bluuebunny/crossref_metadata_2025_split huggingface dataset:
Prevalence and determinants of fever, ARI and diarrhea among children aged 6–59 months in Bangladesh
Authors: Rahman Azizur , Hossain Md. Moyazzem 
Published: March 2022

Abstract
Background
Although efforts have been made by the international community to improve childhood health, risk factors linked with the healthiness of preschool-age children in low and middle-income countries (LMICs) are very diverse. Therefore, this paper examines the prevalence and determinants of fever, acute respiratory infection and diarrhea of preschool children in Bangladesh.

Methods
A sample of 8,421 children from the latest country representative BDHS-2017–18 survey was analyzed by utilizing both the bivariate and multivariate techniques.

Results
The results revealed that about 4.7, 33.1, and 35.8% of the children aged under 5 years had suffered from diarrhea, fever and ARI respectively during the 2 weeks preceding the date of the survey. Demographic, socio-economic, and community and health characteristics likely to play an important role in suffering under-five children from diarrhea, fever, and ARI in Bangladesh. The child’s age of 13–24 months, delivery by cesarean section, unsafe drinking water, unhygienic toilet facility, low level of family wealth index and parental education, a higher number of living children in the household, rural residency and regional difference were all found to be most crucial determinants of the occurrences of fever, ARI and diarrhea.

Conclusion
Interventions should focus on improving these significant demographic, socioeconomic, and community and health risk factors. A special attention is necessary to the people who live in rural areas and geospatially disadvantaged regions.
Dose error reduction software in medication safety risk management – optimising the smart infusion pump dosing limits in neonatal intensive care unit prior to implementation
Authors: Kuitunen Sini , Kärkkäinen Krista , Linden-Lahti Carita , Schepel Lotta , Holmström Anna-Riia 
Published: March 2022

AbstractBackgroundSmart infusion pumps with dose error reduction software can be used to prevent harmful medication errors. The aim of this study was to develop a method for defining and assessing optimal dosing limits in a neonatal intensive care unit’s smart infusion pump drug library by using simulation-type test cases developed based on medication error reports.MethodsThis mixed-methods study applied both qualitative and quantitative methods. First, wrong infusion rate-related medication errors reported in the neonatal intensive care unit during 2018–2019 were explored by quantitative descriptive analysis and qualitative content analysis to identify the error mechanisms. The researchers developed simulation-type test cases with potential errors, and a literature-based calculation formula was used to set upper soft limits to the drug library. The limits were evaluated by conducting programming of pumps without errors and with potential errors for two imaginary test patients (1 kg and 3.5 kg).ResultsOf all medication errors reported in the neonatal intensive care unit, 3.5% (n = 21/601) involved an error or near-miss related to wrong infusion rate. Based on the identified error mechanisms, 2-, 5-, and 10-fold infusion rates, as well as mix-ups between infusion rates of different drugs, were established as test cases. When conducting the pump programming for the test cases (n = 226), no alerts were triggered with infusion rates responding to the usual dosages (n = 32). 73% (n = 70/96) of the erroneous 2-, 5-, and 10-fold infusion rates caused an alert. Mix-ups between infusion rates triggered an alert only in 24% (n = 24/98) of the test cases.ConclusionsSimulation-type test cases can be applied to assess the appropriateness of dosing limits within the neonatal intensive care unit’s drug library. In developing the test cases, combining hospital’s medication error data to other prospective data collection methods is recommended to gain a comprehensive understanding on mechanisms of wrong infusion rate errors. After drug library implementation, the alert log data and drug library compliance should be studied to verify suitability of dosing limits.
Immune alveolitis in interstitial lung disease: an attractive cytological profile in immunocompromised patients
Authors: Moui Antoine , Dirou Stéphanie , Sagan Christine , Liberge Renan , Defrance Claire , Arrigoni Pierre-Paul , Morla Olivier , Kandel-Aznar Christine , Cellerin Laurent , Cavailles Arnaud , Eschapasse Emmanuel , Morio Florent , Gourraud Pierre-Antoine , Goronflot Thomas , Tissot Adrien , Blanc François-Xavier 
Published: March 2022

