bluuebunny/crossref_metadata_2025_split huggingface dataset:
Consanguineous marriages and their association with women’s reproductive health and fertility behavior in Pakistan: secondary data analysis from Demographic and Health Surveys, 1990–2018
Authors: Iqbal Sarosh , Zakar Rubeena , Fischer Florian , Zakar Muhammad Zakria 
Published: April 2022

Abstract
Background
Pakistan has been showing consistently the highest prevalence of consanguinity. The popularity of consanguineous marriages is not declining in the country, because of social, cultural, and religious beliefs as well as economic advantages. However, couples also face various health-related implications, such as poor pregnancy outcomes or multiple reproductive and fertility consequences, having adverse effects on mothers and their children. This research investigated the trend of consanguineous marriages and their association with women’s reproductive health and fertility behavior in Pakistan from 1990 to 2018.

Methods
This study is based on secondary data analysis, using all four waves of the Pakistan Demographic Health Surveys carried out from 1990 to 2018. The analysis is limited to women aged 15–49 years, who had given birth in the previous five years preceding each survey. Sampling weights were calculated and subsequently weighted analysis was conducted. Descriptive statistics, bivariable and multivariable logistic regression analysis were performed to determine the association of consanguinity with multiple characteristics related to socio-demographics, co-variates, and women’s reproductive health and fertility behaviors.

Results
The findings revealed a high but overall stable trend of consanguinity prevalence of about 63% during the last three decades. Consanguineous marriages were more prevalent amongst young and uneducated women, living in rural areas, with poorer wealth status and having less exposure to mass media to access information. A strong association of consanguinity was observed with women’s reproductive health and fertility behavior, particularly for women who gave first birth at a younger age, had multi-gravida pregnancies, multi-parity, pregnancy termination, ANC visits, and higher fertility.

Conclusion
Consanguineous marriages are predominant in the patriarchal society of Pakistan. Findings revealed that consanguinity contributes significantly to women’s reproductive health and fertility behaviors. Appropriate counseling, educational, and health promotional programs related to consanguinity should be designed and launched at the community level to raise awareness about risks towards women’s reproductive health and fertility.
Application of a pre-emptive question and answer platform to improve the level of satisfaction during family meetings in general medical wards
Authors: Yu Wen-Chun , Huang Chun-Ta , Sheng Wang-Huei 
Published: April 2022

Abstract
Background
A successful family meeting is key to family-centered care and may foster communication and improve the level of satisfaction of the family in terms of communication. In this study, we evaluated whether a proactive communication channel could improve the level of satisfaction of family members following a family meeting in a general medical ward setting.

Methods
We conducted a pre- and post-study to compare the level of satisfaction of a family with a family meeting before (N = 39) and after (N = 29) intervention in two general medical wards of a tertiary-care referral center. The intervention included a pre-emptive question and answer platform and a written response to family-raised queries in addition to a regular setting. Following each family meeting, family members were requested to fill a 10-item survey assessing their levels of satisfaction.

Results
The characteristics of the family members in terms of demographics, education levels, and previous experiences with family meetings in the pre- and post-intervention groups were similar. The scores in all the items that indicated the level of satisfaction significantly improved after intervention. The overall score for satisfaction increased from 85 (interquartile range, 80–95) to 98 (interquartile range, 93–100; P < 0.001).

Conclusions
Compared with conventional practice, the inclusion of a proactive communication platform along with a written response to raised queries as a part of family meetings improved the satisfaction levels of the family in terms of the content and process of the meeting in the general ward setting. Further studies are needed to delineate the optimal timing and use of such a communication modality.
Massive primary cardiac synovial sarcoma of the left atrium: a case report
Authors: Zhou Alice L. , Halub Meghan E. , Gross John M. , Shou Benjamin L. , Kilic Ahmet 
Published: April 2022

Abstract
Background
Synovial sarcomas are tumors typically located in the extremities and characterized by a t(X;18)(p11.2;q11.2) chromosomal translocation. With only around 100 cases reported in the literature, cardiac synovial sarcomas are extremely rare.

