bluuebunny/crossref_metadata_2025_split huggingface dataset:
Global prevalence of Clostridioides difficile in 17,148 food samples from 2009 to 2019: a systematic review and meta-analysis
Authors: Borji Soroush , Kadivarian Sepide , Dashtbin Shirin , Kooti Sara , Abiri Ramin , Motamedi Hamid , Moradi Jale , Rostamian Mosayeb , Alvandi Amirhooshang 
Published: April 2023

Abstract
Background
Clostridioides (Clostridium) difficile is an important infectious pathogen, which causes mild-to-severe gastrointestinal infections by creating resistant spores and producing toxins. Spores contaminated foods might be one of the most significant transmission ways of C. difficile-associated infections. This systematic review and meta-analysis study were conducted to investigate the prevalence of C. difficile in food.

Methods
Articles that published the prevalence of C. difficile in food in PubMed, Web of Science, and Scopus databases were retrieved using selected keywords between January 2009 and December 2019. Finally, 17,148 food samples from 60 studies from 20 countries were evaluated.

Results
The overall prevalence of C. difficile in various foods was 6.3%. The highest and lowest levels of C. difficile contamination were detected to seafood (10.3%) and side dishes (0.8%), respectively. The prevalence of C. difficile was 4% in cooked food, 6.2% in cooked chicken and 10% in cooked seafood.

Conclusions
There is still little known concerning the food-borne impact of C. difficile, but the reported contamination might pose a public health risk. Therefore, to improve the food safety and prevent contamination with C. difficile spores, it is necessary to observe hygienic issues during foods preparation, cooking and transfer.
Study protocol for an economic evaluation and budget impact of implementation strategies to support routine provision of antenatal care for gestational weight gain: a stepped-wedge cluster trial
Authors: Wynne Olivia , Szewczyk Zoe , Hollis Jenna , Farragher Eva , Doherty Emma , Tully Belinda , Paolucci Francesco , Gillham Karen , Reeves Penny , Wiggers John , Kingsland Melanie 
Published: April 2023

AbstractBackgroundAntenatal clinical practice guidelines recommend routine assessment of weight and provision of advice on recommended weight gain during pregnancy and referral to additional services when appropriate. However, there are barriers to clinicians adopting such best-practice guidelines. Effective, cost-effective, and affordable implementation strategies are needed to ensure the intended benefits of guidelines are realised. This paper describes the protocol for evaluating the efficiency and affordability of implementation strategies compared to the usual practice in public antenatal services.MethodThe prospective trial-based economic evaluation will identify, measure, and value key resource and outcome impacts arising from the implementation strategies compared with usual practice. The evaluation will comprise of (i) costing, (ii) cost-consequence analyses, where a scorecard approach will be used to show the costs and benefits given the multiple primary outcomes included in the trial, and (iii) cost-effectiveness analysis, where the primary outcome will be incremental cost per percent increase in participants reporting receipt of antenatal care for gestational weight gain consistent with the guideline recommendations. Affordability will be evaluated using (iv) budget impact assessment and will estimate the financial implications of adoption and diffusion of this implementation strategy from the perspective of relevant fund-holders.DiscussionTogether with the findings from the effectiveness trial, the outcomes of this economic evaluation will inform future healthcare policy, investment allocation, and research regarding the implementation of antenatal care to support healthy gestational weight gain.Trial registrationTrial Registration: Australian and New Zealand Clinical Trials Registry, ACTRN12621000054819 (22/01/2021)http://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=380680&isReview=true.
Simulating creep induced moment redistribution in prestressed concrete bridges constructed by the balanced cantilever method: ad hoc traditional formulae versus real time-dependent analysis
Authors: Rashed Magdy , Mehanny Sameh S. F. 
Published: April 2023

