bluuebunny/crossref_metadata_2025_split huggingface dataset:
Subacute cutaneous lupus erythematosus as a rare complication of disease-modifying therapy administration in multiple sclerosis: case report
Authors: Xu Ke , Zhang Mengjie , Yang Shilin , Yu Gang , Zheng Peng , Qin Xinyue , Feng Jinzhou 
Published: April 2023

Abstract
Background
Teriflunomide, the active metabolite of leflunomide, is a disease-modifying therapy drug used for the treatment of multiple sclerosis (MS), yet the complications associated with this drug remain not fully understood. Here we present the rare case of a 28-year-old female MS patient who developed subacute cutaneous lupus erythematosus (SCLE) following teriflunomide treatment. Though SCLE has been reported to be associated with leflunomide, the current report represents the first documented evidence demonstrating SCLE as a potential teriflunomide treatment-related complication. Additionally, a literature review on the leflunomide-induced SCLE was conducted to emphasize the association of SCLE with teriflunomide, specifically amongst the female demographic with a preexisting autoimmune diathesis.

Case presentation
A 28-year-old female first presented with MS symptoms in the left upper limb along with blurred vision in the left eye. Medical and family histories were unremarkable. The patient exhibited positive serum biomarkers including ANA, Ro/SSA, La/SSB, and Ro-52 antibodies. Relapsing–remitting MS was diagnosed according to the 2017 McDonald’s diagnostic criteria, and remission was achieved upon intravenous administration of methylprednisolone followed by teriflunomide sequential therapy. Three months post-teriflunomide treatment, the patient developed multiple facial cutaneous lesions. SCLE was subsequently diagnosed and was attributed to treatment-related complication. Interventions include oral administration of hydroxychloroquine and tofacitinib citrate effectively resolved cutaneous lesions. Discontinuation of hydroxychloroquine and tofacitinib citrate treatment led to recurring SCLE symptoms under continuous teriflunomide treatment. Full remission of facial annular plaques was achieved after re-treatment with hydroxychloroquine and tofacitinib citrate. The patient’s clinical condition remained stable in long-term outpatient follow-ups.

Conclusions
As teriflunomide has become a standard disease-modifying therapy for MS, the current case report highlights the importance of monitoring treatment-related complications, specifically in relation to SCLE symptoms.
Interventions to promote healthy lifestyle behaviors in children and adolescents in summer day camps: a scoping review
Authors: Larose David , Chih-Shing Chen Melvin , Panahi Shirin , Yessis Jennifer , Tremblay Angelo , Drapeau Vicky 
Published: April 2023

Abstract
Background
Children and adolescents have suboptimal physical activity and eating habits during summer breaks. Unlike the school setting, there is little evidence on interventions to promote healthy lifestyle behaviors in Summer Day Camps (SDCs).

Methods
The aim of this scoping review was to examine physical activity, healthy eating, and sedentary behavior interventions in the SDCs. A systematic search on four platforms (EBSCOhost, MEDLINE, EMBASE, and Web of Science) was performed in May 2021 and was updated in June 2022. Studies related to promoting healthy behaviors, physical activity, sedentary behaviors and/or healthy eating among campers aged 6 to 16 in Summer Day Camps were retained. The protocol and writing of the scoping review were done according to the guidelines of the “Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for scoping reviews (PRISMA-ScR)”.

Results
Most interventions had a positive effect on the behavioral determinants or the behaviors themselves (i.e., physical activity, sedentary behaviors, or healthy eating). Involving counsellors and parents, setting camp goals, gardening, and education are all relevant strategies in promoting healthy lifestyle behaviors in SDCs.

