kg ha-1+ ZnSO433% Zn @ 15 kg ha-1), T3(BAZU 42% N @ 103 kg ha-1+ Urea 46% N @ 62 kg ha-1+ 1% bioactive Zn @ 1.03 kg ha-1) and T4(BAZU 42% N @ 125 kg ha-1+ Urea 46% N @ 62 kg ha-1+ 1% bioactive Zn @ 1.25 kg ha-1) in quadruplicate under Randomized Complete Block Design. Paddy yield was increased by 13, 11, 12, and 11% whereas wheat grain yield was enhanced by 12, 11, 11, and 10% under T4at Multan, Faisalabad, Sahiwal, and Lahore, respectively, compared to T1. Similarly, paddy Zn concentration was increased by 58, 67, 65 and 77% (32.4, 30.7, 31.1, and 34.1 mg kg-1) in rice whereas grain Zn concentration was increased by 90, 87, 96 and 97% (46.2, 43.9, 46.7 and 44.9 mg kg-1) in wheat by the application of BAZU (T4) at Multan, Faisalabad, Sahiwal, and Lahore, respectively, in comparison to T1. Zinc recovery was about 9-fold and 11-fold higher in paddy and wheat grains, respectively, under BAZU (T4) treatment relative to T2while, the agronomic efficiency was enhanced up to 130% and 141% in rice and wheat respectively as compared to T2.ConclusionThus, T4application at the rate of 125 kg ha-1could prove effective in enhancing the rice paddy and wheat grain yield along with their Zn biofortification (∼34 mg kg-1and ∼47 mg kg-1, respectively) through increased agronomic and Zn recovery efficiencies, the underlying physiological and molecular mechanisms of which can be further explored in future.
Transition between preclinical and clinical training: Perception of dental students regarding the adoption of ergonomic principles
Authors: Hallak Júlia Carrer , Ferreira Franciele de Souza , de Oliveira Caroline Anselmi , Pazos Júlia Margato , Neves Tamíris da Costa , Garcia Patrícia Petromilli Nordi Sasso 
Published: March 2023

ObjectiveThis study aimed to evaluate the perceptions of third-year dental students regarding the application of ergonomic principles in the transition between preclinical and clinical training in Restorative Dentistry.MethodsWe conducted a qualitative observational cross-sectional study. The sample consisted of forty-six third-year dental students at São Paulo State University (Unesp), School of Dentistry, Araraquara. Data was collected using an individual interview recorded on a digital voice recorder. A script containing questions related to the process of adaptation of students to clinical care with a view to ergonomic work posture was used. Data analysis was based on the quali-quantitative technique of Discourse of the Collective Subject (DCS), using Qualiquantisoft®.ResultsMost students (97.80%) perceived the need for an adaptation period in the transition from the preclinic to the clinic regarding ergonomic posture requirements; a part of them (45.65%) claimed that they still could not adapt, primarily due to the difference between the laboratory and clinic in the workstation (50.00%). Some students suggested longer preclinical training in a clinical environment to facilitate this transition (21.74%). The dental stool (32.60%) and the dental chair (21.74%) were the external factors that contributed most to making this transition difficult. The difficulty of the restorative dentistry procedure (10.87%) also interfered with posture. Additionally, the most challenging ergonomic posture requirements in the transition period were maintaining 30 to 40 cm between the patient’s mouth and operator’s eyes (45.65%), positioning the patient in the dental chair correctly (15.22%), and working with the elbows close to the body (15.22%).ConclusionMost students perceived the need for an adaptation period in the preclinical transition to the clinic, attributing difficulties to adopt the ergonomic posture requirements, to use the workstation and to perform the procedures on real patients.
Task interruptions from the perspective of work functions: The development of an observational tool applied to inpatient hospital care in France The Team’IT tool
Authors: Teigné Delphine , Cazet Lucie , Mabileau Guillaume , Terrien Noémie 
Published: March 2023

Background
In France, hospital units responsible for providing inpatient care have few opportunities to address the issue of task interruptions. In Australia, the Dual Perspectives Method (DMP) has been developed to assess interruptions. The method makes it possible to link teamwork and interruptions, by considering the work functions that constitute the system.