AbstractAssessing available numerical techniques adopted to determine the design time-dependent moment for prestressed concrete segmental bridges constructed by the balanced cantilever method is of utmost importance to the bridge design community. In essence, despite some apparent diversity, there are basically two key conventional approaches to compute the design time-dependent moment accounting for creep effects for this type of bridges. The first is a family of varied simplified methods typically known to practicing designers and with pre-consensus on their reliability and effectiveness. Time-dependent moments retrieved from these classical methods always reside in an intermediate state falling between the results from “two” time-independent analysis cases, namely, (a) sequentially adding all partial permanent loads and prestressing pertaining to various construction steps using the part-bridge structural system corresponding to each step, and (b) assuming all loads and prestressing forces to be applied at-once to the final completed bridge. The second approach is through performing real sophisticated step-by-step time-dependent analysis using a specialized software. The research primary objective is to assess the validity/reliability of commonly used ad-hoc approaches that evolved over the years relying on simplified analyses/formulae to cater for time-dependent creep effects for this type of bridges. Aiming at realistic conclusions, three case-study real-world segmental balanced cantilever bridges over the Nile River in Egypt are elected. Midas Civil commercial package is used to perform time-dependent finite element analyses for the three bridges. Main parameters considered are, inter alia, time-dependent effects of creep and shrinkage of concrete, relaxation of prestressed steel, losses due to friction and anchor setting of prestressing tendons, sequence of construction, and construction-driven temporary change of support conditions (where applicable). The study concludes that creep-induced moment redistribution from simplified traditional formulae typically adopted in the literature may lead to a considerable error in estimating the design time-dependent moment in balanced cantilever bridges.
Avelumab First-Line Maintenance for Advanced Urothelial Carcinoma: Results From the JAVELIN Bladder 100 Trial After ≥2 Years of Follow-Up
Authors: Powles Thomas , Park Se Hoon , Caserta Claudia , Valderrama Begoña P. , Gurney Howard , Ullén Anders , Loriot Yohann , Sridhar Srikala S. , Sternberg Cora N. , Bellmunt Joaquim , Aragon-Ching Jeanny B. , Wang Jing , Huang Bo , Laliberte Robert J. , di Pietro Alessandra , Grivas Petros 
Published: April 2023

Clinical trials frequently include multiple end points that mature at different times. The initial report, typically based on the primary end point, may be published when key planned coprimary or secondary analyses are not yet available. Clinical Trial Updates provide an opportunity to disseminate additional results from studies, published in JCO or elsewhere, for which the primary end point has already been reported. Initial results from the phase III JAVELIN Bladder 100 trial (ClinicalTrials.gov identifier: NCT02603432 ) showed that avelumab first-line (1L) maintenance plus best supportive care (BSC) significantly prolonged overall survival (OS) and progression-free survival (PFS) versus BSC alone in patients with advanced urothelial carcinoma (aUC) who were progression-free after 1L platinum-containing chemotherapy. Avelumab 1L maintenance treatment is now a standard of care for aUC. Here, we report updated data with ≥ 2 years of follow-up in all patients, including OS (primary end point), PFS, safety, and additional novel analyses. Patients were randomly assigned 1:1 to receive avelumab plus BSC (n = 350) or BSC alone (n = 350). At data cutoff (June 4, 2021), median follow-up was 38.0 months and 39.6 months, respectively; 67 patients (19.5%) had received ≥2 years of avelumab treatment. OS remained longer with avelumab plus BSC versus BSC alone in all patients (hazard ratio, 0.76 [95% CI, 0.63 to 0.91]; 2-sided P = .0036). Investigator-assessed PFS analyses also favored avelumab. Longer-term safety was consistent with previous analyses; no new safety signals were identified with longer treatment duration. In conclusion, longer-term follow-up continues to show clinically meaningful efficacy benefits with avelumab 1L maintenance plus BSC versus BSC alone in patients with aUC. An interactive visualization of data reported in this article is available.
Randomized Phase III Trial Evaluating Subcutaneous Rituximab for the First-Line Treatment of Low–Tumor Burden Follicular Lymphoma: Results of a LYSA Study
Authors: Cartron Guillaume , Bachy Emmanuel , Tilly Hervé , Daguindau Nicolas , Pica Gian-Matteo , Bijou Fontanet , Mounier Christiane , Clavert Aline , Damaj Gandhi Laurent , Slama Borhane , Casasnovas Olivier , Houot Roch , Bouabdallah Krimo , Sibon David , Fitoussi Olivier , Morineau Nadine , Herbaux Charles , Gastinne Thomas , Fornecker Luc-Matthieu , Haioun Corinne , Launay Vincent , Araujo Carla , Benbrahim Omar , Sanhes Laurence , Gressin Remy , Gonzalez Hugo , Morschhauser Franck , Ternant David , Xerri Luc , Tarte Karin , Pranger Delphine 
Published: April 2023

