bluuebunny/crossref_metadata_2025_split huggingface dataset:
Drug shortages in low- and middle-income countries: Colombia as a case study
Authors: Sabogal De La Pava Martha L. , Tucker Emily L. 
Published: June 2022

Abstract
Background
Drug shortages are a global problem. Analyzing shortages worldwide is important to identify possible relationships between drug shortages across countries, determine strategies that reduce drug shortages, and reduce the inequality in access to medicines between countries. In contrast to well-documented shortages in high-income countries, there are few studies that consider low- and middle-income economies. We evaluate drug shortages in one middle-income country, Colombia.

Methods
We collected data from INVIMA, the institution responsible for managing medicine shortage alerts in Colombia. We classified the data using the Anatomical Therapeutic Chemical (ATC) classification system and analyzed them using descriptive statistics. We considered a study period from 2015 to 2021 (vital medicines) and from 2010 to 2020 (non-vital medicines).

Results
In total, 173 unique ATC codes were in shortage. These included antidotes, alimentary tract and metabolism products, anesthetics, cardiac stimulants and antithrombotic agents. The major causes were manufacturing problems and few suppliers. Drug shortages substantially increased from 2020 to May 2021 due to the COVID-19 pandemic. Among resolved shortages, the average duration was 1.6 years with a standard deviation of 1.9 years. The longest, naloxone tablets, were in shortage for almost 10 years.

Conclusions
Drug shortages are a persistent problem in Colombia. Government institutions have made progress in implementing systems and procedures to report them. However, the approaches implemented need to be maintained and refined. This study lays the groundwork for the analysis of drug shortages in other LMICs. We highlight the necessity of addressing drug shortages in their global context and reducing the inequality in access to medicines between countries.
A prospective longitudinal study evaluating the influence of immunosuppressives and other factors on COVID-19 in autoimmune rheumatic diseases
Authors: Patil Abhishek , Chanakya K. , Shenoy Padmanabha , Chandrashekara S. , Haridas Vikram , Kumar Sharath , Daware Manisha , Janardana Ramya , Pinto Benzeeta , Subramanian Ramaswamy , Nagaraj S. , Singh Yogesh Preet , Singhai Shweta , Jois Ramesh , Jain Vikramraj , Srinivasa C. , Dharmanand B. G. , Dharmapalaiah Chethana , Sangeetha K. N. , Rao Vijay K. , Shobha Vineeta 
Published: June 2022

Abstract
Background
We conducted this study to identify the influence of prolonged use of hydroxychloroquine (HCQ), glucocorticoids and other immunosuppressants (IS) on occurrence and outcome of COVID-19 in patients with autoimmune rheumatic diseases (AIRDs).

Methods
This was a prospective, multicenter, non-interventional longitudinal study across 15 specialist rheumatology centers. Consecutive AIRD patients on treatment with immunosuppressants were recruited and followed up longitudinally to assess parameters contributing to development of COVID-19 and its outcome.

Results
COVID-19 occurred in 314 (3.45%) of 9212 AIRD patients during a median follow up of 177 (IQR 129, 219) days. Long term HCQ use had no major impact on the occurrence or the outcome of COVID-19. Glucocorticoids in moderate dose (7.5–20 mg/day) conferred higher risk (RR = 1.72) of infection. Among the IS, Mycophenolate mofetil (MMF), Cyclophosphamide (CYC) and Rituximab (RTX) use was higher in patients with COVID 19. However, the conventional risk factors such as male sex (RR = 1.51), coexistent diabetes mellitus (RR = 1.64), pre-existing lung disease (RR = 2.01) and smoking (RR = 3.32) were the major contributing risk factors for COVID-19. Thirteen patients (4.14%) died, the strongest risk factor being pre-existing lung disease (RR = 6.36, p = 0.01). Incidence (17.5 vs 5.3 per 1 lakh (Karnataka) and 25.3 vs 7.9 per 1 lakh (Kerala)) and case fatality (4.1% vs 1.3% (Karnataka) and 4.3% vs 0.4% (Kerala)) rate of COVID-19 was significantly higher (p < 0.001) compared to the general population of the corresponding geographic region.

