bluuebunny/crossref_metadata_2025_split huggingface dataset:
Qualitative electroencephalogram and its predictors in the diagnosis of stroke
Authors: Ag Lamat Mohd Syahrul Nizam , Abd Rahman Muhammad Samir Haziq , Wan Zaidi Wan Asyraf , Yahya Wan Nur Nafisah Wan , Khoo Ching Soong , Hod Rozita , Tan Hui Jan 
Published: June 2023

IntroductionStroke is a typical medical emergency that carries significant disability and morbidity. The diagnosis of stroke relies predominantly on the use of neuroimaging. Accurate diagnosis is pertinent for management decisions of thrombolysis and/or thrombectomy. Early identification of stroke using electroencephalogram (EEG) in the clinical assessment of stroke has been underutilized. This study was conducted to determine the relevance of EEG and its predictors with the clinical and stroke features.MethodsA cross-sectional study was carried out where routine EEG assessment was performed in 206 consecutive acute stroke patients without seizures. The demographic data and clinical stroke assessment were collated using the National Institutes of Health Stroke Scale (NIHSS) score with neuroimaging. Associations between EEG abnormalities and clinical features, stroke characteristics, and NIHSS scores were evaluated.ResultsThe mean age of the study population was 64.32 ± 12 years old, with 57.28% consisting of men. The median NIHSS score on admission was 6 (IQR 3-13). EEG was abnormal in more than half of the patients (106, 51.5%), which consisted of focal slowing (58, 28.2%) followed by generalized slowing (39, 18.9%) and epileptiform changes (9, 4.4%). NIHSS score was significantly associated with focal slowing (13 vs. 5, p &lt; 0.05). Type of stroke and imaging characteristics were significantly associated with EEG abnormalities (p &lt; 0.05). For every increment in NIHSS score, there are 1.08 times likely for focal slowing (OR 1.089; 95% CI 1.033, 1.147, p = 0.002). Anterior circulation stroke has 3.6 times more likely to have abnormal EEG (OR 3.628; 95% CI 1.615, 8.150, p = 0.002) and 4.55 times higher to exhibit focal slowing (OR 4.554; 95% CI 1.922, 10.789, p = 0.01).ConclusionThe type of stroke and imaging characteristics are associated with EEG abnormalities. Predictors of focal EEG slowing are NIHSS score and anterior circulation stroke. The study emphasized that EEG is a simple yet feasible investigational tool, and further plans for advancing stroke evaluation should consider the inclusion of this functional modality.
Activation of the microglial P2X7R/NLRP3 inflammasome mediates central sensitization in a mouse model of medication overuse headache
Authors: Wang Yanyun , Dong Liang , Zhang Yun , Zhang Yixin , Qin Guangcheng , Zhang Dunke , Chen Lixue , He Wei , Zhou Jiying 
Published: June 2023

BackgroundExcessive use of headache treatments often leads to the development, progression and exacerbation of primary headache, which is defined as medication overuse headache (MOH). A significant pathophysiological mechanism of MOH is central sensitization. Recent evidence suggests that central sensitization in chronic headache is a result of inflammatory responses mediated by microglial activation in the trigeminal nucleus caudalis (TNC). However, it is unknown whether microglial activation has an impact on the central sensitization of MOH. Accordingly, the goal of this research was to determine how microglial activation and the P2X7R/NLRP3 inflammasome signaling pathway in the TNC contribute to the pathogenesis of MOH.MethodsRepeated intraperitoneal injection of sumatriptan (SUMA) was used to establish a mouse model of MOH. Basal mechanical hyperalgesia was evaluated using von Frey filaments. As central sensitization biomarkers, the c-Fos and CGRP expression levels were measured by immunofluorescence analysis. We estimated the expression of microglial biomarkers (Iba1 and iNOS) within the TNC by qRT-PCR, western blotting and immunofluorescence analysis. To elucidate the effect of microglial activation and the P2X7/NLRP3 signaling pathway on central sensitization in MOH, we evaluated whether the microglia-specific inhibitor minocycline, the P2X7R-specific antagonist BBG and the NLRP3-specific inhibitor MCC950 altered SUMA-caused mechanical hyperalgesia. Furthermore, we examined c-Fos and CGRP expression within the TNC following individual injections of these inhibitors.ResultsRepeated SUMA injection induced basal mechanical hyperalgesia, increased c-Fos and CGRP levels, and activated microglia within the TNC. Inhibiting microglial activation with minocycline prevented the emergence of mechanical hyperalgesia and cut down c-Fos and CGRP expression. Immunofluorescence colocalization analysis revealed that P2X7R was predominantly co-localized with microglia. The levels of P2X7R and the NLRP3 inflammasome were elevated by repeated SUMA injection, and blocking P2X7R and NLRP3 inhibited mechanical hyperalgesia and cut down c-Fos and CGRP expression within the TNC.ConclusionBased on the current findings, inhibiting microglial activation could reduce central sensitization caused by chronic SUMA treatment via the P2X7R/NLRP3 signaling pathway. The clinical management of MOH may benefit from a novel strategy that inhibits microglial activation.
Prediction of pathological response grading for esophageal squamous carcinoma after neoadjuvant chemoradiotherapy based on MRI imaging using PDX
Authors: Shi Jingzhen , Li Jianbin , Li Zhenxiang , Li Yankang , Xu Liang , Zhang Yingjie 
Published: June 2023