PURPOSE Rituximab improves progression-free survival (PFS) and time to next treatment (TTNT) when compared with the watch and wait strategy for patients with low–tumor burden follicular lymphoma (FL). Prolonged rituximab maintenance did not prolong TTNT, whereas it raises concerns about resources use and patient adhesion. Our aim was then to investigate the use of short rituximab maintenance using the subcutaneous (SC) route in patients with low–tumor burden FL. METHODS Patients with histologically confirmed CD20+ low–tumor burden FL were randomly assigned to receive either rituximab, 375 mg/m2 once daily on D1, D8, D15, and D22, intravenous route (IV, control arm), or rituximab, 375 mg/m2, on day 1 (D1), IV followed by rituximab 1,400 mg total dose, SC once daily on D8, D15, and D22, with maintenance at months 3 (M3), M5, M7, and M9 (experimental arm). The primary end point was PFS. Secondary end points included safety, overall response rates, TTNT, and overall survival (OS). RESULTS Two hundred two patients with low–tumor burden FL were randomly assigned to the experimental (n = 100) or control arm (n = 102). The primary end point was met: the 4-year PFS was 58.1% (95% CI, 47.5 to 67.4) and 41.2% (95% CI, 30.6 to 51.6) in experimental and control arms, respectively (hazard ratio, 0.585 [0.393 to 0.871]; P = .0076). Complete response (CR) rates were 59.0% (95% CI, 48.7 to 68.7) in the experimental arm and 36.3% (95% CI, 27.0 to 46.4) in the control arm ( P = .001). TTNT and OS were not significantly different. CR was associated with longer PFS and TTNT. High rituximab exposure during the first three months was independently associated with higher CR, PFS, and TTNT. CONCLUSION SC rituximab improves PFS for patients with low–tumor burden FL when used in induction followed by short maintenance. High rituximab exposure during the first 3 months after treatment initiation is, however, the only parameter influencing patient outcomes.
Adverse skin reactions to antiepileptic drugs - a review
Authors: Gruszczyńska Michalina , Jarzemski Adam , Kolossa Agnieszka , Porzych Rafał 
Published: April 2023

Introduction and objective: Treatment with antiepileptic drugs (AEDs) is frequently used all around the world. Just like in the course of all the drugs administration, side effects may appear, including characteristic side effects presenting on the skin. The aim of the study was to analyse adverse skin reactions to antiepileptic drugs, focusing on their epidemiology, symptoms and treatment.
Methods: Databases including PubMed and Google Scholar were browsed using keywords.
Description of the state of knowledge: The majority of adverse skin reactions (ASRs) constitute mild rashes and urticaria, however in about 10% cases severe reactions may occur, which can be life-threatening. They include Drug Reaction with Eosinophilia and Systemic Symptoms (DRESS), Stevens-Johnson syndrome (SJS), Toxic Epidermal Necrolysis (TEN), Serum Sickness and Serum Sickness - like Reactions and Drug Induced Vasculitis. In the course of TEN mortality rates are highest, however all reactions can be dangerous and treatment should be applied immediately. In mild and moderate cases drug withdrawal is usually sufficient, however more severe cases need to be treated with immunosuppressive agents.
Summary: The awareness about possible adverse effects and their treatment is crucial as some can be life-threatening and immediate therapy increases the chance of recovery.
Long-standing osteomyelitis: a case report and discussion
Authors: McDonnell Fiona , Eyeson Josiah 
Published: April 2023

Osteomyelitis is a chronic inflammatory bone disease, which can present management difficulties owing to its complex pathogenic process and increasingly virulent micro-organisms. The incidence of the condition has decreased in recent years, primarily due to the availability of antimicrobial therapy; however, this alone does not always resolve symptoms. Once established osteomyelitis can be challenging to manage. This case demonstrates that in certain instances a more aggressive form of multidisciplinary treatment is required to improve the condition and alleviate the patient's symptoms, allowing for a better quality of life. CPD/Clinical Relevance: Knowledge of osteomyelitis is relevant to both general dental practitioners and specialists involved in the management of patients with complex medical needs.
Surgical techniques to reduce oronasal fistula risk in wide cleft palate repair: a systematic review
Authors: Kreshanti Prasetyanugraheni , Sadikin Patricia Marcellina , Anggraeni Margareth Ingrid , Wibowo Jasmine Athiyya , Bangun Kristaninta 
Published: April 2023

