bluuebunny/crossref_metadata_2025_split huggingface dataset:
Successful treatment with steroid pulse therapy for a COVID-19 case with progressive respiratory failure during treatment for pleural metastasis of breast cancer
Authors: Jimbo Hikari , Horimoto Yoshiya , Hiki Makoto , Tabe Yoko , Watanabe Junichiro , Saito Mitsue , Naito Toshio 
Published: May 2022

Abstract
Background
Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infected patients are at high risk for developing severe conditions if other comorbidities are present, such as advanced cancer. Although the regulation of immune response is thought to play an important role in the treatment of coronavirus disease 2019 (COVID-19), physicians often have difficulties in selecting the most appropriate treatment. Furthermore, the impact that interrupting breast cancer treatment due to a COVID-19 infection has on patient outcomes is still unknown. Herein we report a case of advanced breast cancer in a patient whose COVID-19 acute respiratory failure was successfully treated with minimal interruption to their anticancer therapy for recurrent breast cancer.

Case presentation
A 48-year-old woman developed carcinomatous pleurisy after curative surgery for breast cancer. One month after the initiation of targeted therapy with palbociclib and fulvestrant, the pleural effusion decreased, but soon after she developed a COVID-19 infection. Dexamethasone (8 mg/day) was administered due to a prolonged fever, but her respiratory symptoms got worse and pneumonia appeared on a computed tomography (CT) scan 7 days after hospitalization. Thus, steroid pulse therapy (methylprednisolone 1000 mg/day) was administered for 3 days. Her respiratory condition rapidly improved. Two weeks after hospital discharge, complete regression of pneumonia was confirmed on CT scan, and her targeted therapy was resumed at the same dose and strength. More than 6 months later, her metastatic disease remains stable while on the same treatment. Retrospective analysis of the patient's neutralizing antibodies found the neutralizing activity was low in the early stages of infection, but became high after recovery. This suggests the patient acquired an immunity to SARS-CoV-2 through the infection, despite having a mild myelosuppression due to treatment for recurrent breast cancer.

Conclusions
Steroid pulse therapy is available worldwide, and may have an important role in cancer patients who develop severe pneumonia from SARS-CoV-2, by enabling them to avoid any long-term disruption to anticancer therapy. Moreover, it might also be useful when antiviral therapies lose their efficacy due to mutations of the virus, such as the Omicron variant. A critical element in cases such as this one is that treatment decisions are made by a team of specialists, including pulmonologists.
Re-thinking the drivers of regular and irregular migration: evidence from the MENA region
Authors: Dennison James 
Published: May 2022

AbstractWhy do individuals vary in their desire to emigrate? Why are some willing to emigrate irregularly? This article tests four theoretical approaches—socio-demographics; economic and political context; access to migrant networks; and psychological factors—across the Middle East and North Africa region. Data from the Arab Barometer is used to show that the most prevalent factors are youth, university education, being male, and stress levels as well as negative economic and political perceptions, being unmarried, trust in social media, remittances, and low religiosity. Notably, economic factors such as unemployment and income are shown to rarely have an effect. The determinants of being willing to emigrate without papers are fewer and distinct: gender and lower income especially as well as lower education and negative economic and political perceptions. Several contributions to our understanding of emigration are made: a two-step model of irregular emigration based on findings across 12 countries, new evidence of the complex and, within-country, muted role of economic factors, the centrality of psychology, and how, tentatively, it appears that both extreme wealth and war interact with the most fundamental socio-demographic drivers.
The codesign of implementation strategies for children’s growth assessment guidelines in the dental setting
Authors: Villarosa Amy Ruth , Maneze Della , Ramjan Lucie Michelle , Kong Ariana , George Ajesh 
Published: May 2022

Abstract
Background
Considering the interdisciplinary role dental staff can play in addressing overweight and obesity in childhood, this study aimed to codesign guideline implementation strategies for children’s growth assessment and dietary advice guidelines in the dental setting.

Methods
This qualitative study utilised principles of codesign and appreciative inquiry through a series of four, two-hour focus groups with dental staff and parents. Focus groups were analysed using content analysis.

Results
Discussion fell into two main themes, engaging patients throughout their care journey and supporting staff to engage with the guidelines. Six strategies were developed within these themes: (1) providing growth assessment information to patients and families before appointments, (2) providing refresher training to staff, (3) involving dental assistants in the growth assessment, (4) keeping dental staff updated regarding referral outcomes, (5) culturally appropriate information resources for patients and families, and (6) enabling longitudinal growth tracking in patient information systems.