Conclusions
Immunosuppressants have a differential impact on the risk of COVID-19 occurrence in AIRD patients. Older age, males, smokers, hypertensive, diabetic and underlying lung disease contributed to higher risk. The incidence rate and the case fatality rate in AIRD patients is much higher than that in the general population.
Recovery of cobalt and copper from single- and co-contaminated simulated electroplating wastewater via carbonate and hydroxide precipitation
Authors: Quiton Khyle Glainmer N. , Huang Yao-Hui , Lu Ming-Chun 
Published: June 2022

AbstractWastewater containing cobalt and copper comprised of plating wash water, plant wash water, and equipment cooling and wash water is generated in the electroplating industry. These metals can be detrimental to humans, animals, plants, and the environment. Thus, it is necessary to treat electroplating wastewater to remove these toxic metals. Carbonate and hydroxide precipitation were utilized for the removal of Co (II) and Cu (II) from synthetic electroplating wastewater by jar tests in this work. The effects of solution pH, precipitant-to-metal ratio, and type of precipitant on the precipitation efficiency of cobalt and copper from the single- and co-contaminated systems were investigated. Carbonate precipitation achieved higher removal efficiency for both target metals in the single- and co-contaminated wastewater streams. Furthermore, it can operate at relatively low pH range of about 7–8. Cobalt in both pollutant systems was almost completely removed at pH 10 using both precipitant systems. Copper was found to be easily removed which was possibly brought about by precipitation-adsorption mechanism. The extent of the co-removal of cobalt with copper is significantly pH dependent. The effect of precipitant-to-metal ratio for cobalt and copper treatment varied in single- and co-contaminated streams. Carbonate precipitation led to higher sludge volume than that of hydroxide precipitation.
Failure rates and clinical outcomes of synthetic meniscal implants following partial meniscectomy: a systematic review
Authors: Kohli Suraj , Schwenck Jonas , Barlow Ian 
Published: June 2022

Abstract
Background
Meniscal injury is one of the most common indications for knee surgery. The advent of meniscal repair techniques has facilitated meniscal preservation in suitable cases. Meniscal substitution with scaffolds may be advantageous following partial meniscal resection. There are three main scaffolds in current clinical use; Collagen Meniscal Implant (CMI Stryker Corporation, Kalamazoo, MI, USA), Actifit (Actifit, Orteq Ltd, London, UK) and NUsurface (Active Implants, LLC). The purpose of this systematic review was to compare clinical outcomes and failure rates of patients who have had implantation with these meniscal scaffolds.

Methods
MEDLINE and EMBASE databases were searched for studies that included patients who had surgical implantation with Actifit or CMI. Eligibility criteria included papers that described both clinical outcomes and failure rates of these implants, a mean follow up of 5 years and studies published in English. A Google search was also performed to identify any grey literature.

Results
Five Level IV studies were found for Actifit. One Level II, one Level III and four Level IV studies were found for the CMI implant. One Level II study was identified for the NUsurface scaffold with a follow-up 12 months and was included for completeness. Overall, 262 patients were treated with Actifit, 109 with CMI and 65 with NUsurface. Failure rates for Actifit were 18% (range 6.3–31.8%) with a mean follow up of 66.8 months, and for CMI 6.5% (range 0–11.8%) with a mean follow up of 97.1 months. The NUsurface failure rate was 16.9% at 12 months. Clinical outcomes such as VAS, Tegner and Lysholm scores improved significantly post-operatively. However, there was a high volume of concurrent procedures, such as anterior cruciate ligament reconstructions and high tibial osteotomies in each study group; 118 (45%) for Actifit and 53 (45%) for CMI.

Conclusion
The evidence for meniscal scaffold use is insufficient to suggest that they could potentially improve clinical outcomes in patients post-meniscal resection. This is largely due to the high proportion of concurrent procedures performed at index procedure for both CMI and Actifit. On the basis of current evidence, the use of meniscal scaffolds as a sole treatment for partial meniscal defects cannot be recommended, owing to the relatively high failure rate and paucity of clinical data.
Improving BDS broadcast ephemeris accuracy using ground-satellite-link observations
Authors: Chen Junping , Wang Jungang , Yu Chao , Zhang Yize , Wang Bin 
Published: June 2022