Objective
To develop a tool that can characterize interruptions from the point of view of work functions that is tailored to French hospital units providing inpatient care. The aim was to adapt the items recorded using the DPM and their response categories, and to study the acceptability of observing interruptions for participating teams.

Method
The items recorded in the DPM were translated and adapted taking into account the French definition of interruptions. This step identified 19 items that targeted the interrupted professional, and 16 that targeted the interrupting professional. The characteristics of interruptions were recorded in September 2019 among 23 volunteer teams in a region in western France. Two observers simultaneously observed the same professional. Observations lasted seven consecutive hours, and targeted all professional categories within the same team.

Results
The characteristics of 1,929 interruptions were noted. The observation period was well-received by teams. The following terminology regarding the work functions of the interrupting professional was clarified: “coordination of institutional resources”, in relation to “the establishment’s support processes”, “patient services”, and “the patient’s social life”. We believe that our categorization of response modes is exhaustive.

Conclusions
We have developed an observational tool, Team’IT, which is tailored to inpatient hospital care in France. Its implementation is the first step in a system to support teams in managing interruptions, and will enable them to reflect on their working methods, and whether interruptions can be avoided. Our work is part of an approach that seeks to improve and enhance the safety of professional practices, by contributing to the longstanding, complex debate about the flow and effectiveness of patient care.

Trial registration
ClinicalTrials.gov NCT03786874 (December 26, 2018).
Association between parental absence during childhood and metabolic syndrome during adulthood: A cross-sectional study in rural Khanh Hoa, Vietnam
Authors: Manandhar Shrestha Rachana , Mizoue Tetsuya , Pham Thuy Thi Phuong , Fukunaga Ami , Hoang Dong Van , Nguyen Chau Que , Phan Danh Cong , Hachiya Masahiko , Huynh Dong Van , Le Huy Xuan , Do Hung Thai , Inoue Yosuke 
Published: March 2023

Background
This study aimed to determine the association between parental absence during childhood and metabolic syndrome (MetS) in adulthood among middle-aged adults in rural Khanh Hoa province, Vietnam. Given that broader literature on adverse childhood experiences (ACEs) suggests a strong positive association between ACEs and cardiometabolic risk or diseases, we hypothesized that parental absence during childhood, which is a major component of ACEs, is more likely to cause MetS in adulthood.

Methods
Data were obtained from the baseline survey of the Khanh Hoa Cardiovascular Study, in which 3000 residents aged between 40 to 60 years participated. MetS was assessed using the modified Adult Treatment Panel III (ATP III) criteria. It was considered parental absence if the participants had experienced parental absence due to death, divorce, or out-migration before three or between three to 15 years. We used multiple logistic regression analyses to examine the association between parental absence during childhood and metabolic syndrome during adulthood.

Results
There was no significant association between parental absence and MetS; adjusted odds ratio [AOR] was 0.97 (95% confidence interval [CI] = 0.76–1.22) for those who experienced parental absence between three to 15 years and the corresponding figure for those who experienced it before three years was 0.93 (95% CI = 0.72–1.20). No significant associations were observed when these were examined for the causes of parental absence.

Conclusion
This study did not support our hypothesis of an association between parental absence during childhood and metabolic syndrome during adulthood. Parental absence may not be a predictor of MetS among Vietnamese people in rural communities.
Chronic kidney disease, preoperative use of antispasmodics and lower resected prostate volume ratios are risk factors for postoperative use of adrenergic Alpha-blockers and antispasmodics
Authors: Hsueh Chen-Hsun , Chang Li-Wen , Chiu Kun-Yuan , Hung Sheng-Chun , Chen Jun-Peng , Li Jian-Ri 
Published: March 2023

Objectives
Transurethral resection of prostate (TURP) and laser prostate surgery are common surgeries for benign prostate hyperplasia (BPH). We conducted an investigation using hospital database to evaluate the clinical factors associated with post-operative usage of alpha-blockers and antispasmodics.

