bluuebunny/crossref_metadata_2025_split huggingface dataset:
The impact of disease-modifying therapies on immunoglobulin blood levels in patients with multiple sclerosis: a retrospective cross-sectional study
Authors: Klein Ana , Flaskamp Martina , Berthele Achim , Held Friederike , Muratovic Harisa , Hemmer Bernhard 
Published: April 2023

Background: Although disease-modifying therapies (DMTs) in multiple sclerosis (MS) are known to target the immune system, mechanisms of action, efficacy, safety, and tolerability profiles differ. The long-term impact of DMTs on the immune system and its relation to infectious complications is still poorly understood. Objectives: To analyze the effect of DMTs on serum immunoglobulin (Ig) levels under consideration of patient demographics and therapy duration. Design: We included 483 patients on DMTs, 69 patients without DMTs, and 51 controls in this retrospective cross-sectional study. Methods: IgG, IgM, and IgG subclass 1–4 levels of patients with MS under treatment with DMTs were compared with treatment naive MS patients and controls by multivariate linear regression. Further, Ig levels stratified by DMTs were analyzed regarding therapy duration. Results: MS patients treated with fingolimod (FG), natalizumab, and B-cell depleting therapies (BCDT) demonstrated significantly lower IgG and IgM levels than healthy controls after a median treatment of 37, 31, and 23 months, respectively (p < 0.05). Treatment with dimethyl fumarate (DMF) and teriflunomide was associated with lower IgG, but not IgM levels. DMF and BCDT were also associated with lower IgG1 levels, while FG led to a reduction of IgG2. Treatment with interferon-beta (IFN) and glatiramer acetate (GA) had no impact on Ig levels. Analysis of subgroups by linear regression also showed a time-dependent decrease of Igs levels in patients treated with BCDT with a median annual reduction of IgG of 3.2% and IgM of 6.2%. Conclusion: Treatment with DMTs, except GA and IFN, was associated with a decrease in Ig levels. DMTs differed in the extent of decreasing Ig levels but also in their differential effects on Ig subclasses. Monitoring of Ig levels should be considered in patients on long-term treatment with DMTs, particularly those on BCDT, to identify patients at risk of low immunoglobulin levels.
Peripherally Inserted Central Catheters-associated blood stream infections—occurrence, risk factors, and pathogens, a single center study
Authors: Arjun Rajalakshmi , Niyas Vettakkara Kandy Muhammed , Sasidharan Aswathy , Jomes Jeffery , Yadav Manish Kumar , Kesavan Suresh 
Published: April 2023

Background Peripherally inserted central catheters (PICCs) are central venous catheters inserted peripherally but terminate in great vessels. PICCs are widely used for patients requiring long-term intravenous therapy in both in-patient and out-patient settings. Aim This study was carried out to understand PICC-related complications, specifically infections and causal pathogens, in a tertiary care hospital in Kerala, South India. Methods A retrospective analysis of PICC insertions and follow-up during a 9 years period to look at patient demographics and infections related to PICC was carried out. Results The overall PICC-related complication rate is 28.1% (4.98 per 1000 PICC days). Commonest complication was thrombosis followed by infection, either PICC-associated bloodstream infection (PABSI) or local infection (LI). PABSI noted in this study was 1.34 per 1000 catheter days. The majority (85%) of PABSI were due to Gram-negative rods. The average duration of PICC days for occurrence of PABSI was 14 days and the majority occurred in in-patients. Conclusion Thrombosis and infection were the commonest PICC-related complications. PABSI rate was comparable to that of previous studies.
The supine moving apprehension test—Reliability and validity among healthy individuals and patients with anterior shoulder instability
Authors: Rabin Alon , Chechik Ofir , Olds Margie K , Uhl Timothy L , Kazum Efi , Deutsch Adin , Citron Eran , Cohen Tal , Dolkart Oleg , Bibas Assaf , Maman Eran 
Published: April 2023