AbstractBackgroundBronchoalveolar lavage (BAL) is a major diagnostic tool in interstitial lung disease (ILD). Its use remains largely quantitative, usually focused on cell differential ratio. However, cellular morphological features provide additional valuable information. The significance of the “immune alveolitis” cytological profile, characterized by lymphocytic alveolitis with activated lymphocytes and macrophages in epithelioid transformation or foamy macrophages desquamating in cohesive clusters with lymphocytes, remains unknown in ILD. Our objective was to describe patients’ characteristics and diagnoses associated with an immune alveolitis profile in undiagnosed ILD.MethodsWe performed a monocentric retrospective observational study. Eligible patients were adults undergoing diagnostic exploration for ILD and whose BAL fluid displayed an immune alveolitis profile. For each patient, we collected clinical, radiological and biological findings as well as the final etiology of ILD.ResultsBetween January 2012 and December 2018, 249 patients were included. Mean age was 57 ± 16 years, 140 patients (56%) were men, and 65% of patients were immunocompromised. The main etiological diagnosis wasPneumocystispneumonia (PCP) (24%), followed by drug-induced lung disease (DILD) (20%), viral pneumonia (14%) and hypersensitivity pneumonitis (HP) (10%). All PCP were diagnosed in immunocompromised patients while HP was found in only 8% of this subgroup. DILD and viral pneumonia were also commonly diagnosed in immunocompromised patients (94% and 80%, respectively).ConclusionOur study highlights the additional value of BAL qualitative description in ILD. We suggest incorporating the immune alveolitis profile for the diagnosis and management of ILD, especially in immunocompromised patients, since it guides towards specific diagnoses.
Hospitalization for computer-assisted hexapod ring fixation application – analyses of patient variability, peri-operative complications, hospital costs, and discharge status
Authors: Reid J. Spence , Vanderkarr Mollie , Ray Bidusee , Chitnis Abhishek , Holy Chantal E. , Sparks Charisse 
Published: March 2022

Abstract
Background
Computer-assisted hexapod ring fixation systems (HRF) are used for multiple conditions and in very diverse patient populations. This study analyzes perioperative outcomes following HRF application based on patient etiology and clinical presentation.

Methods
Data from patients in the Premier Hospital Billing Database between 2007–2019 undergoing HRF application were analyzed for the duration of patients’ hospitalizations. Patients were grouped based on etiology: acquired deformity, arthrosis, congenital deformity, deep infection, infected nonunion, fracture, nonunion, and other post-operative complications. Demographics, comorbidities, operating room time (ORT), length of stay (LOS), peri-operative complications, and hospital costs were estimated using generalized linear models. Logistic regression evaluated factors associated with peri-operative complications.

Results
One thousand eight hundred eighteen patients (average age: 46.9, standard deviation (SD) (19.6) – 38.9% female) were included in the study, and included 72% fracture cases, 9.6% deep infection, 10.2% deformity (acquired: 5.9%, congenital: 4.3%), 4.2% nonunions, 2% arthrosis and 1.4% other sequelas from prior fractures. Comorbidities varied across diagnosis categories and age, 40% adults and 86% pediatric had no comorbidities. Pediatric cases mostly suffered from obesity (16.1%) and pulmonary disease (10.7%). Complicated diabetes was present in 45.9% of arthropathy and 34.3% of deep infection patients. ORT, LOS and inflation-adjusted hospital costs for all patients averaged 277.7 min (95% Confidence interval (CI): 265.1–290.3), 7.07 days (95% CI: 6.6–7.5) and $41,507 (95%CI: $39,728-$43,285), respectively, but were highest in patients with deep infection (ORT: 369 min (95%CI: $321.0-$433.8); LOS: 14.4 days (95%CI: $13.7-$15.1); Cost: $54,666 (95%CI: $47,960-$63,553)). The probability of having an intraoperative complication averaged 35% (95%CI: 28%-43%) in adult patients with deep infection vs 7% (95%CI: 2%-20%) in pediatric cases treated for congenital deformity. The risk for intraoperative complications was mostly associated with preexisting comorbidities, an Elixhauser > 5 was the most predictive risk factor for complications (odds ratios: 4.53 (95%CI: 1.71–12.00, p = 0.002).