AbstractThe BeiDou Navigation Satellite System (BDS) employs a hybrid constellation including GEO (Geosynchronous Earth Orbit), IGSO (Inclined Geosynchronous Orbit), and MEO (Medium Earth Orbit) satellites, where the GEO and IGSO satellites are critical to providing continuous and reliable Positioning, Navigation, and Timing (PNT) services in the Asia–Pacific region. To handle the inconsistency between the satellite orbits and clocks in the broadcast ephemeris, which are determined by the Orbit Determination and Time Synchronization (ODTS) and the Two-way Satellite Time Frequency Transfer (TWSTFT) technique, respectively, we present the strategies using ground-satellite-link observations to improve the accuracy of broadcast ephemeris. The clock differences between the ODTS and TWSTFT techniques are used for correcting the radial orbit component to derive the refined orbits, which are used to generate the refined broadcast ephemeris. The test results show the precision of the refined orbits is improved by 50–60% in the 3-h to 12-h predicted arcs for the GEO satellites, and by 40–50% for the IGSO satellites. Moreover, the validation using satellite laser ranging observations shows the mean precision of the refined broadcast ephemeris is improved by 27% compared to the original one. Applying the proposed strategies in the BDS Operational Control Segment (OCS), the time evolution of BDS Single Point Positioning (SPP) in the period from Jan. 2016 to April 2021 is evaluated. The SPP accuracy is improved from 1.94, 2.06 and 3.29 m to 1.39, 1.85, and 2.39 m in the north, east, and up components, respectively. Further update with the inclusion of BDS-3 satellites improve the corresponding SPP precision to 0.68, 0.70 and 1.91 m.
Central line-associated bloodstream infection (CLABSI) with three different vascular access in neonatal intensive care unit
Authors: Rabie Dina , Mostafa Mohammed F. , Abdel Halim Rania M. , Ezzat Ola Ahmad 
Published: June 2022

Abstract
Background
Central venous catheters (CVCs) are a mandatory aspect in the neonatal intensive care units. Unfortunately, bloodstream infection is a frequent complication of CVCs. A needleless connector is attached to the end of CVC to allow infusion of fluids. We aimed to assess the effect of needleless connectors on central line-associated blood stream infection, and to assess rate of occurrence of bloodstream infection with the use of three different types of venous access in neonates.

Methods
This study is a prospective, randomized, comparative study which was held at the Neonatal Intensive Care, Faculty of Medicine, Ain Shams University. The study recruited 120 neonates who were categorized into three groups according to the type of inserted CVC: group A with umbilical venous catheter, group B with peripherally inserted central catheter, and group C with non-tunneled central venous catheter, and each group was further subdivided into two groups according to the use of needleless connector. Criteria of central line-associated bloodstream infection (CLABSI) and central line-related bloodstream infection (CLRBSI) were applied.

Results
The study included 120 neonates, a multivariable logistic regression analysis was held for two predictors (type of CVC and use of needleless connector) of CLABSI/CLRBSI, it revealed that the use of needleless connector was associated with significant lower incidence of CLABSI/CLRBSI (P value < 0.05, adjusted odds ratio [aOR] = 0.303), the use of peripheral inserted central catheter (PICC) was also associated with the lowest incidence of CLABSI/CLRBSI (P value = 0.015, aOR = 0.284). Another multivariable logistic regression analysis was done for four predictors (type of CVC, use of needleless connector, gestational age, and catheter dwell time) which revealed that the gestational age (P value = 0.001, aOR = 0.691) and catheter dwell time (P value = 0.004, aOR = 1.313) were the only independent predictors for the occurrence of CLABSI/CLRBSI.

Conclusion
The use of needleless connector can lower the incidence of CLABSI/CLRBSI, PICC line was associated with the lowest incidence of CLABSI/CLRBSI among the three types of CVCs. Low gestational age and long catheter dwell time were found to be the main risk factors for increasing the incidence of CLABSI/CLRBSI.
Outcome of language therapy in bimodal-fit children versus unilateral cochlear implant children in bilateral sensorineural hearing impairment: a case-control study
Authors: Hassan Megahed M. , Emam Ahmed Mamdouh , Sayed Amal Fouad , El-Adawy Ahlam Abdel-Salam Nabieh 
Published: June 2022

Abstract
Background
Treating hearing-impaired children aims not only to improve their hearing but also to enhance language acquisition capability. In our community, the CI usually performed on one side because of financial issues at least for a period of time. Consequently, the brain may neglect the unfitted ear. Contralateral hearing aid is an alternative solution when bilateral CI is unavailable. Our purpose is to evaluate the language outcome in bimodal-fit children who using cochlear implant (CI) and contralateral hearing aid (HA) compared to children using unilateral cochlear implant only.