Background Performance-based tests for patients with anterior shoulder dislocation are lacking. This study determined the reliability and validity of the supine moving apprehension test designed to assess the ability to control anterior instability loads. Methods Thirty-six participants were recruited (18 healthy individuals, and 18 patients following anterior shoulder dislocation). Healthy participants performed the supine moving apprehension test on 2 separate occasions to determine test-retest reliability. Patients completed the supine moving apprehension test and the Western Ontario Shoulder Instability index before and 6 months after surgical stabilization of their shoulder. The presence of anterior apprehension was also documented post-operatively. Results The supine moving apprehension test demonstrated good test-retest reliability (intraclass correlation coefficient = 0.74−0.84). Patients performed 18−30 repetitions less than healthy individuals during the supine moving apprehension test ( P < 0.01). A strong correlation was found between supine moving apprehension test scores and Western Ontario Shoulder Instability post-operatively ( r = −0.74, P ≤ 0.01). Supine moving apprehension test scores significantly improved among patients following surgery ( P < 0.01). Patients with a negative apprehension test post-operatively performed the supine moving apprehension test significantly better than patients with a positive apprehension test ( P < 0.01). Conclusions The supine moving apprehension test is reliable and valid among patients with anterior shoulder dislocation and may serve to assess patients’ ability to control shoulder anterior instability loads.
COVID-19 vaccination knowledge, attitudes and practices among the general population of Romania during the third wave of COVID-19 pandemic
Authors: Šljivo Armin , Abdulkhaliq Arian , Granov Nermir , Reiter Leopold , Mahendran Eljakim , Zeglis Ioannis , Mohammed Mohammed Abdulkadir , Yousef Assy , Dadić Ilma , Ivanović Katarina , Selimović Amina , Mujičić Ermina , Gabor-Harosa Florina Maria 
Published: April 2023

Objective: Romania began its COVID-19 immunization programme with approved vaccinations in three stages, as follows: The first step of vaccination is for health and social professionals, the second stage is for high-risk persons and the third stage is for the remainder of the general public. This study aims at assessment of knowledge, attitude and practice towards COVID-19 and vaccination against COVID-19 in the Romanian population during the third wave of the pandemic. Methods: This cross-sectional study was based on a Bosnian and Herzegovinian study on COVID-19 vaccination during the country’s third wave of COVID-19 pandemic. Results: Our study sample, dominantly female (629; 61.0%), with a bachelor’s degree (734; 71.2%), either single (539; 52.3%) or in a relationship (363; 35.2%), engaged in intellectual labour (910; 88.3%) and living in an urban environment (874; 84.8%) with a mean age of 25.07 ± 8.21 years, 294 (28.5%) people with COVID-19 symptoms and 86 (8.3%) were tested COVID-19 positive, had a mean knowledge score of 16.38 ± 4.0 with correct answer rates on questions ranging from 30.1% to 88.2%. Being single (odds ratio = 3.92, p = 0.029) or in a relationship (odds ratio = 3.79, p = 0.034), having a bachelor’s degree and higher (odds ratio = 1.61, p = 0.006) and being COVID-19 tested (odds ratio = 1.82, p < 0.001) were associated with higher knowledge test scores. Our sample had relatively optimistic attitudes towards final COVID-19 disease containment (712; 69.1%) and vaccination programmes (679; 65.9%). The majority of the sample followed socio-epidemiological measures and did not visit places of mass social gatherings (666; 64.1%) and wore masks (992; 95.7%) while being outside their home. In terms of vaccination rates, 382 (37.0%) of the individuals were presently immunized against COVID-19. Higher knowledge test scores (>15 points) (odds ratio = 1.66, p = 0.002) and positive attitudes of this study (odds ratio = 1.59, p = 0.001, odds ratio = 4.16, p < 0.001) were identified as independent predictors for vaccinating against COVID-19. Conclusion: Romanian citizens have had good knowledge, optimistic attitudes and appropriate practices towards COVID-19 vaccination during the third wave of COVID-19 outbreak in the country. Higher knowledge regarding the disease and vaccination against it not only increased attitudes towards the end of the pandemic, but also increased the willingness to be vaccinated and to avoid infection risk factors.
Diagnosis and management of thoracic endometriosis syndrome: Case report
Authors: Murphy Shaw Ashley , Demarco Kara , Belovs Laura , Strange Robert , Spitzer Trimble 
Published: April 2023