Methods
This study was conducted using retrospective clinical data from the hospital database, which contained newly diagnosed BPH patients between January 2007 and December 2012 who subsequently received prostate surgery. The study end-point was the use of alpha-blockers or antispasmodics for at least 3 months duration after 1 month of surgery. The exclusion criteria was prostate cancer diagnosed before or after the surgery, recent transurethral surgeries, history of open prostatectomy, and history of spinal cord injury. Clinical parameters, including age, body mass index, preoperative prostate specific antigen value, comorbidities, preoperative usage of alpha-blockers, anstispasmodics and 5-alpha reductase inhibitors, surgical methods, resected prostate volume ratios, and preoperative urine flow test results, were evaluated.

Results
A total of 250 patients receiving prostate surgery in the database and confirmed pathologically benign were included. There was significant association between chronic kidney disease (CKD) and the usage of alpha-blockers after prostate surgery (OR = 1.93, 95% CI 1.04–3.56, p = 0.036). Postoperative antispasmodics usage was significantly associated with preoperative usage of antispasmodics (OR = 2.33, 95% CI 1.02–5.36, p = 0.046) and resected prostate volume ratio (OR = 0.12, 95% CI 0.02–0.63, p = 0.013).

Conclusions
BPH patients with underlying CKD were more likely to require alpha-blockers after surgery. In the meantime, BPH patients who required antispasmodics before surgery and who received lower prostate volume resection ratio were more liable to antispasmodics after prostate surgery.
Population-based real-world registry study to evaluate clinical outcomes of chronic graft-versus-host disease
Authors: Novitzky-Basso Igor , Schain Frida , Batyrbekova Nurgul , Webb Thomas , Remberger Mats , Keating Armand , Mattsson Jonas 
Published: March 2023

Introduction
Chronic graft-versus-host disease (cGVHD) is a serious immune-mediated complication after allogeneic haematopoietic stem cell transplantation (HSCT), but in patients with malignancy, cGVHD development is associated with superior survival. Lack of reliable biomarkers and clinical underreporting means there is insufficient understanding of cGVHD clinical outcomes and balance between cGVHD treatment and maintaining beneficial graft-versus-tumour effects.

Methods
We performed a Swedish population-wide registry study following patients who underwent allogeneic HSCT 2006–2015. cGVHD status was retrospectively classified using a real-world method based on the timing and extent of systemic immunosuppressive treatment.

Results
cGVHD incidence among patients surviving ≥6 months post-HSCT (n = 1246) was 71.9%, significantly higher than previously reported. 5-year overall survival in patients surviving ≥6 months post-HSCT was 67.7%, 63.3%, and 65.3%, in non-, mild, and moderate-severe cGVHD, respectively. Non-cGVHD patients had a mortality risk almost five-fold higher compared to moderate-severe cGVHD patients 12-months post-HSCT. Moderate-severe cGVHD patients had greater healthcare utilization compared with mild and non cGVHD patients.

Conclusion
cGVHD incidence was high among HSCT survivors. Non-cGVHD patients had higher mortality during the first 6 months of follow-up; however, moderate-severe cGVHD patients had more comorbidities and healthcare utilization. This study highlights the urgent need for new treatments and real-time methods to monitor effective immunosuppression after HSCT.
Light and electron microscopic features of preclinical pseudoexfoliation syndrome
Authors: Suwan Yanin , Kulnirandorn Tuangporn , Schlötzer-Schrehardt Ursula , Wongchaya Sattawat , Petpiroon Purit , Supakontanasan Wasu , Tantraworasin Apichat , Teekhasanee Chaiwat 
Published: March 2023