IntroductionTo confirm the efficacy of magnetic resonance-diffusion weighted imaging (MR-DWI) in esophageal squamous cell carcinoma (ESCC) early pathological response prediction and assessment to neoadjuvant chemoradiotherapy (nCRT) using patient-derived xenografts (PDXs)MethodsPDX-bearing mice were randomly divided into two groups: the experimental group receiving cisplatin combined with radiotherapy, whereas the control group receiving normal saline. MRI scans were performed in treatment groups in the before, middle, and end of treatment. The correlations between tumor volumes, ADC values and tumor pathological response at different time nodes were explored. Then, expression of proliferation marker and apoptotic marker were detected using immunohistochemistry, and apoptosis rate was detected by TUNEL assay to further verify the results observed in the PDX models.ResultsThe ADC values of the experimental group were significantly higher than the control group in the both middle and end stage of treatment (allP&lt; 0.001), however, significant difference was only observed in tumor volume at the end stage of treatment (P&lt; 0.001). Furthermore, the △ADCmid-prein our study may able to identify tumors with or without pCR to nCRT at an early stage, due to these changes were prior to the changes of tumor volume after treatment. Finally, TUNEL results also showed that the apoptosis rate of the experiment groups increased the most in the middle stage of treatment, especially the groups with pCR, but the highest apoptosis rate occurred in the end of the treatment. Further, the two PDX models with pCR exhibited the highest levels of apoptotic marker (Bax), and lowest levels of proliferation marker (PCNA and Ki-67) in the both middle and end stage of the treatment.ConclusionsADC values could be used to determine the tumor’s response to nCRT, especially in the middle stages of treatment and before the tumor tissue morphology changes, and further, the ADC values were consistent with the potential biomarkers reflecting histopathological changes. Therefore, we suggest that radiation oncologists could refer to the ADC values in the middle stages of treatment when predicting the tumor histopathological response to n CRT in patients with ESCC.
Management of fever and acute painful crises in children with sickle cell disease in emergency departments: a tertiary hospital experience
Authors: Almahmoud Tameem , Alnashwan Tasneem , Al Kuhaimi Lara , Essa Mohammed F. , Al Balawi Nouf , Jamaan Khaled Al , Al-Harthy Nesrin 
Published: June 2023

