bluuebunny/crossref_metadata_2025_split huggingface dataset:
Characteristics of outpatient gynecology oncology services before and after COVID-19 pandemic at Ulin Regional General Hospital, Banjarmasin, Indonesia
Authors: Waluyo Setyo Teguh , Armanza Ferry , Yuseran Hariadi , Halim Kevin Stanley 
Published: August 2023

HIGHLIGHTS

The characteristics of gynecology oncology services at Ulin Regional General Hospital before and after the COVID-19 pandemic were evaluated.
There was a decrease of 19% in the number of visits by Gynecology Oncology Clinic patients at Ulin Regional General Hospital between the period of March 2019 - February 2020 and March 2020 - February 2021.

ABSTRACT
Objective: The aim of this study was to investigate the characteristics of the Gynecology Oncology Outpatient Clinic at Ulin Hospital Banjarmasin before and after the COVID-19 pandemic.
Materials and Methods: This descriptive study utilized existing patient data from the Gynecology Oncology Outpatient Clinic at Ulin Hospital Banjarmasin covering the period from March 2019 to February 2021. The study received ethical approval from the Ulin General Hospital ethics committee with clearance number 10/I-Reg Research/RSUDU/23. The collected data was presented in a tabular format to compare the service characteristics before the pandemic (March 2019 - February 2020) and after the pandemic (March 2020 – February 2021).
Results: During the periods of March 2019 – February 2020 and March 2020 – February 2021, there was a reduction of 19% in patient visits. The number of patients undergoing treatment also decreased, from 1081 patients (53.9%) in the period of March 2019 – February 2020 to 926 patients (46.1%) in the period of March 2020 – February 2021. Notably, there was a decrease in the number of patients undergoing surgical procedures, dropping from 76 patients (70.4%) in the period of March 2019 – February 2020 to 32 patients (29.6%) in the period of March 2020 – February 2021. A similar trend was seen in patients receiving chemotherapy, with the count decreasing from 1005 patients (52.9%) in the period of March 2019 – February 2020 to 894 patients (47.1%) in the period of March 2020 – February 2021. These changes were attributed to various hospital measures implemented to address the COVID-19 pandemic, including a reduction in outpatient clinic visits and the temporary suspension of surgical procedures from March 2020 to October 2020 to minimize potential exposure.
Conclusion: The study highlights a noticeable decline in both the frequency of visits to the Gynecology Oncology Outpatient Clinic at Ulin Regional General Hospital Banjarmasin and the number of patients receiving treatment during the periods before and after the onset of the COVID-19 pandemic.
Is maternal pre-pregnancy Body Mass Index associated with type of Congenital Heart Disease in offspring?
Authors: Fachryandini Nofita , Hidayat Taufiq , Ernawati Ernawati , A Rahman Mahrus 
Published: August 2023

HIGHLIGHTS

The most common CHD was atrial septal defect for acyanotic CHD and Tetralogy of Fallot for cyanotic CHD.
There was no association between maternal pre-pregnancy BMI and type of CHD in offspring.

ABSTRACT
Objectives: This study aimed to determine the association between maternal pre-pregnancy BMI and type of congenital heart disease (CHD) in offspring.
Materials and Methods: This retrospective cross-sectional study involved all mothers of children with CHD who visited Pediatric Outpatient Unit at Dr. Soetomo General Academic Hospital, Surabaya, Indonesia, from January to December 2019. The maternal data were obtained from the KIA's (Maternal and Child Health) book or through anamnesis by telephone, while the offspring’s data were collected from medical records. The data were analyzed using the Chi-Square test. Significance was determined at a 5% level (p <0.05).
Results: We studied 117 mothers of children with CHD. The most frequent maternal pre-pregnancy body mass index (BMI) was normal (BMI 17-23 kg/m2) accounting for 56.4% of the study population. The most common CHD was atrial septal defect (33.3%) among acyanotic patients and Tetralogy of Fallot (8.5%) among cyanotic patients. The Chi-Square test showed p=0.958 for the association between maternal pre-pregnancy BMI and type of CHD in offspring.
Conclusion: There was no association between maternal pre-pregnancy BMI and type of CHD in offspring.
A systematic review of real-world applications of genome sequencing for newborn screening
Authors: Magnifico Giuditta , Artuso Irene , Benvenuti Stefano 
Published: August 2023