Case presentation
We describe a case of a 59-year-old male who presented to his primary care physician with chest pain, palpitations, and dyspnea and was diagnosed with atrial flutter. Following atrial ablation, a transthoracic echocardiogram incidentally revealed a 5.5 × 5.0 cm heterogeneous mass. Further workup found a heterogeneous mass with mild fluorodeoxyglucose uptake that was abutting the left atrium, left ventricle, and left pulmonary veins. The tumor was resected and confirmed to be a monophasic synovial sarcoma with a SS18-SSX gene fusion. Four months post-operative, the patient had recovered well from surgery. He is currently undergoing concurrent radiation and chemotherapy.

Conclusions
Due to the rarity of this tumor, guidelines on diagnosis and treatment come only from case reports. Our case describes a primary cardiac synovial sarcoma arising from the left atrium in the atrioventricular groove in which diagnosis of atrial flutter preceded detection of the mass.
Hormone and receptor activator of NF-κB (RANK) pathway gene expression in plasma and mammographic breast density in postmenopausal women
Authors: Mintz Rachel , Wang Mei , Xu Shuai , Colditz Graham A. , Markovic Chris , Toriola Adetunji T. 
Published: April 2022

Abstract
Background
Hormones impact breast tissue proliferation. Studies investigating the associations of circulating hormone levels with mammographic breast density have reported conflicting results. Due to the limited number of studies, we investigated the associations of hormone gene expression as well as their downstream mediators within the plasma with mammographic breast density in postmenopausal women.

Methods
We recruited postmenopausal women at their annual screening mammogram at Washington University School of Medicine, St. Louis. We used the NanoString nCounter platform to quantify gene expression of hormones (prolactin, progesterone receptor (PGR), estrogen receptor 1 (ESR1), signal transducer and activator of transcription (STAT1 and STAT5), and receptor activator of nuclear factor-kB (RANK) pathway markers (RANK, RANKL, osteoprotegerin, TNFRSF18, and TNFRSF13B) in plasma. We used Volpara to measure volumetric percent density, dense volume, and non-dense volume. Linear regression models, adjusted for confounders, were used to evaluate associations between gene expression (linear fold change) and mammographic breast density.

Results
One unit increase in ESR1, RANK, and TNFRSF18 gene expression was associated with 8% (95% CI 0–15%, p value = 0.05), 10% (95% CI 0–20%, p value = 0.04) and % (95% CI 0–9%, p value = 0.04) higher volumetric percent density, respectively. There were no associations between gene expression of other markers and volumetric percent density. One unit increase in osteoprotegerin and PGR gene expression was associated with 12% (95% CI 4–19%, p value = 0.003) and 7% (95% CI 0–13%, p value = 0.04) lower non-dense volume, respectively.

Conclusion
These findings provide new insight on the associations of plasma hormonal and RANK pathway gene expression with mammographic breast density in postmenopausal women and require confirmation in other studies.
Explainable multiview framework for dissecting spatial relationships from highly multiplexed data
Authors: Tanevski Jovan , Flores Ricardo Omar Ramirez , Gabor Attila , Schapiro Denis , Saez-Rodriguez Julio 
Published: April 2022

AbstractThe advancement of highly multiplexed spatial technologies requires scalable methods that can leverage spatial information. We present MISTy, a flexible, scalable, and explainable machine learning framework for extracting relationships from any spatial omics data, from dozens to thousands of measured markers. MISTy builds multiple views focusing on different spatial or functional contexts to dissect different effects. We evaluated MISTy on in silico and breast cancer datasets measured by imaging mass cytometry and spatial transcriptomics. We estimated structural and functional interactions coming from different spatial contexts in breast cancer and demonstrated how to relate MISTy’s results to clinical features.
Severe COVID-19-associated variants linked to chemokine receptor gene control in monocytes and macrophages
Authors: Stikker Bernard S. , Stik Grégoire , van Ouwerkerk Antoinette F. , Trap Lianne , Spicuglia Salvatore , Hendriks Rudi W. , Stadhouders Ralph 
Published: April 2022