Conclusions
This study successfully designed six implementation strategies for children’s growth assessment guidelines in the dental setting. Further research is required to determine their impact on guideline adherence.
Familial exudative vitreoretinopathy in a 4 generations family of South-East Asian Descendent with FZD4 mutation (c.1501_1502del)
Authors: Wai Yong Zheng , Chong Yong Yuin , Lim Lik Thai , Hamzah Norhafizah , Rahmat Jamalia 
Published: May 2022

Abstract
Background
Familial Exudative Vitreoretinopathy (FEVR) is a hereditary disorder characterized by peripheral avascular retina with neovascularization. Although FEVR has been thoroughly described in multiple literature publications from different countries, there are currently limited articles describing the phenotypes of FEVR among South-East Asian Descendent. This paper describes the clinical phenotype of the FZD4 gene with c.1501_1502 deletion in a 4-generation case series of a South East Asian family.

Methods
We reviewed a 4-generation case series of a South-East Asian descendent family consisting of 27 family members with 10 members diagnosed with FEVR. We observed the clinical phenotype of these series of patients, including some of the family members who underwent whole-exome sequencing, PCR amplification and DNA sequencing techniques to identify the mutated gene.

Results
Frameshift mutation (c.1501_1502del) were found in FZD4 gene in this series of patients with the age ranging from 1 month old to 69 years old. There was a 100% (4/4) of our paediatric patients being diagnosed within 21 days of life. It was also found that 75% of patients (6/8) less than 40 years old exhibited disease asymmetry of 2 stages or more and 80% (8/10) had a history of vitreoretinal surgery or diode laser photocoagulation, with a further 50% of the adult patients identified as legally blind; the mean age of blindness was 18-years-old.

Conclusions
Phenotypic manifestation of FZD4 gene with c.1501_1502del mutation can be identified within the neonatal period. They have relatively greater clinical asymmetry of 2 stages or more compared to other mutations. Without treatment, most of them will have bilateral severe visual impairment around the adolescent age group.
Internal structure and classification of pelvic floor dysfunction distress by PFDI-20 total score
Authors: de Arruda Guilherme Tavares , de Andrade Dalton Francisco , Virtuoso Janeisa Franck 
Published: May 2022

Abstract
Purpose
To evaluate the internal structure (structural validity and internal consistency) and propose a classification for the distress caused by the presence of pelvic floor dysfunction (PFD) symptoms based on the total score of the Pelvic Floor Distress Inventory (PFDI-20).

Methods
Cross-sectional study conducted with Brazilian women over 18 years of age. Exploratory and confirmatory factor analysis were performed with Parallel Analysis and to test three models to compare them with the Root Mean Square Error of Approximation (RMSEA) and Comparative Fit Index (CFI). Internal consistency was calculated using Cronbach's alpha. Partial credit model (PCM) was performed to classify the total score of the PFDI-20.

Results
Data from 237 women (49.62 ± 16.95 years) were analyzed. The one-dimensional structure had 43.74% of the explained variance with α = 0.929. The one-dimensional model was the most appropriate (CFI = 0.987 and RMSEA = 0.022). The total PFDI-20 score was classified as the absence of symptoms (score zero), symptoms with mild distress (1 to 15 points), symptoms with moderate distress (16 to 34 points), and symptoms with severe distress (35 to 40 points).

Conclusion
The PFDI-20 has an one-dimensional structure and the distress caused by the presence of PFD symptoms can be classified as mild, moderate and severe. Health professionals and future studies can use our classification to facilitate the understanding of the patient's health status and to obtain other analyses on the severity of the distress of the symptoms of PFD.
Characterization of indigenous Bacillus thuringiensis isolate RM11 toxic to the diamondback moth, Plutella xylostella (L.) (Lepidoptera: Plutellidae)
Authors: Navya R. Naga Sri , Balasubramani V. , Raveendran M. , Murugan M. , Lakshmanan A. 
Published: May 2022

Abstract
Background
Bacillus thuringiensis (Bt) Berliner is an omnipresent soil bacterium used as world’s leading biopesticide to combat agriculturally important insect pests. This study was aimed at protein and gene profiling of an indigenous Bt isolate RM11, which was toxic to the larvae of diamondback moth, Plutella xylostella (L.) in laboratory bioassays.