Conclusions
Since only one intervention directly targeted sedentary behaviors, it should strongly be considered for inclusion in future studies. In addition, more long-term and experimental studies are needed to establish cause-and-effect relationships between healthy behavior interventions in SDCs and behaviors of children and young adolescents.
COVID-19 and the law in Uganda: a case study on development and application of the public health act from 2020 to 2021
Authors: Achan Martha Isabella , Nabukenya Immaculate , Mitanda Sarah , Nakacwa Joanita , Bakiika Herbert , Nabatanzi Maureen , Bukirwa Justine , Nakanwagi Aisha , Nakiire Lydia , Aperce Cedric , Schwid Aaron , Okware Solome , Obuku Ekwaro A. , Lamorde Mohammed , Luswata Brian , Makumbi Issa , Muruta Allan , Mwebesa Henry G. , Aceng Ocero Jane Ruth 
Published: April 2023

Abstract
Background
Despite the discovery of vaccines, the control, and prevention of Coronavirus disease 2019 (COVID-19) relied on non-pharmaceutical interventions (NPIs). This article describes the development and application of the Public Health Act to implement NPIs for COVID-19 pandemic control in Uganda.

Methods
This is a case study of Uganda’s experience with enacting COVID-19 Rules under the Public Health Act Cap. 281. The study assessed how and what Rules were developed, their influence on the outbreak progress, and litigation. The data sources reviewed were applicable laws and policies, Presidential speeches, Cabinet resolutions, statutory instruments, COVID-19 situation reports, and the registry of court cases that contributed to a triangulated analysis.

Results
Uganda applied four COVID-19 broad Rules for the period March 2020 to October 2021. The Minister of Health enacted the Rules, which response teams, enforcement agencies, and the general population followed. The Presidential speeches, their expiry period and progress of the pandemic curve led to amendment of the Rules twenty one (21) times. The Uganda Peoples Defense Forces Act No. 7 of 2005, the Public Finance Management Act No. 3 of 2015, and the National Policy for Disaster Preparedness and Management supplemented the enacted COVID-19 Rules. However, these Rules attracted specific litigation due to perceived infringement on certain human rights provisions.

Conclusions
Countries can enact supportive legislation within the course of an outbreak. The balance of enforcing public health interventions and human rights infringements is an important consideration in future. We recommend public sensitization about legislative provisions and reforms to guide public health responses in future outbreaks or pandemics.
Effectiveness of family support health education intervention to improve health-related quality of life among pulmonary tuberculosis patients in Melaka, Malaysia
Authors: Saidi Syafiq Sidqi , Abdul Manaf Rosliza 
Published: April 2023

Abstract
Background
Pulmonary Tuberculosis (PTB) is an important public health problem in Malaysia. In this country, limited research has been carried out on the impact of the disease on the health-related quality of life (HRQoL). Family support interventions had been shown to be effective in improving the PTB treatment outcomes.

Objectives
This study aims to determine the effectiveness of a newly developed Family Support Health Education (FASTEN) intervention in improving the health-related quality of life (HRQoL) among PTB patients in Melaka, as compared to the current conventional disease management.

Materials and methods
A single-blinded, randomized controlled field trial study design was conducted in Melaka from September 2019 until August 2021, involving newly diagnosed PTB patients. The participants were randomized either into the intervention group (FASTEN intervention) or into the control group (conventional management). They were interviewed by using a validated questionnaire that includes the Short Form 36 Health Survey version 2 (SF-36v2), at three time points: at diagnosis, two months and six months after diagnosis. Data were analyzed using IBM SPSS Statistics for Windows version 24. The Generalized Estimating Equations (GEE) analysis was used to evaluate the effectiveness of the intervention, in terms of the HRQoL score difference between the groups, adjusted for baseline covariates.

Results
The HRQoL among PTB patients was lower than the HRQoL of general Malaysian population. Among the total 88 respondents, the three lowest HRQoL domains scores at baseline were Social Functioning (SF), Role limitation due to Physical condition (RP) and Vitality (VT) with the median (IQR) scores of 27.26 (10.03), 30.21 (11.23) and 34.77 (8.92) respectively. The median (IQR) for Physical Component Score (PCS) was 43.58 (7.44) and for Mental Component Score (MCS) was 40.71 (8.77). There were significant difference in the HRQoL median scores between the intervention group compared to the control group, as the Physical Functioning (PF) (p = 0.018), RP (p < 0.001), General Health (GH) (p < 0.001), VT (p < 0.001), SF (p < 0.001), Role limitation due to Emotional condition (RE) (p < 0.001), General Mental Health (MH) (p < 0.001), and the MCS (p < 0.001).