Introduction: While the diagnosis of endometriosis is relatively common, thoracic endometriosis is a rare manifestation. Thoracic Endometriosis Syndrome (TES) most commonly presents with pneumothorax, 3% which are bilateral, making this case unique in the already limited breadth of TES with catamenial hemopneumothorax. Additionally, this patient had laboratory values constant with ovarian suppression yet continued menses and recurrent hemopneumothorax, necessitating surgical intervention. We propose that with this severity of disease a combination of surgical intervention and hormonal therapy is the ideal approach, providing the lowest rate of recurrence. Case description: A 33 year old woman with 2-day history of chest pain and shortness of breath with heavy menstrual cycles and significant dysmenorrhea. A chest radiograph and computed tomography scan revealed right-sided pneumothorax and bilateral hemothoraces with left-sided diaphragmatic hernia. Video-assisted thoracoscopic surgery confirmed sanguinous pleural effusions and biopsy proven endometriotic lesions. The patient was started on a gonadotropin-releasing hormone agonist and experienced short-interval recurrence of her symptoms. An aromatase inhibitor was added to her regimen and she underwent a left diaphragmatic hernia repair. Conclusions: The recurrence of symptoms despite complete hypothalamic-pituitary-ovarian axis suppression, in addition to the surgical requirements and findings make this case unique in the already limited breadth of thoracic endometriosis syndrome with catamenial hemopneumothorax.
Effects of Ultrasonic Instrumentation on the Shear Bond Strength of Ceramic Brackets: An In Vitro Study
Authors: Rajamanickam Preethi , Ramasamy Navaneethan 
Published: April 2023

Aim: Accumulation of plaque during orthodontic treatment makes oral prophylaxis a regular necessity. The use of esthetic brackets has gained popularity, it becomes necessary to assess the consequences of ultrasonic instrumentation during oral prophylaxis on ceramic bracket’s shear bond strength (SBS). Materials and Methods: Fifty-four premolar teeth which were extracted due to therapeutic reasons were divided into six groups with each group containing nine teeth each. Ceramic brackets were bonded onto the labial surfaces using two different adhesive systems (Ormco Enlight and Transbond) and were subjected to ultrasonic scaling at different scaler tip angulations. The samples were then rendered a debonding force in a Universal testing machine and the bond strengths were assessed. Results: In terms of angulation of ultrasonic instrumentation, among the groups bonded with the Ormco Enlight, the 45° angulation group had statistically significant higher bond strength values compared to the 0° angulation group. Among the transbond groups, there was no statistically significant difference in the bond strengths even though the 45° angulation group had slightly higher bond strength value than the 0° angulation group. Conclusion: Supragingival scaling around the bracket base at 0° around the ceramic brackets for 1 min resulted in the reduction of SBS. Therefore, the clinicians should be cautious during plaque removal, avoid performing extended ultrasonic instrumentation at the bracket base, especially at 0° angulation.
A Development Approach to a Protracted IDP Situation: Lessons from Azerbaijan
Authors: Wistrand Jennifer S. 
Published: April 2023

This article highlights the realities facing Azerbaijan’s internally displaced persons (IDPs), living in a state of protracted displacement. It argues that the World Bank’s development approach to the IDP population in Azerbaijan and to IDP populations elsewhere has likely done more for these populations’ long-term welfare and prospects than exclusively humanitarian approaches could have accomplished, even though displaced peoples have traditionally been presumed to be the responsibility of the humanitarian community. The article begins with a brief discussion of the differences between refugees and IDPs and between humanitarian and development approaches. It then outlines a history of the conflict between Azerbaijan and Armenia over the contested region of Nagorno-Karabakh which, in the early 1990s, produced upward of a half-million Azerbaijani IDPs. Next, the article discusses some of the realities (economic, social, and mental health, among others) that confronted Azerbaijan’s IDPs 15 years into their displacement. It focuses on a community of IDPs who lived in a temporary-turned-long-term “collective center” on the outskirts of Azerbaijan’s capital of Baku. Finally, the article discusses one of the World Bank’s projects in Azerbaijan with IDPs. The article concludes with policy recommendations on the way future scholars, practitioners, and policymakers should be trained to understand and approach IDPs. More broadly, it recommends that combined humanitarian and development approaches to IDP situations should become the norm. This seems imperative given that the number of IDPs displaced by conflict and violence world-wide has increased each year for more than a decade, while the ability of IDPs to avail themselves of traditional durable solutions has not kept pace.
Five Years Lost: Youth Inclusion in the Rohingya Response
Authors: Islam Imrul , Naing Zia 
Published: April 2023