Results
Indigenous Bt isolate RM11 was characterized along with the standard checks B. thuringiensis subsp. kurstaki (Btk) HD1 and 78/11, based on colony characters, protein profile and PCR screening. All three Bt colonies were fried egg type, white in color with flat elevation and undulated margin. PCR screening revealed the presence of cry1Ac and vip3A genes, which encode lepidopteran toxic proteins in RM11. SDS-PAGE results showed the presence of a prominent protein band of cry1Ac, vip3A with molecular weights 135 kDa, 88 kDa and other bands at 70, 50, 32 and 10 kDa. In leaf disk bioassay with spore crystal mixture, RM11 exhibited toxicity with LC50 of 4.51 µg/ml as against 0.07 µg/ml in positive standard HD1, based on mortality at 72 h after treatment. At LC50 of 4.51 µg/ml, solubilized and insolubilized protein of RM11 was found to produce 56 and 70% mortality.

Conclusions
The present study revealed that RM11 could be a viable alternative for consideration in developing a native Bt formulation and for inclusion in the integrated management of P. xylostella with other native isolates producing different toxins. Furthermore, these findings imply that RM11 could be a source of new cry toxin, which can be confirmed through whole-genome sequencing analysis.
Clinical features, laboratory characteristics and risk factors for mortality of COVID-19 patients in a secondary hospital in Oman during the first wave of the SARS-CoV-2 pandemic
Authors: Almayahi Zayid K. , Raveendran A. V. , Al Malki Rashid , Safwat Amira , Al Baloshi Muradjan , Abbas Amal , Al Salami Ahmed S. , Al Mujaini Sami M. , Al Dhuhli Khalid , Al Mandhari Said 
Published: May 2022

Abstract
Background
The changing epidemiological profile of the COVID-19 pandemic and the uncertain clinical picture of patients characterise this ongoing and most challenging health event.

Objectives
To report clinical features, laboratory characteristics, and mortality risk factors among COVID-19 patients admitted to a secondary hospital in Oman.

Methods
A retrospective study for the first 455 patients admitted with COVID-19 to Rustaq hospital from 12th April, 2020 to 27th September, 2020. A predesigned questionnaire collected data from the hospital medical electronic system.

Results
The mean age was 42.84 (SD = 19.86) years, and the majority of patients were aged 30 to 59 and 60 or above; 207 (45.5%) and 189 (41.5%), respectively. Male patients constituted approximately two-thirds of the subjects. Fever, dyspnea and cough were the most common presenting symptoms (69%, 66%, and 62%, respectively), while comorbidities with diabetes mellitus and hypertension were 47% and 44%, respectively. Bacterial growth was identified at approximately 10%. Bivariate analysis turned out to be significant with a number of factors. However, multivariate analysis showed significance with patients aged over 60 (OR = 7.15, 95% CI 1.99–25.63), dyspnea (OR = 2.83, 95% CI 1.5–5.33), dyslipidemia (OR = 1.93, 95% CI 1.02–3.66) and being bed-ridden (OR = 5.01, 95% CI 1.73–14.44). Durations from onset of symptoms to admission and respiratory distress were lower among patients who died; p = 0.024 and p = 0.001, respectively. Urea, Troponin and LDH may act as potential diagnostic biomarkers for severity or mortality.

Conclusions
This study identified groups of patients with a higher risk of mortality, with severe disturbance in the laboratory markers while some could act as potential diagnostic biomarkers.
Effect of COVID-19 lockdown on Moroccan patients with type 1 and type 2 diabetes
Authors: Kaddar Rochdi , Tarik Chayma , Atmani Maryam , Enakhil Ikrame , Fakhri Nada , Khalis Mohamed , Lotfy Abdellah , El Kadmiri Nadia 
Published: May 2022

Abstract
Background
The implementation of coronavirus disease of 2019 (COVID-19) lockdown has affected the daily practices of subjects with chronic diseases such as diabetes and caused negative impact on their lifestyle and habits such as physical activity, dietary habits and accessibility to medications. Diabetic people are considered the most vulnerable groups to COVID-19, and the lockdown measure has disturbed the diabetes self-management. In our study, we aimed to assess, for the first time at the regional level (Souss Massa Region), the COVID-19 lockdown impact on HbA1c levels in patients with type 1 diabetes (T1D) and type 2 diabetes (T2D). We carried out a cross-sectional quantitative analysis at the health center of the industrial district in Agadir City.