Aim: With the costs of genomic sequencing falling quickly and an ever-increasing number of clinical laboratories equipped with new-generation sequencing machines, healthcare systems around the world are getting ready to enter the era of genomic newborn screening (NBS). However, the adoption of Genomic Sequencing (GS), encompassing whole-exome sequencing (WES) and whole-genome sequencing (WGS), in NBS programs raises a number of clinical, ethical, and legal questions as well as organizational and economic challenges. This systematic review is part of a feasibility study to assess the introduction of WGS for NBS in Lombardy region with the specific aim of gathering evidence from existing pilots in the field whose results have been published.
Methods: Three different sources were identified for the selection of articles in order to obtain a various and unbiased set of publications. 33 articles were retained for analysis to answer the following questions: 1. Clinical: Does genomic sequencing demonstrate clinical utility in the context of NBS? What are the limitations of these kind of programs? 2. Societal: What are the social, ethical and psychological implications of using GS for NBS? 3. Governance: What are the legal, economic, and organizational challenges for GS-based NBS programs?
Results: There is a general consensus in the literature on the key principles that should guide the adoption of GS in NBS, such as the inclusion of actionable genes only, the need for informed consent from the parents, the right of the newborn to an open future, which means the exclusion of late-onset diseases even when those are considered treatable. However, there are still several differences in how these principles are detailed and applied.
Conclusion: Real-world evidence from a handful of pilot projects (namely BabySeq and NC-Nexus, both carried out in the USA) have been published recently; however, this evidence is not yet sufficient to put an end to the broad and animated debate on the use of GS for NBS. Ethical, legal, and social issues still constitute great challenges and major barriers to wide and uniform adoption of GS in NBS. On the clinical side, a number of issues remain unaddressed, such as the benefits and limitations of the different approaches (targeted sequencing, GS only versus GS+standard NBS), the genes/diseases to include and the frequency of incidental findings, identification of carrier status, and variants of uncertain significance (VUS). Further pilots and consultations with involved stakeholders will be necessary before GS-based NBS can be accepted and systematically implemented in national healthcare programs.
Programmed evolution: Using asexual gene drives to sculpt tumor populations and combat genetic diversity
Authors: Pritchard Justin , Leighow Scott , Reynolds Joshua , Sokirniy Ivan , Yao Shun , Yang Zeyu , Inam Haider , Wodarz Dominik , Archetti Marco 
Published: August 2023

Abstract

Resistance evolution is responsible for the failure of most targeted anticancer therapies. Tumor heterogeneity is so profound that pre-existing resistance is thought to be guaranteed at the time that advanced disease is detected. The practice of waiting for treatment failure and then responding to the refractory tumor with next-generation targeted therapies locks clinicians in an evolutionary arms race until no further treatment options are available. Here, we posit that disease evolution can be reproducibly reprogrammed to design more readily treated tumors, regardless of the exact ensemble of pre-existing genetic heterogeneity. To this end, we conceive of a modular genetic platform that couples an inducible fitness advantage with a shared fitness cost. Using stochastic models of evolutionary dynamics, we identify the design criteria of these “selection gene drives.” We then build prototypes that leverage the selective pressure of various approved tyrosine kinase inhibitors and employ therapeutic mechanisms as diverse as prodrug catalysis and immune activity induction. By using saturating mutagenesis across a drug target and genome-scale loss-of-function libraries, we show that our selection gene drives can eradicate extremely diverse forms of genetic resistance. Finally, using theory to guide treatment scheduling, we demonstrate that model-informed switch engagement can create dramatic in vivo efficacy. These results establish selection gene drives as a powerful new paradigm for evolution-guided anticancer therapy.
Theoretical boundaries of annual flood risk for single-family homes within the 100-year floodplain
Authors: Assi Ayat Al , Mostafiz Rubayet Bin , Friedland Carol J. , Rohli Robert V. 
Published: August 2023