Sickle Cell Disease (SCD) is highly prevalent in Saudi Arabia with variable demographics and access to health care facilities including emergency departments. Literature reviews for locally published articles are deficient in the in-depth evaluation of current emergency practices in managing patients with SCD. The study aims to assess the current emergency practice in managing SCD patients in tertiary hospitals. We reviewed data of 212 visits by patients with SCD over three years and assessed the current emergency department practices in managing common SCD crises, such as vaso-occlusive (VOC) and febrile episodes. Our findings revealed that 47.2%, 37.7%, and 15% of the patients presented with pain, fever, or both, respectively. The patients were triaged level III according to the Canadian triage and acuity scale system in 89% of the visits. The Median time for patients to see healthcare providers was 22 min. In the first 2 h, 86% of the patients received at least one fluid bolus and 79% of them received appropriate analgesia for pain crises. Approximately 41.5% of the patients with fever were admitted and received ceftriaxone as single intravenous antimicrobial agent. However, none of the patients had bacteremia. Only 2.4% of the patients had either urinary tract infection or osteomyelitis based on imaging.ED management is a key factor in the successful management of patients with SCD in a timely manner by providing fluids, analgesia, and antibiotics. Adopting evidence-based guidelines and avoiding unnecessary admissions are suggested in clinically well patients with fever in the era of completed vaccination, antibiotic prophylaxis, and good access to care for patients with a clear viral infection focus.
A semi purified hydroalcoholic fraction from Caesalpinia bonduc seeds causes ergosterol biosynthesis inhibition in Candida albicans resulting in cell membrane damage
Authors: Sasidharan Shan , Nishanth Kumar S. , Nair Hareendran. J 
Published: June 2023

Candida species are currently developing resistance to prevailing commercially available drugs, which raises an instantaneous need to discover novel antifungals. To cope with this shocking situation, phytochemicals are the richest, safest, and most potent source of excellent antimicrobials with broad-spectrum activity. The aim of the current study is to explore the anticandidal potential of the various fractions purified from the hydroalcoholic extract of C. bonduc seed. Out of five fractions purified from the hydroalcoholic extract, fraction 3 (Fr. 3) recorded the best activity against C. albicans (8 μg/mL) and thus this species was chosen for further mechanism of action studies. The phytochemical examination reveals that Fr. 3 was found to contain steroids and triterpenoids. This was further supported by LC-QTOF-MS and GCMS analyses. Our findings show that Fr. 3 targets the ergosterol biosynthesis pathway in C. albicans by inhibiting the lanosterol 14-α demethylase enzyme and downregulating expression of its related gene ERG11. Molecular docking outcomes disclosed favorable structural dynamics of the compounds, implying that the compounds present in Fr. 3 would be able to successfully bind to the lanosterol 14-α demethylase, as evidenced by the docked compounds’ strong interaction with the target enzyme’s amino acid residues. Considering virulence factors, the Fr. 3 recorded significant antibiofilm activity as well as germ-tube reduction potential. Furthermore, Fr. 3 enhances the production of intracellular reactive oxygen species (ROS). This suggests that the antifungal activity of Fr. 3 was associated with membrane damage and the induction of ROS production, resulting in cell death. Fluorescence microscopic analysis of PI stained Candida further showed changes in the plasma membrane permeability, which causes severe loss of intracellular material and osmotic balance. This was demonstrated by the potassium ion leakage and release of genetic materials. Finally, the erythrocyte lysis assay confirmed the low cytotoxicity of Fr. 3. Both in silico and in vitro results suggest that Fr. 3 has the potential to propel forward novel antifungal drug discovery programmes.
Factors influencing clinical pharmacists’ integration into the clinical multidisciplinary care team
Authors: Wang Chenyu , Li Maozhen , Huang Yuankai , Xi Xiaoyu 
Published: June 2023

Objectives: To investigate the factors influencing clinical pharmacists’ integration into the clinical multidisciplinary care team, using interprofessional collaboration between clinical pharmacists and physicians as the focus.Methods: Through stratified random sampling, a cross-sectional questionnaire survey was conducted among clinical pharmacists and physicians in secondary and tertiary hospitals in China from July to August 2022. The questionnaire, comprising the Physician–Pharmacist Collaborative Index (PPCI) scale to reflect the collaboration level and a combined scale to measure influencing factors, was made available in two versions for clinical pharmacists and physicians. Multiple linear regression was adopted to analyze the association between the collaboration level and influencing factors, as well as the heterogeneity of the significant factors in hospitals of different grades.Results: Valid self-reported data from 474 clinical pharmacists and 496 paired physicians were included, who were serving in 281 hospitals from 31 provinces. In terms of participant-related factors, standardized training and academic degree, respectively, exerted significant positive effects on the perceived collaboration level by clinical pharmacists and physicians. In terms of context characteristics, manager support and system construction were the main factors for improving collaboration. In terms of exchange characteristics, clinical pharmacists having good communication skills, physicians trusting others’ professional competence and values, and both parties having consistent expectations had significant positive effects on collaboration.Conclusion: The study provides a baseline data set on the current level and associated factors of clinical pharmacists’ collaboration with other professionals in China and other countries with a related health system, providing references for individuals, universities, hospitals, and national policymakers to facilitate the development of clinical pharmacy and multidisciplinary models and further improve the patient-centered integrated disease treatment system.
Drought and recovery in barley: key gene networks and retrotransposon response
Authors: Paul Maitry , Tanskanen Jaakko , Jääskeläinen Marko , Chang Wei , Dalal Ahan , Moshelion Menachem , Schulman Alan H. 
Published: June 2023