Results
We found a significant improvement in post-lockdown mean ± SD HbA1c in 150 subjects suffering from T1D and T2D; p = 0.005). Our analysis revealed a significant association of HbA1c deviation with educational level and medical coverage (p = 0.01). No significant association was detected between HbA1c deviation and age, gender, weight, height, current BMI status, fasting blood sugar, family history, urban or rural areas, marital status, professional activity, socioeconomic income, type of diabetes, dietary, comorbidities, diabetic complications, housing, adherence to the dietary recommendations, physical activity, medical appointments, stopping medication, self-monitoring, fasting and anxiety about getting COVID-19.

Conclusions
COVID-19 lockdown had no deleterious effect on HbA1c levels in Moroccan patients with T1D and T2D.
Robust facial expression recognition system in higher poses
Authors: Owusu Ebenezer , Appati Justice Kwame , Okae Percy 
Published: May 2022

AbstractFacial expression recognition (FER) has numerous applications in computer security, neuroscience, psychology, and engineering. Owing to its non-intrusiveness, it is considered a useful technology for combating crime. However, FER is plagued with several challenges, the most serious of which is its poor prediction accuracy in severe head poses. The aim of this study, therefore, is to improve the recognition accuracy in severe head poses by proposing a robust 3D head-tracking algorithm based on an ellipsoidal model, advanced ensemble of AdaBoost, and saturated vector machine (SVM). The FER features are tracked from one frame to the next using the ellipsoidal tracking model, and the visible expressive facial key points are extracted using Gabor filters. The ensemble algorithm (Ada-AdaSVM) is then used for feature selection and classification. The proposed technique is evaluated using the Bosphorus, BU-3DFE, MMI, CK + , and BP4D-Spontaneous facial expression databases. The overall performance is outstanding.
Vascular endothelial growth factor A with two genetic variants for prediction of mixed microvascular diabetic complications
Authors: Omar Thoria Ahmed , El-Saeed Gehan Kamal , Khodeer Seham Ahmed , Dawood Alaa Abdelsalam , El-Deeb Sara Mahmoud , ELShemy Asmaa Mohammed , Montaser Belal Abdelmohsen 
Published: May 2022

Abstract
Background
Vascular endothelial growth factor (VEGF) is a signal protein, induces cell proliferation, and enhances the permeability of the endothelial cells. VEGF-A gene is highly polymorphic, with different near-gene variants at varied frequencies linked with altered VEGF protein expression, type 2 diabetes mellitus (T2DM) susceptibility, and associated microvascular complications. The present study aimed to investigate the role of two genetic variants of VEGF-A, − 583C > T (rs3025020) and + 936 C/T (rs3025039), for predicting mixed microvascular complications in T2DM. This case–control study was performed on 26 T2DM patients with mixed microvascular complications and 26 apparently healthy individuals, as a control group. Clinical, neurological, funds examinations, and biochemical laboratory investigations were conducted on all groups. The serum level of VEGF-A was measured using ELISA. Genotyping of VEGF-A was performed by real-time PCR allelic discrimination system.

Results
Serum level of VEGF-A was significantly increased in T2DM with mixed complications. T allele of VEGF-A rs3025020 showed higher frequency among T2DM patients with mixed complications than in control group [OR 2.67; 95% CI 1.03–6.91; p = 0.04], while CT genotype and T allele of VEGF-A rs3025039 had a high frequency in mixed complication group [OR 4.08; 95% CI 1.32–17.44; p = 0.01 and OR 4.02; 95% CI 1.52–10.63; p = 0.004, respectively].

Conclusion
VEGF-A increased the level contributed in the pathogenesis of mixed diabetic microvascular complications. T allele of VEGF-A rs3025020, CT genotype, and T allele of VEGF-A rs3025039 had the highest frequency in mixed diabetic microvascular complications, so they were considered risk genes for mixed diabetic microvascular complications.
Pericardial cyst in a one-year-old boy with ventricular septal defect and patent ductus arteriosus
Authors: Panthee Nirmal , Pradhan Sidhartha , Koirala Raamesh , Pant Anil Dev , Pokhrel Bishow , Shah Subhash Chandra , Timala Rabindra Bhakta 
Published: May 2022

Abstract
Background
Pericardial cysts are rare, with the most common etiology being congenital. Ventricular septal defect is the most common congenital heart disease in children. However, the combination of pericardial cyst, ventricular septal defect, and patent ductus arteriosus is extremely rare.