PurposeThis study sought to explore the features of the anterior lens capsule in patients with preclinical pseudoexfoliation syndrome (pPEX) via light microscopy (LM) and transmission electron microscopy (TEM).DesignCross-sectional, prospective, and observational case series.MethodsWe recruited consecutive patients with and without pPEX who underwent routine cataract surgery at Ramathibodi Hospital, between April 2018 and November 2020. pPEX can be characterized by pigmented spoke-wheel deposition (P) on the anterior lens capsule, midperiphery cleft/lacunae (C), faint central disc present within the photopic pupil (D), white-spoke pattern (W) noted at the midperiphery, and a combination of at least two signs (Co). LM and TEM were used to examine anterior lens capsule specimens for the presence of characteristic pseudoexfoliation material (PXM). The features of the anterior lens capsule in pPEX explored via LM and TEM were recorded.ResultsThis study included a total of 96 patients (101 excised anterior lens capsules); among them, 34 (35 excised anterior lens capsules) exhibited pPEX signs (pPEX group) but 62 (66 excised anterior lens capsules) did not (control group). The patients had a mean age of 74 ± 7 (range, 58–89) years. LM and TEM revealed no definite PXM in any patient. In the pPEX group, LM analysis identified two capsule specimens with suspected PXM; PXM precursors were observed in 1 of the 34 excised capsule specimens analyzed via TEM. Furthermore, 39 eyes (59.09%) exhibited signs of true exfoliation syndrome (TEX) in LM analysis (12.82%, 25.64%, 10.26%, 10.26%, and 41.03% for patients exhibiting P, D, C, W, and Co, respectively). However, no TEX signs were observed in the control group. We found that the anterior lens capsules exhibiting C and D were significantly associated with TEX (odds ratio = 5.4 and 7.9; P = 0.007 and 0.004, respectively).ConclusionsLM analysis revealed no definite PXMs were detected in the excised anterior lens capsules, whereas TEM analysis showed PXM precursors in one specimen (2.94%). Notably, a significant association was observed between C and D signs and TEX.
Health of children who experienced Australian immigration detention
Authors: Tosif Shidan , Graham Hamish , Kiang Karen , Laemmle-Ruff Ingrid , Heenan Rachel , Smith Andrea , Volkman Thomas , Connell Tom , Paxton Georgia 
Published: March 2023

Background
Australian immigration policy resulted in large numbers of children being held in locked detention. We examined the physical and mental health of children and families who experienced immigration detention.

Methods
Retrospective audit of medical records of children exposed to immigration detention attending the Royal Children’s Hospital Immigrant Health Service, Melbourne, Australia, from January 2012 –December 2021. We extracted data on demographics, detention duration and location, symptoms, physical and mental health diagnoses and care provided.

Results
277 children had directly (n = 239) or indirectly via parents (n = 38) experienced locked detention, including 79 children in families detained on Nauru or Manus Island. Of 239 detained children, 31 were infants born in locked detention. Median duration of locked detention was 12 months (IQR 5–19 months). Children were detained on Nauru/Manus Island (n = 47/239) for a median of 51 (IQR 29–60) months compared to 7 (IQR 4–16) months for those held in Australia/Australian territories (n = 192/239). Overall, 60% (167/277) of children had a nutritional deficiency, and 75% (207/277) had a concern relating to development, including 10% (27/277) with autism spectrum disorder and 9% (26/277) with intellectual disability. 62% (171/277) children had mental health concerns, including anxiety, depression and behavioural disturbances and 54% (150/277) had parents with mental illness. Children and parents detained on Nauru had a significantly higher prevalence of all mental health concerns compared with those held in Australian detention centres.

Conclusion
This study provides clinical evidence of adverse impacts of held detention on children’s physical and mental health and wellbeing. Policymakers must recognise the consequences of detention, and avoid detaining children and families.