Conclusion
The FASTEN intervention is effective to improve the overall HRQoL among PTB patients, as the HRQoL scores were significantly higher in the intervention group compared to the control group who received conventional management. Therefore, it is recommended that the TB program should incorporate the involvement of family members in the patient’s management.

Date of registration and number
The protocol was registered with RCT registered body on 05/12/2019 (Australian New Zealand Clinical Trial Registry – Registration Number: ACTRN12619001720101).
Internationalisation of the curriculum in health programs
Authors: Davey Andrew Keith 
Published: April 2023

AbstractInternationalisation is a broad term that has been used to encompass a range of activities including international student recruitment, student mobility and exchange, international teaching and research collaborations, institutional partnerships, and embedding international and/or intercultural perspectives within curricula.There are numerous drivers for institutions to develop an internationalisation strategy including building global reputation and influence, having a positive influence on communities, income generation, and helping their students gain a global perspective or develop intercultural competencies. Health students benefit from internationalisation activities as they will enter a workforce that increasingly engages with global diseases and works within multicultural societies.However, there are risks associated with internationalisation that stem from disjointed institutional decision making, power imbalances, and neo-colonial attitudes. There are also multiple barriers to effectively engaging in internationalisation including individual student circumstances, staff and institutional preparedness, and geopolitical factors.Within this broader context, internationalisation of the curriculum (IoC) is aimed at incorporating international, intercultural, and global dimensions into the curriculum, including consideration of content, teaching methods, learning outcomes, and how these are supported at a program and institutional level. This is a major undertaking requiring alignment of philosophy between teaching academics, senior university leadership, and the relevant professional body. Examples of IoC within health programs, and the significant challenges involved, are critically discussed in this paper, and strategies to overcome these challenges highlighted.Whilst recognising the challenges, this paper concludes that undertaking purposeful IoC is a critical step towards ensuring that the future health workforce is adequately prepared for the 21st Century environment.
An early detection and segmentation of Brain Tumor using Deep Neural Network
Authors: Aggarwal Mukul , Tiwari Amod Kumar , Sarathi M Partha , Bijalwan Anchit 
Published: April 2023

Abstract
Background
Magnetic resonance image (MRI) brain tumor segmentation is crucial and important in the medical field, which can help in diagnosis and prognosis, overall growth predictions, Tumor density measures, and care plans needed for patients. The difficulty in segmenting brain Tumors is primarily because of the wide range of structures, shapes, frequency, position, and visual appeal of Tumors, like intensity, contrast, and visual variation. With recent advancements in Deep Neural Networks (DNN) for image classification tasks, intelligent medical image segmentation is an exciting direction for Brain Tumor research. DNN requires a lot of time & processing capabilities to train because of only some gradient diffusion difficulty and its complication.

Methods
To overcome the gradient issue of DNN, this research work provides an efficient method for brain Tumor segmentation based on the Improved Residual Network (ResNet). Existing ResNet can be improved by maintaining the details of all the available connection links or by improving projection shortcuts. These details are fed to later phases, due to which improved ResNet achieves higher precision and can speed up the learning process.

Results
The proposed improved Resnet address all three main components of existing ResNet: the flow of information through the network layers, the residual building block, and the projection shortcut. This approach minimizes computational costs and speeds up the process.

Conclusion
An experimental analysis of the BRATS 2020 MRI sample data reveals that the proposed methodology achieves competitive performance over the traditional methods like CNN and Fully Convolution Neural Network (FCN) in more than 10% improved accuracy, recall, and f-measure.
Undervalued professionals: placement of nutritionist in the Ecuadorian health system
Authors: Román A. C. , Villar M. A. , Belmont-Guerron P. , Ocampo M. B. 
Published: April 2023

Abstract
Background
Currently, many public health issues are directly related to malnutrition, and are made worse by social inequities. Nutrition professionals must be a key player in improving epidemiological aspects of nutrition-related diseases and must be part of clinical teams to control nutritional concerns.