Abstract
Special flood hazard areas (SFHAs), defined as having an annual probability of occurrence of 0.1 or above, are used by U.S. Federal Emergency Management Agency (FEMA) to demarcate areas within which flood insurance purchase is required to secure a mortgage. However, quantifying flood risk within SFHAs can be challenging due to the lack of modeled flood depth data for all return periods. To address this issue, this research quantifies flood risk indicated by average annual loss (AAL) within the A Zone – the subset of the SFHA where wave heights can potentially range from 0 to 3 feet. The methodology resolves the Gumbel quantile function for four distinct flooding cases (i.e., location flooded at return periods exceeding 1.58-, 10-, 25-, and 50-year return period events) and generates synthetic flood hazard parameters for these cases within the 100-year floodplain, as well as with additional elevation above the base blood elevation (BFE), known as freeboard, for single-family homes with different attributes. The results indicate that for single-family homes in the A Zone, with the lowest floor elevated to the BFE, the AAL ranges from 0.3 to 1 percent of the building replacement cost value. Adding one foot of freeboard reduces flood risk by over 90% if the annual flood risk is between the minimum and 25th percentiles, and the 100-year flood depth is less than two feet. The demonstrated approach helps to enhance flood resilience in the A Zone, demonstrating the feasibility of proactive measures to protect communities.
Impact of breast cancer neoadjuvant chemotherapy on plasma and urine amino acid profile, plasma proteins and nitrogen metabolism
Authors: Dastych Milan , Holánek Miloš , Gottwaldová Jana , Čermáková Zdenka , Mikušková Alena 
Published: August 2023

Abstract

Purpose
This pilot observational prospective study examined the effect of neoadjuvant chemotherapy (NAC) using anthracycline + cyclophosphamide (AC) followed by paclitaxel (PTx) on a portfolio of 22 plasma and urinary amino acids, plasma proteins (albumin, prealbumin, transferrin), and products of nitrogen metabolism (urea, creatinine, uric acid) in plasma and urine.
Methods
Plasma and 24-hour urine samples were obtained from ten patients with early breast cancer (N1-3 N0-2 M0), at the following time points: before the start of NAC and during the AC/PTx treatment period (a total of 8 measurements at three-weekly intervals). Amino acids were analyzed using ion exchange chromatography.
Results
There were no significant differences in the measured parameters in plasma and urine between pre-NAC and during AC- and PTx-treatment. No trend was detected. A significant difference in the portfolio of plasma and urinary amino acids was found only in the pre-treatment period compared to the control group. Levels of eight plasma amino acids (8/22) were significantly reduced and those of 9 urine amino acids were increased (9/22). Nitrogenous catabolites in plasma and urine were not indicative of increased protein catabolism during the anthracycline and taxane treatment periods. A slightly positive nitrogen balance was accompanied by an average weight gain of 2.5 kg (range 0–5 kg).
Conclusion
The AC/PTx treatment regimen did not cause significant changes in the monitored laboratory parameters.
Barriers to proper maternal referral system of health facilities: a qualitative study in Eastern Ethiopia
Authors: Mengist Betelhem , Semahegn Agumasie , Yibabie Shegaye , Amsalu Bezabih , Tura Abera Kenay 
Published: August 2023

Abstract
Background
Appropriate referral system plays an essential role in curbing maternal mortality. Although the occurrence of obstetric complications is often unpredictable, addressing bottlenecks of the referral system is crucial to facilities the women have access to timely lifesaving interventions. Nonetheless, little is known about the barriers to maternal referral system in the eastern part of Ethiopia. Therefore, this study aimed to explore the barriers to maternal referral system at selected referral hospitals in eastern Ethiopia.
Methods
Key informant interviews and in-depth interviews were conducted among purposively selected respondents who had a role in the maternal referral processes. A total of 12 key informants that comprised of liaisons officers, healthcare providers and three in-depth interviews with referred women were conducted. Semi-structured interview guide was developed and used to facilitate the interviews. All the interviews were tape recorded, complemented by note taking. Then audio recorded interviews were transcribed as per verbatim of participants, and imported to NVivo for coding and merging. The data were thematically synthesized.
Results
The study identified a range of barriers that affect the maternal referral system in Eastern Ethiopia. The main barriers are grouped into three domains, such as: communication, transportation, and healthcare system. The most commonly reported barriers were lack of pre referral communication and feedback, using informal communication, incomplete referral communication, poor ambulance service including misuse of ambulances, lack of skilled healthcare, escort, and lack of medical equipment, at emergency, unnecessary self-referrals, poor referral skills, and limited number of health professions.
Conclusions
The maternal referral system is overwhelmingly affected by lack of skill, logistics (referral form), misuse of available ambulance, poor communication, and limited seeking of feedback. We suggest a regular consultative meeting with relevant stakeholders and uptake of feedbacks are crucial to improve referral communication, proper use of ambulance and building capacity of health workforce about referral, management that will improve the maternal referral system in the study area.
Establishing Dietary intake Behavior of children to prevent iron deficiency to sustain their growth, Oromiya region, Ethiopia: Community Cluster trial
Authors: Ferede Abebe , Belachew Tefera , Abera Muluemebet 
Published: August 2023