AbstractGenome-wide association studies have identified 3p21.31 as the main risk locus for severe COVID-19, although underlying mechanisms remain elusive. We perform an epigenomic dissection of 3p21.31, identifying a CTCF-dependent tissue-specific 3D regulatory chromatin hub that controls the activity of several chemokine receptor genes. Risk SNPs colocalize with regulatory elements and are linked to increased expression of CCR1, CCR2 and CCR5 in monocytes and macrophages. As excessive organ infiltration of inflammatory monocytes and macrophages is a hallmark of severe COVID-19, our findings provide a rationale for the genetic association of 3p21.31 variants with elevated risk of hospitalization upon SARS-CoV-2 infection.
Improving glycemic control in patients with type 2 diabetes mellitus through a peer support instant messaging service intervention (DiabPeerS): study protocol for a randomized controlled trial
Authors: Höld Elisabeth , Grüblbauer Johanna , Wiesholzer Martin , Wewerka-Kreimel Daniela , Stieger Stefan , Kuschei Werner , Kisser Philip , Gützer Elisabeth , Hemetek Ursula , Ebner-Zarl Astrid , Pripfl Jürgen 
Published: April 2022

Abstract
Background
Diabetes mellitus is one of the four priority non-communicable diseases worldwide. It can lead to serious long-term complications and produces significant costs. Due to the chronicle character of the disease, it requires continuous medical treatment and good therapy adherence of those suffering. Therefore, diabetes self-management education (DSME) (and support DSMES) plays a significant role to increase patient’s self-management capacity and improve diabetes therapy. Research indicates that these outcomes might be difficult to maintain. Consequently, effective strategies to preserve the positive effects of DSMES are needed. Preliminary results show that peer support, which means support from a person who has experiential knowledge of a specific behavior or stressor and similar characteristics as the target population, is associated with better outcomes in terms of HbA1c, cardiovascular disease risk factors or self-efficacy at a lower cost compared to standard therapy. Peer-supported instant messaging services (IMS) approaches have significant potential for diabetes management because support can be provided easily and prompt, is inexpensive, and needs less effort to attend compared to standard therapy. The major objective of the study is to analyze the impact of a peer-supported IMS intervention in addition to a standard diabetes therapy on the glycemic control of type 2 diabetic patients.

Methods
A total of 205 participants with type 2 diabetes mellitus will be included and randomly assigned to an intervention or control group. Both groups will receive standard therapy, but the intervention group will participate in the peer-supported IMS intervention, additionally. The duration of the intervention will last for 7 months, followed by a follow-up of 7 months. Biochemical, behavioral, and psychosocial parameters will be measured before, in the middle, and after the intervention as well as after the follow-up.

Discussion
Type 2 diabetes mellitus and other non-communicable diseases put healthcare systems worldwide to the test. Peer-supported IMS interventions in addition to standard therapy might be part of new and cost-effective approaches to support patients independent from time and place.

Trial registration
ClinicalTrials.govNCT04797429. Registered on 15 March 2021.
Leishmania infantum infection serosurveillance in stray dogs inhabiting the Madrid community: 2007–2018
Authors: Müller Aurora , Montoya Ana , Escacena Cristina , de la Cruz María , Junco Ana , Iriso Andrés , Marino Eloy , Fúster Fernando , Miró Guadalupe 
Published: April 2022

Abstract
Background
Leishmaniosis is an endemic zoonotic disease in the Mediterranean basin caused by Leishmania infantum and transmitted by phlebotomine sandflies. While in dogs disease may be severe, leishmaniosis is also a public health concern as was shown in the largest outbreak of human leishmaniosis (HL) in Europe in 2009 occurring in the Madrid region. The aim of the present study was to assess the applicability of the Leishmaniosis Surveillance Program (LeishSP) established in Madrid in 1996 by examining trends in L. infantum seroprevalence and associated epidemiological risk factors based on data for the 2007–2018 period.