Results
In this case-control study, 15 children who are using binaural-bimodal stimulation by unilateral CI and contralateral HA and 15 children using monaural cochlear implant received auditory training and language therapy. All participants have been assigned randomly from the Phoniatrics and Audiology clinics. Filtering of patients was made to get the two groups matched regarding age, sex, family motivation, age of implantation, and age of hearing impairment. Evaluation and language therapy were performed in the Phoniatrics clinic. Language progress in each group was compared over different time-points. Also, it was compared between the two groups in each time-point. Both groups revealed significant language improvement over time with intensive auditory training and language therapy. In addition, the bimodal-fit children showed better language and speech outcomes than the unilateral CI children in receptive semantics, expressive semantics, word class, mean length of utterance, and speech intelligibility. The differences were significant with P-values 0.047, 0.034, 0.03, 0.016, and 0.028, respectively, after 9 months of rehabilitation.

Conclusion
Bimodal-fit children showed better improvement in language than the unilateral CI group. The contralateral hearing aid may be complementary to the unilateral cochlear implant by covering wider speech frequency range. Also, it prevents auditory deprivation and enables binaural hearing with positive impact on language outcome.
Awareness of Colorectal Cancer Risk Factors in Palestine: Where Do We Stand?
Authors: Elshami Mohamedraed , Dwikat Mohammad F. , Al-Slaibi Ibrahim , Alser Mohammed , Mohamad Balqees M. , Isleem Wejdan S. , Shurrab Adela , Yaghi Bashar , Qabaja Yahya Ayyash , Naji Shoruq A. , Hmdan Fatima K. , Ayyad Mohammed M. , Sweity Raneen R. , Jneed Remah T. , Assaf Khayria A. , Albandak Maram E. , Hmaid Mohammed M. , Awwad Iyas I. , Alhabil Belal K. , Alarda Marah N. , Alsattari Amani S. , Aboyousef Moumen S. , Aljbour Omar A. , AlSharif Rinad , Giacaman Christy T. , Alnaga Ali Y. , Abu Nemer Ranin M. , Almadhoun Nada M. , Skaik Sondos M. , Bottcher Bettina , Abu-El-Noor Nasser 
Published: June 2022

PURPOSE To assess the public awareness level of colorectal cancer (CRC) risk factors in Palestine and identify factors associated with the good awareness level. MATERIALS AND METHODS Adult Palestinians were recruited using convenience sampling from hospitals, primary health care centers, and public locations in 11 governorates. The recognition of 11 CRC risk factors was evaluated using a translated-into-Arabic version of the validated bowel cancer awareness measure. Participants were given one point for each correctly recognized risk factor. The awareness level was determined by the number of CRC risk factors recognized: poor (0-3), fair (4-7), and good awareness (8-11). RESULTS A total of 4,877 participants, of 5,254 approached, completed the questionnaire (response rate = 92.3%). The final analysis included 4,623 questionnaires, 2,700 from the West Bank and Jerusalem (WBJ) and 1,923 from the Gaza Strip. Participants from the WBJ were older, gained higher monthly income, and had more chronic diseases than participants from the Gaza Strip. The most recognized modifiable CRC risk factor was not doing 30 minutes of moderate physical activity five times a week (n = 3,846, 83.2%), whereas the least recognized was having a diet low in fiber (n = 1,985, 42.9%). The most recognized nonmodifiable CRC risk factor was having a bowel disease (n = 3,320, 71.8%), whereas the least recognized was having diabetes (n = 1,581, 34.2%). Only 1,840 participants (39.8%) demonstrated good awareness of CRC risk factors. Participants from the Gaza Strip were more likely than participants from the WBJ to have good awareness (46.5.0% v 35.0%). Female sex, knowing someone with cancer, and completing postsecondary education were all associated with good awareness. CONCLUSION Awareness of CRC risk factors was found to be low in Palestine. There is a substantial need to raise awareness of CRC risk factors through educational campaigns and programs.
Disparities in Treatment Satisfaction and Supportive Care Receipt for Young Adult Oncology Patients on the Basis of Residential Location
Authors: Hess Eric , Anandan Apoorva , Osman Fauzia , Lee-Miller Cathy , Parkes Amanda 
Published: June 2022