Abstract
Background: Distressing iron deficiency anemia (IDA) in young children requires an appropriate prevention strategy. This study aimed to determine how dietary intake behavior change (DIBC) could improve the effects of hemoglobin (Hb) concentration on children's growth from 6 to 59 months of age.
Methods: A cluster randomized controlled trial was conducted. The intervention and control groups were randomly assigned to the 16 lower community units (LCU). Children paired with their mothers were chosen from each LCU. At the starting point and finish line, Hb, anthropomorphic, and other variable data were collected. A t-test was used to analyze the mean variations. We determined significant parameters using a Generalized Estimating Equation (GEE).
Results: Approximately 1012 and 935 children were enrolled at the start and end of the study, respectively. At baseline, the mean Hb was 128.4 g/L + 15.6, and at the end, it was 141.3 g/L + 42.5. In contrast, in the control group, the incidence of iron deficiency anemia (IDA) was 15.2% (n = 77) at baseline. In the intervention group, IDA was 107 (21.1%) at baseline and 18 (3.6%) at the end line. At the time of completion, stunted growth in the intervention group decreased to 65 (12.8%) and climbed to 237 (55.2%) in the control group. Hb Mean differences between the groups in the baseline - end-line difference by height was 27.5g/L, p = 0.001. Children who were allocated to the intervention group by 12.6 cm (p = 0.001) in a month rated their height among the many tested parameters
Conclusions: Higher IDA and a very high prevalence of stunted growth were observed in both groups of children, but at the end line was radically reduced to low among the intervention group. Implementing healthy eating habits and dietary intake practices could essentially be improved among interventions, while the control group continued to experience negative effects. As a result, this type of intervention is more likely to have a widespread impact on the physical and nutritional well-being of children.
Clinical trial registration numbers: NCT04846062, Date: 15/04/2021
Posterior cruciate ligament repair in acute knee instabilities with internal bracing: midterm follow up for clinical and kinematic results
Authors: Martens Eike , Krackhardt Tilmann , Wicke Lino , Kratzenstein Stefan , Wegner Mathis , Lippross Sebastian 
Published: August 2023

Abstract
Background:
Injuries of the PCL are comparably rare. They occur with or without accompanying injuries of the knee and frequently occur in multi-ligament knee instability. Internal bracing is a recent treatment option for acute PCL tears. For low-grade instability, a conservative therapy is recommended while severe instability in multi-ligament injuries is mostly addressed by surgical reconstruction. Recent evaluations of internal bracing demonstrate good options for both isolated ligamentous and multiligamentous injuries.
The aim of this study was to assess general outcomes in joint function and stability as well as activity and quality of life by clinical examination and functional gait analysis.
Methods:
A total of 19 patients were examined after internal bracing of an acute II/III° PCL- injury between 2017 and 2021. Included were patients with MRI-proven unilateral PCL tear. In addition to clinical tests for mobility and posterior drawer test, a IMU based kinematic gait analysis was performed. Further IKDC-Score, TAS and Lysholm Score were examined. Regular stress radiographs of both knee joints were included for further evaluation.
Results:
Follow-up examination took place after 29.40 ± 10.47 months. The mean ROM of the injured knee showed 0.79° ± 1,9° for extension and 138,4° ± 3,4° for flexion. In gait and walking analysis, no significant movement restrictions for either knee joint remained. IKDC amounted to 53,2 ± 4,2% after injury and 91.7 ± 7,4% at follow-up. The Lysholm Score was 95.5% ± 8,3%. The TAS showed no significant difference (5,5 ± 1.30 pt pre-injury and 5,2 ± 1.2 pt at follow-up). The mean difference of posterior tibial translation reached 2,5 ± 1,5 mm in clinical examination and demonstrated significant difference to the healthy side. 1 patient needed revision surgery by complete PCL- reconstruction due to grade II-Instability postoperative but no other complications occurred.
Conclusions:
Internal bracing can offer good treatment for acute grade II and grade III PCL-instabilities, especially when further meniscal or ligamentous injuries require surgical repair. Despite the limited evidence-based results and applications to date, restoration of joint mobility and a minor residual posterior tibial translation can be confirmed. Results for everyday and sports activities are comparable with conservative and established surgical procedures.
Pneumococcus suppresses host inflammatory response through COMMD2 mediated NF-κB degradation by aggrephagy
Authors: Hamon Melanie , Connor Michael , Sanchez Lisa , Chevalier Christine , Carvalho Filipe , Eldridge Matthew , Chaze Thibault , Matondo Mariette , Weight Caroline , Dufour Sara , Impens Francis , Baumgarten Sebastian , Enninga Jost 
Published: August 2023