BACKGROUND Wide cleft palate is a common congenital anomaly, particularly in developing countries with limited access to plastic surgeons and specialized cleft centers. It can be severe and may contribute to the development of oronasal fistula, which can occur in up to 78% of cases. Despite numerous surgical techniques for wide cleft repair, the best method remains unclear. This study aimed to identify surgical techniques for wide cleft palate repair to minimize the occurrence of oronasal fistula.
METHODS Literature searching was conducted using multiple online databases including PubMed, Scopus, and Cochrane Library. The keywords used were “cleft palate”, ” surgery”, “technique”, “palatoplasty”, and “wide”. Inclusion and exclusion criteria were applied to select relevant studies, and the quality was assessed.
RESULTS A total of 12 studies discussed surgical techniques to repair the primary wide cleft palate and their outcome on oronasal fistula formation. The surgical techniques included modified Furlow palatoplasty, two-flap palatoplasty, and modified Bardach’s two-flap palatoplasty. The incidence of oronasal fistula was 9.6% (n = 28/291) in one-stage Furlow palatoplasty and 12.0% (n = 24/200) in the modified one-stage two-flap palatoplasty.
CONCLUSIONS Two-flap palatoplasty and Furlow palatoplasty (and their modifications) were the safe surgical techniques for wide cleft repair with a low occurrence of oronasal fistula.
Design of a panoramic annular lens system with an ultra-wide angle via an annular Gaussian radial basis function freeform surface
Authors: Yang Yingzhe , Wang Jia , Li Yuejia , Bai Jian 
Published: April 2023

The panoramic annular lens (PAL) system can capture plentiful scene information in real time. The locally described freeform surface can provide more degrees of freedom for the optical system design than the globally described one. In this paper, we propose a locally described annular Gaussian radial basis function freeform surface that enables a high-performance yet compact PAL system. The designed PAL system achieves an ultra-wide field of view (FOV) of (30∘∼125∘)×360∘. The F-theta distortion of the system is less than 3%, and the modulation transfer function across the whole FOV is greater than 0.5 at 100 lp/mm. The proposed system can be implemented for various applications such as video conferencing or robotic navigation.
Knowledge and attitudes of deaf persons towards safe abortion services in Ghana
Authors: Mprah Wisdom Kwadwo , Duorinaah Juventus , Opoku Maxwell Peprah , Nketsia William , Amponteng Michael 
Published: April 2023

Background
Deafness refers to partial or total loss of hearing, which, if not appropriately accommodated, may interfere with day-to-day living experiences. Deaf people encountered challenges in their efforts to access essential services, such as health care. While some attention has been given to general access to reproductive health services, less research has focused on the experiences of deaf women and girls when accessing safe abortion services. With unsafe abortion being a major cause of maternal deaths among women in developing countries, this study attempted to explore the perception of deaf women and girls in Ghana towards safe abortion services.

Objective
The main aim of this study was to understand the perception and awareness safe abortion services among deaf women and girls in Ghana. In doing this, the contributors towards unsafe abortion practices among deaf women and girls were gathered.

Method
Penchansky and Thomas’ accessibility to health care theory availability, accessibility, accommodation/adequacy, affordability, and acceptability guides this study. A semi-structured interview guide based on components of the theory was used for data collection from 60 deaf persons.

Results
The components of the theory were used as a priori themes that guided the data analysis. The results showed challenges associated with the indicators of health access. For instance, in terms of availability, it was revealed that deaf women had little knowledge about existing laws on safe abortion in Ghana. In relation to acceptability, deaf women were highly opposed to abortion for cultural and religious reasons. However, there was consensus that safe abortion could be conducted under certain conditions.