Objective
To identify and analyze the nutritionists´ employment situation in Ecuador and areas of work covered and determine if type of university has an impact over work situation.

Methodology
A cross-sectional study was conducted, approved by the ethics committee of Universidad San Francisco de Quito. It included 442 nutritionists in Ecuador who graduated in 13 universities (5 private (PR) and 8 public (PU)) between 2008 and 2019. It implied an online survey that questioned their satisfaction with their education and current work situation. All the statistical analyses were performed using R version 4.0.3, two-sided weighted chi-square test was performed to estimate the difference between public and private university graduates, IC 95%, p between 0.01 and 0.05.

Results
38,6% of participants are unemployed, 68,28% private university graduates (PR) are currently employed and 58.87% work as nutritionists, compared to 56,86% from a public university (PU) currently working and 44.69% working in the field. 76% have reported being unemployed at some point in their careers, being difficulty finding jobs the main reason. Regarding the professional field, most professionals have their own business, and the less common area of work was public and community nutrition. One third of the participants had another paid activity. The main salary is 800USD per month and graduated from PR perceived better salaries than from PU.

Conclusion
There is a lack of job opportunities for Ecuadorian nutritionists despite the high demand in every level of the health system. Most have been unemployed at some point in their careers due to difficulties finding jobs. There is a minimum nutrition staff working in community and public health nutrition.
Dancers with non-specific low back pain have less lumbar movement smoothness than healthy dancers
Authors: Lin Chai-Wei , Fang Yi-Ting , Yang Jeng-Feng , Hsue Bih-Jen , Lin Cheng-Feng 
Published: April 2023

Abstract
Background
Ballet is a highly technical and physically demanding dance form involving extensive end-range lumbar movements and emphasizing movement smoothness and gracefulness. A high prevalence of non-specific low back pain (LBP) is found in ballet dancers, which may lead to poor controlled movement and possible pain occurrence and reoccurrence. The power spectral entropy of time-series acceleration is a useful indicator of random uncertainty information, and a lower value indicates a greater smoothness or regularity. The current study thus applied a power spectral entropy method to analyze the movement smoothness in lumbar flexion and extension in healthy dancers and dancers with LBP, respectively.

Method
A total of 40 female ballet dancers (23 in the LBP group and 17 in the control group) were recruited in the study. Repetitive end-range lumbar flexion and extension tasks were performed and the kinematic data were collected using a motion capture system. The power spectral entropy of the time-series acceleration of the lumbar movements was calculated in the anterior–posterior (AP), medial–lateral (ML), vertical (VT), and three-directional (3D) vectors. The entropy data were then used to conduct receiver operating characteristic curve analyses to evaluate the overall distinguishing performance and thus cutoff value, sensitivity, specificity, and area under the curve (AUC) were calculated.

Results
The power spectral entropy was significantly higher in the LBP group than the control group in the 3D vector in both lumbar flexion and lumber extension (flexion: p = 0.005; extension: p < 0.001). In lumbar extension, the AUC in the 3D vector was 0.807. In other words, the entropy provides an 80.7% probability of distinguishing between the two groups (i.e., LBP and control) correctly. The optimal cutoff entropy value was 0.5806 and yielded a sensitivity of 75% and specificity of 73.3%. In lumbar flexion, the AUC in the 3D vector was 0.777, and hence the entropy provided a probability of 77.7% of distinguishing between the two groups correctly. The optimal cutoff value was 0.5649 and yielded a sensitivity of 90% and a specificity of 73.3%.

Conclusions
The LBP group showed significantly lower lumbar movement smoothness than the control group. The lumbar movement smoothness in the 3D vector had a high AUC and thus provided a high differentiating capacity between the two groups. It may therefore be potentially applied in clinical contexts to screen dancers with a high risk of LBP.
A study on the equity of self-rated health of older adults at the family level
Authors: Ren Weicun , Xing Yiqing , Tarimo Clifford Silver , He Ruibo , Liang Zhang 
Published: April 2023

Abstract
Background
The self-rated health of older adults (SHOA) plays an important role in enhancing their medical service utilization and quality of life. However, the determinants and magnitude variations in SHOA at the family level (SHOAFL) remain unknown. The purpose of this study was to assess the status and equitable level of SHOAFL in China, as well as to analyze the influencing factors and the precise nature and scope of their impacts.