IntroductionDuring drought, plants close their stomata at a critical soil water content (SWC), together with making diverse physiological, developmental, and biochemical responses.MethodsUsing precision-phenotyping lysimeters, we imposed pre-flowering drought on four barley varieties (Arvo, Golden Promise, Hankkija 673, and Morex) and followed their physiological responses. For Golden Promise, we carried out RNA-seq on leaf transcripts before and during drought and during recovery, also examining retrotransposon BARE1expression. Transcriptional data were subjected to network analysis.ResultsThe varieties differed by their critical SWC (ϴcrit), Hankkija 673 responding at the highest and Golden Promise at the lowest. Pathways connected to drought and salinity response were strongly upregulated during drought; pathways connected to growth and development were strongly downregulated. During recovery, growth and development pathways were upregulated; altogether, 117 networked genes involved in ubiquitin-mediated autophagy were downregulated.DiscussionThe differential response to SWC suggests adaptation to distinct rainfall patterns. We identified several strongly differentially expressed genes not earlier associated with drought response in barley. BARE1 transcription is strongly transcriptionally upregulated by drought and downregulated during recovery unequally between the investigated cultivars. The downregulation of networked autophagy genes suggests a role for autophagy in drought response; its importance to resilience should be further investigated.
Measuring school social climate in Latin America: the need for multidimensional and multi-informant tests – A systematic review
Authors: Bravo-Sanzana Mónica V. , Varela Jorge , Terán-Mendoza Oscar , Rodriguez-Rivas Matias E. 
Published: June 2023

IntroductionSchool social climate is central to understanding learning experiences in education environments. Previous studies describe various conceptual and operational definitions around the construct; however, there are no records of reviews focused on Latin America.AimThis study sought to analyze the available evidence and the quality of school social climate measures in Latin America through a systematic review of the literature based on the PRISMA methodology and the COSMIN checklist to assess the psychometric properties of the instruments.MethodologyThe Web of Science, Scopus, Psycinfo, and SciELO databases were consulted. A total of 582 records was identified, of which 27 fulfilled the inclusion criteria and methodological quality to be included in the systematization.ResultsThe results show that the country with the greatest scientific production on the topic is Chile, the measures are centered mainly on the students’ perspective and the most used instrument is the CECSCE. In addition, a common aspect to all the records is that they were not sufficient to capture the complexity of school social climate.ConclusionMultidimensional and multi-informant measures are needed to adequately assess the construct.
Youth sexual offending in Hong Kong: examining the role of self-control, risky sexual behaviors, and paraphilic interests
Authors: Chan Heng Choon (Oliver) 
Published: June 2023

IntroductionLittle is known about the nature and prevalence of sexual offending among youth in Hong Kong.MethodsTesting self-control theory and sexual health risk factors (i.e., risky sexual behaviors [general and two subtypes] and paraphilic interests [general and 14 subtypes]), the prevalence of self-reported sexual offending behaviors (i.e., threat of sexual assault, penetrative sexual assault, and nonpenetrative sexual offense) was examined in a community-based sample of 863 young people (aged 17 to 20) in Hong Kong.ResultsIn this study, men reported significantly higher levels of threat of sexual assault and of general and 12 subtypes of paraphilic interests than women; and women reported a significantly higher level of a specific paraphilic interest subtype (i.e., transvestic fetishism) than men. Logistic regressions found that, in general, a low level of self-control and high levels of risky sexual behaviors and paraphilic interests were important factors in the participants’ likelihood of issuing threats of sexual assault and engaging in penetrative and nonpenetrative sexual assault.DiscussionImportant practical implications for reducing the tendency of young people to engage in sexual offending behavior can be derived from this study.
A comparative analysis on serious adverse events reported for COVID-19 vaccines in adolescents and young adults
Authors: Cappelletti-Montano Beniamino , Demuru Giuseppe , Laconi Ezio , Musio Monica 
Published: June 2023