Methods
The study population consisted of 3225 stray dogs from 17 animal shelters collaborating with the LeishSP. Seroprevalences were recorded twice annually (April and November) from 2007 to 2018. In each yearly period, a minimum of 100 dogs were tested to detect dogs infected before and after the sandfly risk season in Madrid area. Each dog was subjected to the same protocol of blood sample collection and clinical examination to collect epidemiological data and clinical signs. Anti-Leishmania-specific IgG was determined by IFAT cut-off ≥ 1:100.

Results
Overall seroprevalence was 6.1% (198 positive dogs). Epidemiological data indicate a significantly higher seroprevalence in dogs > 4 years old, purebred dogs (Pit Bull and related breeds), and medium to large size dogs. There were no seroprevalence differences according to sex and/or season (April and November). In addition, no significant differences were observed according to whether dogs lived inside or outside the HL outbreak area. Remarkably, of 198 dogs testing positive for L. infantum, 64.6% had no clinical signs, indicating a high proportion of clinically healthy infected dogs that could be a potential source of infection.

Conclusions
Results indicate a stable seroprevalence of L. infantum infection after 2006 in stray dogs in Madrid but with a recent slightly increasing trend. These observations support the need to continue with the LeishSP implemented by sanitary authorities of the Madrid Community as an early warning strategy for human and animal leishmaniosis and to enable continued assessment of the epidemiological role of dogs with subclinical infection in this important zoonotic disease.

Graphical Abstract
Radiomics combined with clinical characteristics predicted the progression-free survival time in first-line targeted therapy for advanced non-small cell lung cancer with EGFR mutation
Authors: Zhu Jian-man , Sun Lei , Wang Linjing , Zhou Tong-Chong , Yuan Yawei , Zhen Xin , Liao Zhi-Wei 
Published: April 2022

Abstract
Objective
This study was to explore the most appropriate radiomics modeling method to predict the progression-free survival of EGFR-TKI treatment in advanced non-small cell lung cancer with EGFR mutations. Different machine learning methods may vary considerably and the selection of a proper model is essential for accurate treatment outcome prediction. Our study were established 176 discrimination models constructed with 22 feature selection methods and 8 classifiers. The predictive performance of each model were evaluated using the AUC, ACC, sensitivity and specificity, where the optimal model was identified.

Results
There were totally 107 radiomics features and 7 clinical features obtained from each patient. After feature selection, the top-ten most relevant features were fed to train 176 models. Significant performance variations were observed in the established models, with the best performance achieved by the logistic regression model using gini-index feature selection (AUC = 0.797, ACC = 0.722, sensitivity = 0.758, specificity = 0.693). The median R-score was 0.518 (IQR, 0.023–0.987), and the patients were divided into high-risk and low-risk groups based on this cut-off value. The KM survival curves of the two groups demonstrated evident stratification results (p = 0.000).
A study on canine dirofilariasis in selected areas of Sri Lanka
Authors: Dasanayake Randima , Balendran Thivya , Atapattu Dhilma , Iddawela Devika 
Published: April 2022

Abstract
Objectives
Canine dirofilariasis is a mosquito borne zoonotic filarial parasitic disease caused by Dirofilaria species. In Sri Lanka, human dirofilariasis is endemic and well documented. Even though canine dirofilariasis is an established infection among dog populations in Sri Lanka, the prevalence and risk factors were not documented in Kanthale divisional secretariat, Eastern Province of Sri Lanka. Therefore, the main objective of this study is to determine the prevalence of dirofilariasis and to identify the exposure-related risk factors in dogs using an interviewer administered questionnaire in Kanthale divisional secretariat.