Methods
This study analyzed the data from the "Chinese residents' health service needs survey in the New Era", and included a total of 1413 families with older adults. The status and influencing factors of SHOAFL were analyzed using mean comparison and Logistic regression (LR) models. The Concentration Index method was used to explore the equity of the distribution of SHOAFL. The relationship between differences in personal characteristics among family members and differences in SHOA was determined by the method of Coupling Coordination Degree (CCD).

Results
The total score of SHOAFL was 66.36 ± 15.47, and LR results revealed that the factors with a significant impact on SHOAFL were number of people living in family, distance to the nearest medical service institution, travel time to the nearest medical service institution, annual family income, yearly family medical and health expenditures, average age, and residence (all P < 0.05). The Concentration index of SHOAFL ranged from -0.0315 to 0.0560. CCD of the differences between SHOA and medical insurance and smoking status were 0.9534 and 0.7132, respectively.

Conclusion
The SHOAFL was found to be generally but more inclined towards urban families with high incomes and a short time to medical service institution. The observed disparities in SHOA among family members were mostly attributable to differences in health insurance and pre-retirement occupations. The status and equality of SHOAFL may be improved if policymakers prioritize making services more accessible to older rural residents with low incomes. Concurrently, reducing the existing discrepancy in health insurance coverage between older couples may also enhance their health.
Proteomics profiling for the global and acetylated proteins of papillary thyroid cancers
Authors: Wei Wei , Wu Yuezhang , Chen Dong-Dong , Song Yuntao , Xu Guohui , Shi Qi , Dong Xiao-Ping 
Published: April 2023

Abstract
Background
Papillary thyroid carcinoma (PTC) is the most common endocrine malignancy cancer among the malignancies of thyroid. Despite of wide usages of proteomics in PTC, the profile of acetylated proteins in PTC remains unsettled, which is helpful for understanding the carcinogenesis mechanism and identifying useful biomarkers for PTC.

Methods
The surgically removed specimens of cancer tissues (Ca-T) and adjacent normal tissues (Ca-N) from 10 female patients pathological diagnosed as PTC (TNM stage III) were enrolled in the study. After preparing the pooled extracts of the whole proteins and the acetylated proteins from 10 cases, TMT labeling and LC/MS/MS methods were applied to the assays of global proteomics and acetylated proteomics separately. Bioinformatics analysis, including KEGG, gene ontology (GO) and hierarchical clustering were performed. Some differentially expressed proteins (DEPs) and differentially expressed acetylated proteins (DEAPs) were validated by individual Western blots.

Results
Controlled with the normal tissues adjacent to the lesions, 147 out of 1923 identified proteins in tumor tissues were considered as DEPs in global proteomics, including 78 up-regulated and 69 down-regulated ones, while 57 out of 311 identified acetylated proteins in tumor tissues were DEAPs in acetylated proteomics, including 32 up-regulated and 25 down-regulated, respectively. The top 3 up- and down-regulated DEPs were fibronectin 1, KRT1B protein and chitinase-3-like protein 1, as well as keratin, type I cytoskeletal 16, A-gamma globin Osilo variant and Huntingtin interacting protein-1. The top 3 up- and down-regulated DEAPs were ribosomal protein L18a-like protein, alpha-1-acid glycoprotein 2 and eukaryotic peptide chain release factor GTP-binding subunit ERF3A, as well as trefoil factor 3, thyroglobulin and histone H2B. Functional GO annotation and KEGG pathway analysis based on the DEPs and DEAPs showed completely different changing pictures. Contrary to the top 10 up- and -down regulated DEPs, most of which were addressed in PTC and other types of carcinomas, changes of the majority DEAPs were not mentioned in the literatures.

Conclusions
Taken the profiling of the global and acetylated proteomics together will provide more broad view of protein alterations on the carcinogenesis and new direction for selecting biomarker for diagnosis of PTC.