While youth are routinely lauded as “change-makers,” they are often underserved and unsupported in refugee responses. As the Rohingya face protracted displacement in Bangladesh, what is the state of youth inclusion in the response? Do youth and adolescents feel supported, or are they ignored and left behind? To answer these questions, the paper uses: Literature on youth participation and inclusion in humanitarian programming; Key informant interviews with practitioners from national and international non-governmental organizations (NGOs) and UN agencies; Focus group discussions and key informant interviews with refugee individuals and groups across nine camps for Rohingya refugees in Bangladesh. It finds that: Refugee Rohingya youth and adolescents remain firmly on the margins of humanitarian programming, and are largely excluded from decision-making processes; Approximately 96 percent of surveyed youth between 18 and 24 years of age report being unemployed; For surveyed women aged 18–24 years, unemployment rates bordered on 99 percent; and Stress and anxiety are omnipresent amongst the community: an overwhelming majority of respondents reported experiencing disturbing thoughts and resorting to negative coping mechanisms. The paper ends with a series of recommendations to the Strategic Executive Group (SEG) and the Inter-Sector Coordination Group (ISCG), to donors, the international community, and the government of Bangladesh. 1
Integration Through Health During Protracted Displacement: Case Studies From Colombia and Jordan
Authors: McCann Katherine , Fouad Fouad M. , Harker Roa Arturo , Zard Monette 
Published: April 2023

As the global rate of displacement reaches new highs and the average length of displacement extends from years to decades, integration is an increasingly crucial lifeline for refugees and displaced communities seeking to rebuild their lives. Health systems serve as an ideal conduit for integration due to universal need, system complexity, and the interplay of political, social, and economic factors on health outcomes. Using lessons learned from case studies in Colombia and Jordan, this paper will explore different strategies for integration of refugee health services with host population health systems. It will highlight successful policy implementation and innovative approaches as well as predict potential barriers to success via a population-centered approach that emphasizes the importance of supporting host communities concurrently with displaced populations. It offers the following findings and recommendations for governmental and humanitarian actors. Effective integration requires a “whole of person” approach which acknowledges and responds to the linkages between legal status, economic needs, and mental and physical health and wellbeing. Addressing the health needs of populations experiencing protracted displacement must go hand-in-hand with, and cannot be decoupled from, addressing the needs of host communities. Demographic and epidemiologic data inclusive of both host and displaced populations enables governments and service providers to better plan for and respond to key health and non-health needs. Donors and financing structures can play a critical role in facilitating greater integration of health and other services.
Strategies for the Facilitation of Self-Leadership Among Ward Nurses in a Nurse-Led Critical Care Outreach Service
Authors: Prinsloo Carine 
Published: April 2023