Abstract
NF-κB driven cellular immunity is essential for both pro- and anti-inflammatory responses to microbes, which makes it one of the most frequently targeted pathways by bacteria during pathogenesis. How NF-κB tunes the epithelial response to Streptococcus pneumoniae across the spectrum of commensal to pathogenic outcomes is not fully understood. In this study, we compare a commensal-like 6B ST90 strain to an invasive TIGR4 isolate and demonstrate that TIGR4 both blunts and antagonizes NF-κB activation. We identified, through comparative mass spectrometry of the p65 interactome, that the 6B ST90 isolate drives a non-canonical NF-κB RelB cascade, whereas TIGR4 induces p65 degradation though aggrephagy. Mechanistically, TIGR4 challenge triggers a novel interaction of COMMD2 with p65 and p62. This complex mediates export of p65 for degradation and is necessary for repressing host inflammatory transcription. With these results, we reveal for the first time a new bacterial pathogenesis mechanism to repress host inflammatory response though COMMD2 mediated turnover of p65, and present a paradigm for diverging NF-κB responses to pneumococcus.
Association of T-wave Changes and Type 2 diabetes: A cross-sectional sub-analysis of MASHAD cohort population using Minnesota coding system of Electrocardiogram
Authors: Soflaei Sara Saffar , Nazar Isa , Sahranavard Toktam , Fayedeh Farzad , Ghalibaf AmirAli Moodi , Ebrahimi Mahmoud , Alimi Hedieh , Shahri Bahram , Izadi-Moud Azadeh , Ferns Gordon A. , Ghodsi Alireza , Mehrabi Saeed , Tarhimi Milad , Esmaily Habibollah , Moohebati Mohsen , Ghayour-Mobarhan Majid 
Published: August 2023

Abstract
Background: Type 2 Diabetes Mellitus (T2DM) has become a major health concern with an increasing prevalence and is now one of the leading causes of death globally. T2DM and cardiovascular disease are strongly associated and T2DM is an important independent risk factor for ischemic heart disease. T-wave abnormalities (TWA) on electrocardiogram (ECG) can indicate several pathologies including ischemia. In this study, we aimed to investigate the association between T2DM and T-wave changes evaluated using the Minnesota coding system.
Methods: A cross-sectional study was conducted on the MASHAD cohort study population. All participants of the cohort population were enrolled in the study. 12-lead ECG and Minnesota coding system (codes 5-1 to 5-4) were utilized for T-wave observation and interpretation. Regression models were used for the final evaluation with a level of significance being considered at p<0.05.
Results: A total of 9035 participants aged 35-65 years old were included in the study, of whom 1273 were diabetic. The prevalence of code 5-2, 5-3, major and minor TWA were significantly higher in diabetics (p<0.05). Following adjustment for age, gender, and hypertension, no TWAs were significantly associated with T2DM (p>0.05). Whereas, hypertension, age, and body mass index were significantly associated with T2DM.
Conclusions: Although some T-wave abnormalities were more frequent in diabetics, none of them were statistically associated with T2DM in our study. Further research is needed to better understand the associations between T2DM and ischemic heart diseases.