This study aims to assess the safety profile of COVID-19 vaccines (mRNA and viral vector vaccines) in teenagers and young adults, as compared to Influenza and HPV vaccines, and to early data from Monkeypox vaccination in United States.MethodsWe downloaded data from the Vaccine Adverse Event Reporting System (VAERS) and collected the following Serious Adverse Events (SAEs) reported for COVID-19, Influenza, HPV and Monkeypox vaccines: deaths, life-threatening illnesses, disabilities, hospitalizations. We restricted our analysis to the age groups 12–17 and 18–49, and to the periods December 2020 to July 2022 for COVID-19 vaccines, 2010–2019 for Influenza vaccines, 2006–2019 for HPV vaccines, June 1, 2022 to November 15, 2022 for Monkeypox vaccine. Rates were calculated in each age and sex group, based on an estimation of the number of administered doses.ResultsAmong adolescents the total number of reported SAEs per million doses for, respectively, COVID-19, Influenza and HPV vaccines were 60.73, 2.96, 14.62. Among young adults the reported SAEs rates for, respectively, COVID-19, Influenza, Monkeypox vaccines were 101.91, 5.35, 11.14. Overall, the rates of reported SAEs were significantly higher for COVID-19, resulting in a rate 19.60-fold higher than Influenza vaccines (95% C.I. 18.80–20.44), 4.15-fold higher than HPV vaccines (95% C.I. 3.91–4.41) and 7.89-fold higher than Monkeypox vaccine (95% C.I. 3.95–15.78). Similar trends were observed in teenagers and young adults with higher Relative Risks for male adolescents.ConclusionThe study identified a risk of SAEs following COVID-19 vaccination which was markedly higher compared to Influenza vaccination and substantially higher compared to HPV vaccination, both for teenagers and young adults, with an increased risk for the male adolescents group. Initial, early data for Monkeypox vaccination point to significantly lower rates of reported SAEs compared to those for COVID-19 vaccines. In conclusion these results stress the need of further studies to explore the bases for the above differences and the importance of accurate harm-benefit analyses, especially for adolescent males, to inform the COVID-19 vaccination campaign.
Exploring potential applications of measles and rubella microarray patches (MR-MAPs): use case identification
Authors: Malvolti Stefano , Ko Melissa , Menozzi-Arnaud Marion , Mantel Carsten , Jarrahian Courtney , Amorij Jean-Pierre , Giersing Birgitte , Hasso-Agopsowicz Mateusz 
Published: June 2023

IntroductionInnovative vaccine products will be critical in helping to address the existing implementation barriers that have prevented the achievement of the measles and rubella (MR) vaccine coverage targets. Overcoming those barriers will be necessary to achieve the “Immunization Agenda 2030” goals. Microarray patches (MAPs), an innovative needle-free delivery device currently in clinical development, can be a potential game changer in this respect and contribute to the equitable delivery of vaccines in low- and middle-income countries and pandemic preparedness and response. Developing in-depth knowledge of the most desired and impactful uses of MRMAPs can prove critical to identifying the critical attributes of the target product profile, informing policy and adoption decisions, and helping to evaluate the potential public health and economic value of this technology. The first step in this process is the definition of the potential use cases for MR-MAPs, i.e., where and how this product is most likely to be used within the immunization programme.MethodsBy applying a design-based user-centric approach, we implemented a three-step process, including a desk review, a survey, and interviews, to define the most relevant use cases for MR MAPS.ResultsSix use cases have been identified as relevant across all different countries and immunization programme designs and validated by experts.DiscussionThe identified use cases have already informed the demand estimate for MR-MAPs and provided the foundation for developing an initial full vaccine value assessment. We believe that, in the future, they will be highly valuable in ensuring that the roll-out of this promising innovation is designed in a way that maximizes the impact, particularly in populations and countries that are most in need.