Conclusions
There is important heterogeneity among HRF patients. Adults with HRF for fracture, deep infection and arthrosis are at far greater risk for peri-operative complications vs. patients with deformity, especially pediatric deformity cases, mostly due to existing comorbidities and age. Device-specific HRF clinical studies cannot be generalized beyond their exact patient population.
Granular cell odontogenic tumor: report of a rare case and a review of literature
Authors: Etemadi Sh Milad , Razavi Sayed Mohammad , Ghazavi Olia , Nikbakht Mohammad Hossein 
Published: March 2022

Abstract
Background
Granular cell odontogenic tumor (GCOT) is a rare neoplasm with about 45 cases reported in the literature. It usually occurs in the posterior mandible of middle-aged women.

Case presentation
We report a case of asymptomatic GCOT in the posterior mandible of a 28 years old female and provide a literature review of GCOT cases. Some unusual features such as root resorption, displacement of inferior tooth canal, and multilocular appearance were considerable in this case.

Conclusions
Complete surgical excision of the lesion was beneficial for the patient.
Sexual Assault of Women in the region of Kairouan, Tunisia: an 8-year retrospective study on epidemiological and medicolegal characteristics
Authors: Brahim Oumeima , Turki Elyes , Chebbi Elaa , Fersi Oumayma , Fatnassi Ridha 
Published: March 2022

AbstractBackgroundDespite the abundance of studies reporting the prevalence of women's sexual abuse all over the world, there is a real lack of such reports in developing countries in general and Arab-Muslim societies in particular. However, due to the little number of published studies in Tunisia, and the absence of a national database, data on female sexual assaults are still underestimated, which is a gap that needs to be filled in order to make specific preventive actions. We aim to identify the pattern of female victims of sexual abuse in the governorate of Kairouan (Tunisia) in order to provide recommendations for prevention.MethodsRetrospective data were collected on all-female sexual assault victims, particularly rape, presented to the Department of Forensic Medicine of the University Hospital Ibn El Jazzar of Kairouan (Tunisia), during an 8-year period, from 2009 to 2016.ResultsTwo hundred and sixteen victims were included. Age ranged from 3 to 82 years with a mean age of 20.4 years. Victims were single in 84.3%, unmarried in 90.7% and they lived in rural areas in the majority of cases. Rape was committed by a single individual in 94.9% of cases, and the assailant was a stranger in only 26.8%. The assault occurred most frequently in the assailant's home (73.6%) or the public places (11.6%). Evidence of recent acute general body trauma was found in 41.2% of the victims, and the most common injuries were located on the thigh, upper arm, and chest. In 28.1% of the cases, injuries were seen in the face and the neck. Genital examination showed that 188 victims (87%) had a tear in the hymenal membrane and only 13% of victims had intact hymenal membrane. A complacent hymen was noted in 2.3%. A recent anal lesion was seen in 8.3% of the cases. Cytology was performed on 78 victims. In 22 cases (28.2%), sperm could be detected in vaginal swabs up to 3 days post-assault, and pregnancy was seen in 7.4% of assault victims.ConclusionSexual abuse represents a human rights and public health problem that is thriving in a culture of silence, particularly in the Arab region. There is a particular need to create a Tunisian national database on female sexual assaults, in order to centralize data and provide holistic follow-up for specific preventive measures. Finally, efficient management of such cases will need, in addition to legislation, a partnership between the various actors involved in taking care of the victims (health care professionals, the police, social specialists, and psychologists). In addition, civil societies are key partners to break the silence, support this issue, and raise awareness.
Medical student’s perception of the COVID-19 pandemic effect on their education and well-being: a cross-sectional survey in the United States
Authors: Chakladar Jaideep , Diomino Anthony , Li Wei Tse , Tsai Joseph C. , Krishnan Aswini R. , Zou Angela E. , Kharidia Khush , Baig Farhan A. , Householder Sarah , Kuo Selena Z. , Chandrasekar Shyam , Chang Eric Y. , Ongkeko Weg M. 
Published: March 2022