Introduction Nurses are responsible for monitoring and providing nursing care to patients. The early detection of a patient who is starting to deteriorate – and the activation of critical care outreach services (CCOS) – can improve patient outcomes. However, the literature indicates that CCOS are underutilised. Self-leadership is a process whereby persons influence their own behaviour. Objective The purpose of this study was to develop strategies for the facilitation of self-leadership in ward nurses that will enable them to act proactively and promptly in utilising CCOS at a private hospital group in South Africa. Methods A sequential exploratory mixed-method research approach was followed to develop strategies for the facilitation of self-leadership in nurses that will enable them to utilise CCOS proactively when a patient starts to deteriorate. An adapted version of Neck and Milliman's self-leadership strategic framework was used as the methodological steps of the study. Results The quantitative analysis extracted eight factors, which were used as the departure point to develop strategies for the facilitation of self-leadership among nurses in a CCOS. Five strategies were developed that related to self-motivation, role models, patient outcome, assistance and guidance from CCOS, and the power of self-confirmation; these strategies aligned with the themes and categories extracted from the qualitative data analysis. Conclusion There is a need for self-leadership among nurses in a CCOS.
Rotator Cuff Repair With Bone Grafting of Greater Tuberosity Cyst: A Technique Video
Authors: Forsythe Brian , Gamsarian Vahram , Ward Caitlin , Mirle Vikranth , Brusalis Christopher M. 
Published: April 2023

Background: Nearly 500,000 rotator cuff repairs are performed annually in the United States. Cysts within the humeral head have been reported to occur in more than half of patients diagnosed with a rotator cuff tear. They are related to age-related degeneration and rotator cuff dysfunction, and may arise from congenital abnormalities. Indications: Humeral head cysts may pose technical challenges during rotator cuff repair. Cysts located at the footprint of a planned rotator cuff repair can decrease biological healing capacity and reduce the fixation strength of suture anchors. One treatment strategy to address bone loss secondary to humeral head cysts is to incorporate cancellous allograft bone chips, which provide an osteoconductive scaffold for bone formation. Technique Description: Standard arthroscopic portals were established and during arthroscopy, the rotator cuff tear was identified, and tissue was mobilized. The cyst was debrided to healthy, bleeding bone using curettes and an arthroscopic shaver. A 2.5 mL sterile syringe was packed with crushed, cancellous allograft bone chips. The tip of the syringe was removed to allow for a wider aperture to facilitate injection of bone chips. Through an accessory, percutaneous portal just lateral to the acromion, the syringe was inserted into the cyst site, and bone graft contents were injected into the cyst. Pressure was applied to the syringe to impact the bone graft material. The bone chips were impacted with the syringe plunger. Following rotator cuff repair, the patient underwent subacromial decompression, distal clavicle excision, and open sub-pectoral biceps tenodesis with suture anchor fixation. Discussion/Conclusion: Greater tuberosity cysts can impose a technical challenge during arthroscopic rotator cuff repair. Incorporation of impacted cancellous allograft bone chips is an efficient, reproducible method to enhance healing of the RTC tendon enthesis. Patient Consent Disclosure Statement: The author(s) attests that consent has been obtained from any patient(s) appearing in this publication. If the individual may be identifiable, the author(s) has included a statement of release or other written form of approval from the patient(s) with this submission for publication.
Variation in the proportion of the segregating genome shared between full-sibling cattle and sheep
Authors: Kenny David , Berry Donagh P. , Pabiou Thierry , Rafter Pierce 
Published: April 2023

AbstractThe construction of covariance matrices that account for the genetic relationships among individuals, using pedigree or genotype data, is integral to genetic evaluations, which are now routinely used in the field of animal breeding. The objective of the present study was to estimate the standard deviation in the proportion of the segregating genome that is shared between pairs of full-sibling cattle and sheep independently. Post edits, genotype data comprising 46,069 autosomal single nucleotide polymorphisms (SNPs) were available for 4532 unique full-sibling sheep pairs, as well as for their respective parents. Post edits, genotypes from 50,493 autosomal SNPs were also available for 10,000 unique full-sibling cattle pairs, as well as their respective parents. Genomic relationship matrices were constructed for the sheep and cattle populations, separately. After accounting for both parental genomic inbreeding and the genomic relationship between both parents, the standard deviation in full-sibling cattle and sheep genomic relationships was 0.040 and 0.037 units, respectively. In addition, the intercept value from a linear regression model which regressed each full-sibling genomic relationship on both sire and dam inbreeding, as well as the genomic relationship between the parents, was 0.499 (0.001) for sheep and 0.500 (0.001) for cattle, conforming to the expectation that full-siblings, on average, share 50% of their segregating genome.