PURPOSE: Adolescent and young adult oncology programs are critical but exist primarily in academic centers, prompting potential disparities in care on the basis of patient residence. We studied the impact of residential location on supportive care receipt and treatment satisfaction in young adults (YAs) with cancer age 19-39 years treated at the University of Wisconsin Carbone Cancer Center (UWCCC). METHODS: YA patients with cancer age 19-39 years seen at UWCCC from March 30, 2019, to March 29, 2020, were sent a survey assessing supportive care receipt and satisfaction. Survey results were compared with retrospective chart review of YAs seen at UWCCC between April 1, 2011, and April 1, 2021. Data were categorized on the basis of residential location using distance from UWCCC and 2013 Rural-Urban Continuum Code (RUCC). RESULTS: Survey results were obtained for 145 YAs, including 29 from nonmetro RUCC (20.0%) and 81 living > 20 miles from UWCCC (55.9%). YAs from nonmetro locations had lower satisfaction with available treatments (79.3% v 91.4%, P = .005), and distant YAs living > 20 miles from UWCCC more frequently identified location as a barrier to supportive care receipt (35.6% v 15.8%, P = .02). Metro YAs more frequently listed fertility consultations as unavailable (38.0% v 16.0%, P = .04) in the survey despite chart review data showing higher rates of sexual health assessments (48.2% v 20.4%, P = .002) and fertility visits (29.6% v 18.5%, P = .18). CONCLUSION: We identified differences in both supportive care receipt and treatment satisfaction on the basis of residential location. These findings support the need for measures to successfully meet treatment and supportive care needs regardless of residential location.
The Modulatory Role of Growth Hormone in Inflammation and Macrophage Activation
Authors: Huang Zhengxiang , Xiao Lan , Xiao Yin , Chen Chen 
Published: June 2022

Abstract
Inflammation is a body’s response to remove harmful stimuli and heal tissue damage, which is involved in various physiology and pathophysiology conditions. If dysregulated, inflammation may lead to significant negative impacts. Growth hormone (GH) has been shown responsible for not only body growth but also critical in the modulation of inflammation. In this review, we summarize the current clinical and animal studies about the complex and critical role of GH in inflammation. Briefly, GH excess or deficiency may lead to pathological inflammatory status. In inflammatory diseases, GH may serve as an inflammatory modulator to control the disease progression and promote disease resolution. The detailed mechanisms and signaling pathways of GH on inflammation, with a focus on the modulation of macrophage polarization, are carefully discussed with potential direction for future investigations.
The Changing Face of Turner Syndrome
Authors: Gravholt Claus H , Viuff Mette , Just Jesper , Sandahl Kristian , Brun Sara , van der Velden Janielle , Andersen Niels H , Skakkebaek Anne 
Published: June 2022

AbstractTurner syndrome (TS) is a condition in females missing the second sex chromosome (45,X) or parts thereof. It is considered a rare genetic condition and is associated with a wide range of clinical stigmata, such as short stature, ovarian dysgenesis, delayed puberty and infertility, congenital malformations, endocrine disorders, including a range of autoimmune conditions and type 2 diabetes, and neurocognitive deficits. Morbidity and mortality are clearly increased compared with the general population and the average age at diagnosis is quite delayed. During recent years it has become clear that a multidisciplinary approach is necessary toward the patient with TS. A number of clinical advances has been implemented, and these are reviewed. Our understanding of the genomic architecture of TS is advancing rapidly, and these latest developments are reviewed and discussed. Several candidate genes, genomic pathways and mechanisms, including an altered transcriptome and epigenome, are also presented.
Brain vascular damage-induced lymphatic ingrowth is directed by Cxcl12b/Cxcr4a
Authors: Chen Jingying , He Jianbo , Luo Lingfei 
Published: June 2022

ABSTRACT
After ischemic stroke, promotion of vascular regeneration without causing uncontrolled vessel growth appears to be the major challenge for pro-angiogenic therapies. The molecular mechanisms underlying how nascent blood vessels (BVs) are correctly guided into the post-ischemic infarction area remain unknown. Here, using a zebrafish cerebrovascular injury model, we show that chemokine signaling provides crucial guidance cues to determine the growing direction of ingrown lymphatic vessels (iLVs) and, in turn, that of nascent BVs. The chemokine receptor Cxcr4a is transcriptionally activated in the iLVs after injury, whereas its ligand Cxcl12b is expressed in the residual central BVs, the destinations of iLV ingrowth. Mutant and mosaic studies indicate that Cxcl12b/Cxcr4a-mediated chemotaxis is necessary and sufficient to determine the growing direction of iLVs and nascent BVs. This study provides a molecular basis for how the vessel directionality of cerebrovascular regeneration is properly determined, suggesting potential application of Cxcl12b/Cxcr4a in the development of post-ischemic pro-angiogenic therapies.