Abstract
Background
The effects of drastic curricular changes necessitated by the COVID-19 pandemic on medical students’ education and wellbeing have remained largely unstudied. Out study aimed to characterize how medical students were affected by the pandemic, specifically how limitations introduced by the pandemic may have affected the quality, delivery, and experience of medical education.

Methods
Three hundred students from 5 U.S. allopathic medical schools were surveyed to determine students’ perceptions about their quality of medical education, professional development, and mental health during the COVID-19 pandemic (October 2020-December 2020).

Results
A large majority of students report that while lecture-based learning has not been significantly affected by the pandemic, small-group and clinical learning have greatly declined in quality. Students also reported higher levels of depression, anxiety, and uncertainty with regards to their futures as physicians.

Conclusions
The COVID-19 pandemic has greatly affected the medical student education and wellbeing. Although medical schools have implemented measures to continue to train medical students as effectively as they can, further strategies must be devised to ensure the well-being of students in the present and for future national emergencies.
Factors influencing the mutual-support willingness and needs among the rural elderly in Hunan Province, China: a cross-sectional study
Authors: Yao Ke-ru , Yin Xin-hong , Luo Qin , Tang Xi , Tan Xiu-zhu 
Published: March 2022

Abstract
Background
This study aimed to assess the influence factors of the mutual-support willingness and identify the mutual-support needs of elderly living in rural areas of Hunan Province, China.

Methods
Using the Chi-square test and logistic regression to analyze factors influencing Participants’ mutual-support willingness and needs.

Results
Factors influencing the mutual-support willingness and needs included individual characteristics, family environment, and so on. And the rural elderly’s demand for mutual-support is at a relatively high level. The total score for social support for the aged was 36.944 ± 6.487, at a moderate level.

Conclusions
It is necessary to objectively evaluate the factors related to mutual-support willingness and needs and take steps to enhance social support and meet elderly the needs of mutual-support, which is of great significance for improving the happiness of the elderly in their later years and alleviating the crisis of population aging in China.
WHO-led consensus statement on vaccine delivery costing: process, methods, and findings
Authors: Levin Ann , Boonstoppel Laura , Brenzel Logan , Griffiths Ulla , Hutubessy Raymond , Jit Mark , Mogasale Vittal , Pallas Sarah , Resch Stephen , Suharlim Christian , Yeung Karene Hoi Ting 
Published: March 2022

Abstract
Background
Differences in definitions and methodological approaches have hindered comparison and synthesis of economic evaluation results across multiple health domains, including immunization. At the request of the World Health Organization’s (WHO) Immunization and Vaccines-related Implementation Research Advisory Committee (IVIR-AC), WHO convened an ad hoc Vaccine Delivery Costing Working Group, comprising experts from eight organizations working in immunization costing, to address a lack of standardization and gaps in definitions and methodological guidance. The aim of the Working Group was to develop a consensus statement harmonizing terminology and principles and to formulate recommendations for vaccine delivery costing for decision making. This paper discusses the process, findings of the review, and recommendations in the Consensus Statement.

Methods
The Working Group conducted several interviews, teleconferences, and one in-person meeting to identify groups working in vaccine delivery costing as well as existing guidance documents and costing tools, focusing on those for low- and middle-income country settings. They then reviewed the costing aims, perspectives, terms, methods, and principles in these documents. Consensus statement principles were drafted to align with the Global Health Cost Consortium costing guide as an agreed normative reference, and consensus definitions were drafted to reflect the predominant view across the documents reviewed.