Case presentation
A one-year-old boy with ventricular septal defect and patent ductus arteriosus was planned for surgical correction. Intraoperatively, we made an additional diagnosis of a large pericardial cyst; and the cyst was excised along with ventricular septal defect closure and patent ductus arteriosus ligation.

Conclusions
Pericardial cysts can sometimes be missed with transthoracic echocardiography. Excision of the cyst can safely be done during concomitant cardiac surgery.
Outcomes of transnasal endoscopic repair of cerebrospinal fluid leaks: a prospective cohort study
Authors: Baban Muaid I. , Shareef Deman J. , Hadi Sahar J. , Shawkat Abdulrahman , Castelnuovo Paolo 
Published: May 2022

Abstract
Background
Although cerebrospinal fluid (CSF) leak repair of the anterior and middle skull base defect by endonasal endoscopic surgery (EES) presents one of the more difficult challenges, it has shown high success rates with less morbidity. Our objective is to evaluate the outcomes of transnasal endoscopic repair of CSF leak regarding success rate, impact on olfaction, and sinonasal function.

Methods
A prospective cohort study was conducted to evaluate the CSF leak repair outcomes related to the site, size of the defect, surgical techniques, and the materials that been used through Smell Identification Test (SIT), 22-item Sino-Nasal Outcome Test (SNOT-22), Perioperative Sinus Endoscopy score (POSE), and Lund-MacKay Scoring (LM) of CT scan.

Results
Twenty-one patients were enrolled in the study; 12 out of 21 were females with a higher prevalence of traumatic causes of 61.9%. Different techniques and materials were used for the repair with a success rate recorded at 90.5% after the first closure attempt. The mean standard deviation (SD) scores postoperatively (after 6 months) was markedly decreased in SNOT 22 with mean (SD) 5.55 ± 3.6, slightly increase in POSE (mean ± SD = 0.43 ± 0.6), and slightly decrease in SIT (mean ± SD =10.31 ± 4.7) and LM (mean ± SD = 0.57 ± 0.7).

Conclusion
Transnasal endoscopic CSF leak repair is an effective technique for skull base defect closure with a high success rate and no valuable morbidity to sinonasal function other than mild hyposmia in patients where nasoseptal (NSF) and septal flap have been used.

Trial registration
The study was approved by the institutional review board and ethics committee of (The Arab Board of Health Specializations) with order no. (453) on 1April 2018.
Is interleukin-17 implicated in early knee osteoarthritis pathogenesis as in rheumatoid arthritis?
Authors: Abdel-Naby Hoda M. , El-Tawab Sarah S. , Rizk Mohamed M. , Aboeladl Nesrin A. 
Published: May 2022

Abstract
Background
Interleukin-17 (IL-17) is a cytokine that promotes activation of multiple catabolic pathways resulting in cartilage and tissue damage. It has features making it increasingly attractive as a biological marker, especially in rheumatoid arthritis (RA) and osteoarthritis (OA). However, its expression is heterogeneous; not all patients’ exhibit high IL-17 levels, and its level along the disease course is still challenging to predict.

Aim of the work
The objectives of this study were to compare serum IL-17 levels in patients with early knee OA and in RA patients, to determine its correlation with disease activity in RA and to determine if it is correlated with functional scores in both RA and OA.

Subjects and methods
Twenty early knee OA patients (32.7 ± 3.7) years were included. Diagnosis of early OA was based on Luyten et al. 2012 early knee OA classification (early OA 2012). This study also included 25 RA patients aged 32.8 ± 5.1 years, and the diagnosis was according to 2010 ACR-EULAR classification criteria for RA. The current work also included a control group of 20 healthy volunteers aged 31.9 ± 3.2 years. The serum IL-17 level was assessed by using the ELISA technique.

Results
Serum IL-17 level was significantly high in early knee OA patients (5.2 pg/ml) and was significantly higher in RA patients (5.9 pg/ml) compared to the control group (4.9 pg/ml) (P < 0.001).

Conclusions
The increased serum IL-17 level in patients with early knee OA suggests its pathogenic role in the disease. Serum IL-17 positive correlation with the severity of knee OA-related pain proposes that it may be a potential marker to target for early treatment of knee OA-related pain.