Conclusion
The results of the study have implications for policymaking aimed at attaining equitable access to reproductive health care for deaf women. The need for policymakers to expedite public education and incorporate the needs of deaf women in reproductive health policies, as well as other study implications, are discussed.
The potential cost-effectiveness of novel cord blood therapies in children with autism spectrum disorder
Authors: Borre Ethan D. , Myers Evan , Hamilton Lopez Marianne , Kurtzberg Joanne , Shaz Beth , Troy Jesse , Sanders Schmidler Gillian D. 
Published: April 2023

Objective
To model the long-term clinical and economic outcomes of potential cord blood therapy in autism spectrum disorder (ASD).

Study design
Markov microsimulation of ASD over the lifespan was used to compare two strategies: 1) standard of care (SOC), including behavioral and educational interventions, and 2) novel cord blood (CB) intervention in addition to SOC. Input data reflecting behavioral outcomes included baseline Vineland Adaptive Behavior Scale (VABS-3), monthly VABS-3 changes, and CB intervention efficacy on adaptive behavior based on a randomized, placebo-controlled trial (DukeACT). Quality-adjusted life-years (QALYs) were correlated to VABS-3. Costs for children with ASD ($15,791, ages 2–17 years) and adults with ASD ($56,559, ages 18+ years), and the CB intervention (range $15,000–45,000) were incorporated. Alternative CB efficacy and costs were explored.

Results
We compared model-projected results to published data on life-expectancy, mean VABS-3 changes, and lifetime costs. Undiscounted lifetime QALYs in the SOC and CB strategies were 40.75 and 40.91. Discounted lifetime costs in the SOC strategy were $1,014,000, and for CB ranged from $1,021,000-$1,058,000 with CB intervention cost ($8,000-$45,000). At $15,000 cost, CB was borderline cost-effective (ICER = $105,000/QALY). In one-way sensitivity analysis, CB cost and efficacy were the most influential parameters on CB ICER. CB intervention was cost-effective at costs<$15,000 and efficacies ≥2.0. Five-year healthcare payer projected budgetary outlays at a $15,000 CB cost were $3.847B.

Conclusions
A modestly effective intervention designed to improve adaptive behavior in autism can be cost-effective under certain circumstances. Intervention cost and efficacy most affected the cost-effectiveness results and should be targeted to increase economic efficiency.
Seasonal variations in gut microbiota and disease course in patients with inflammatory bowel disease
Authors: Tani Mizuki , Shinzaki Shinichiro , Asakura Akiko , Tashiro Taku , Amano Takahiro , Otake-Kasamoto Yuriko , Yoshihara Takeo , Yoshii Shunsuke , Tsujii Yoshiki , Hayashi Yoshito , Inoue Takahiro , Motooka Daisuke , Nakamura Shota , Iijima Hideki , Takehara Tetsuo 
Published: April 2023

Background and aim
Environmental factors are associated with onset and course of inflammatory bowel disease (IBD). Our previous study by about 1,100 IBD patients revealed half of the patients experienced seasonal exacerbation of disease. We investigated the seasonality of fecal microbiota composition of IBD patients.

Methods
Fecal samples were consecutively collected in each season from IBD outpatients and healthy controls between November 2015 and April 2019. Participants who were treated with full elemental diet or antibiotics within 6 months or had ostomates were excluded. Bacterial profiles were analyzed by 16S rRNA sequencing, and the changes between the diseases and seasons were compared.

Results
A total of 188 fecal samples were analyzed from 47 participants comprising 19 Crohn’s disease (CD) patients, 20 ulcerative colitis (UC) patients, and 8 healthy controls (HC). In CD patients, the phylum Actinobacteria and TM7 were both significantly more abundant in autumn than in spring and winter, but not in UC patients and HC. Moreover, the genera Actinomyces, a member of Actinobacteria, and c_TM7-3;o_;f_;g_ (TM7-3), that of TM7, were significantly more abundant in autumn than in spring, and the abundance of Actinomyces was significantly correlated with that of TM7-3 throughout the year in CD patients, but not in UC patients and HC. CD patients with high abundance of TM7-3 in the autumn required significantly fewer therapeutic intervention than those without seasonal fluctuation.

Conclusions
Oral commensals Actinomyces and its symbiont TM7-3 were correlatively fluctuated in the feces of CD patients by season, which could affect the disease course.