Results
The Working Group identified four major workstreams on vaccine delivery costing as well as nine guidance documents and eleven costing tools for immunization costing. They found that some terms and principles were commonly defined while others were specific to individual workstreams. Based on these findings and extensive consultation, recommendations to harmonize differences in terminology and principles were made.

Conclusions
Use of standardized principles and definitions outlined in the Consensus Statement within the immunization delivery costing community of practice can facilitate interpretation of economic evidence by global, regional, and national decision makers. Improving methodological alignment and clarity in program costing of health services such as immunization is important to support evidence-based policies and optimal resource allocation. On the other hand, this review and Consensus Statement development process revealed the limitations of our ability to harmonize given that study designs will vary depending upon the policy question that is being addressed and the country context.
Determinants of blood eosinophil levels in the general population and patients with COPD: a population-based, epidemiological study
Authors: Miravitlles Marc , Soler-Cataluña Juan José , Soriano Joan B. , García-Río Francisco , de Lucas Pilar , Alfageme Inmaculada , Casanova Ciro , Rodríguez González-Moro José Miguel , Sánchez-Herrero M. Guadalupe , Ancochea Julio , Cosío Borja G. 
Published: March 2022

Abstract
Background
Blood eosinophils are considered a biomarker for the treatment of chronic obstructive pulmonary disease (COPD). Population-based studies are needed to better understand the determinants of the blood eosinophil count (BEC) in individuals with and without COPD.

Methods
EPISCAN II is a multicentre, cross-sectional, population-based epidemiological study aimed at investigating the prevalence and determinants of COPD in Spain. Study subjects were randomly selected from the general population, and COPD was defined by a post-bronchodilator FEV1/FVC < 0.7. For the pre-specified outcomes related to BEC, the first 35 COPD and 35 non-COPD subjects were consecutively recruited in 12 of the participating centres with the objective of analysing 400 individuals in each group. Baseline BEC and its association with demographic, clinical and functional variables were analysed.

Results
A total of 326 COPD and 399 non-COPD subjects were included in the analysis. The mean age (standard deviation [SD]) was 63.2 years (11.0), 46.3% were male, and 27.6% were active smokers. BEC was significantly higher in individuals with COPD [192 cells/μL (SD: 125) vs. 160 cells/μL (SD: 114); p = 0.0003]. In a stepwise multivariate model, being male, active smoker and having a previous diagnosis of asthma were independently associated with having a higher BEC.

Conclusions
This population-based study estimated the distribution of eosinophils in the healthy adult population and concluded that COPD patients have a significantly higher BEC. Male sex, active smoking and concomitant asthma were significantly associated with a higher BEC.
MUC1 is a potential target to overcome trastuzumab resistance in breast cancer therapy
Authors: Hosseinzadeh Aysooda , Merikhian Parnaz , Naseri Nazanin , Eisavand Mohammad Reza , Farahmand Leila 
Published: March 2022

AbstractAlthough resistance is its major obstacle in cancer therapy, trastuzumab is the most successful agent in treating epidermal growth factor receptor 2 positive (HER2 +) breast cancer (BC). Some patients show resistance to trastuzumab, and scientists want to circumvent this problem. This review elaborately discusses possible resistance mechanisms to trastuzumab and introduces mucin 1 (MUC1) as a potential target efficient for overcoming such resistance. MUC1 belongs to the mucin family, playing the oncogenic/mitogenic roles in cancer cells and interacting with several other oncogenic receptors and pathways, such as HER2, β-catenin, NF-κB, and estrogen receptor (ERα). Besides, it has been established that MUC1- Cytoplasmic Domain (MUC1-CD) accelerates the development of resistance to trastuzumab and that silencing MUC1-C proto-oncogene is associated with increased sensitivity of HER2+ cells to trastuzumab-induced growth inhibitors. We mention why targeting MUC1 can be useful in overcoming trastuzumab resistance in cancer therapy.