Results
Out of 162 blood samples collected from dogs, 47.5% (n = 77/162) were positive for the presence of microfilariae by direct smear. Of 162 samples 58.6% (n = 95/162) were molecularly identified as D. repens. Species-specific primer pair DIR3/DIR4 that amplified 5S rRNA was used. The current study observed a significant association between mongrels and canine dirofilariasis (p = 0.049), where 61.3% (n = 95) out of 155 mongrels showed PCR positivity. This study showed no significant association between the occurrence of dirofilariasis and the age, sex, rearing method, presence or absence of skin rash, and stray or domestic dogs. Dirofilaria immitis was not identified in direct smear test and PCR.
A network of change: united action on research integrity
Authors: Evans Thomas Rhys , Pownall Madeleine , Collins Elizabeth , Henderson Emma L. , Pickering Jade S. , O’Mahony Aoife , Zaneva Mirela , Jaquiery Matt , Dumbalska Tsvetomira 
Published: April 2022

AbstractThe last decade has seen renewed concern within the scientific community over the reproducibility and transparency of research findings. This paper outlines some of the various responsibilities of stakeholders in addressing the systemic issues that contribute to this concern. In particular, this paper asserts that a united, joined-up approach is needed, in which all stakeholders, including researchers, universities, funders, publishers, and governments, work together to set standards of research integrity and engender scientific progress and innovation. Using two developments as examples: the adoption of Registered Reports as a discrete initiative, and the use of open data as an ongoing norm change, we discuss the importance of collaboration across stakeholders.
Burnout en profesionales de atención primaria en la Cataluña Central
Authors: Roig-Grau Isabel , Fornés-Ollé Berta , Rodriguez-Roig Ramon , Delgado-Juncadella Anna , González-Valero Joan Anton , Rodríguez-Martín Irene 
Published: April 2022

Objetivos: Analizar la prevalencia y gravedad del síndrome de Burnout en los profesionales de los Equipos de Atención Primaria y su asociación con variables laborales y demográficas.
Métodos: Estudio transversal, observacional, descriptivo y multicéntrico. La muestra la forman trabajadores de todas las categorías profesionales sanitarias de la Cataluña Central. Se realiza a través del cuestionario autoadministrado y anónimo Maslach Burnout Inventory adaptado a la población española con tres escalas que valoran cansancio emocional, despersonalización y realización personal. Las variables cuantitativas se describen con la media y desviación estándar y las cualitativas con porcentajes. Se comparan mediante la t-Student para variables cuantitativas, chi cuadrado de Pearson para las variables categóricas con la corrección de Fisher y Mann-Whitney para las variables continuas.
Resultados: Participaron 614 profesionales, edad media 45.6 años, 84.9% mujeres. El 54.7% no tiene ninguna escala afectada, un 30.94% tiene una escala afectada. El Burnout con alteración de dos o más escalas se presenta en el 14.3%, de los que un 3.74% presentan Burnout grave con alteración de las tres escalas. La dimensión de cansancio emocional y despersonalización en grado alto y baja realización personal se da mayoritariamente en médicos adjuntos y residentes.
Conclusiones: El síndrome de Burnout en los profesionales de Atención Primaria afecta principalmente a médicos, con ecsasa relación a variables laborales y sociodemográficas, y constituye un factor de riesgo psicosocial para la salud de estos profesionales.
Sección de Medicina del Trabajo de la Unión Europea de Médicos Especialistas (UEMS)
Authors: Rodríguez-Jareño Maria Cruz 
Published: April 2022

Durante el pasado 2021 se celebraron dos reuniones de la sección de Medicina del Trabajo de la Unión Europea de Médicos Especialistas (UEMS).
La primera reunión se realizó de forma telemática el 26 de junio del 2021 con asistencia de 13 representantes de 13 estados, entre ellos España. Los estados representados fueron Austria, Bélgica, Eslovenia, España, Finlandia, Hungría, Italia, Letonia, Luxemburgo, Polonia, Portugal, Reino Unido y República Checa. También asistió la presidenta de EASOM (European Association of Schools of Occupational Medicine).
Durante la reunión se anunció que en la siguiente se procedería a la votación para la renovación de la junta directiva actual. Los tres puestos (presidente, secretario y tesorero), quedaron abiertos para candidatura de cualquier estado al corriente de pago y se adjuntaron las reglas de las elecciones.
Se presentó información sobre el próximo examen europeo de Medicina del Trabajo promovido por la UEMS de acuerdo con las normas CESMA, y se reiteró la firme voluntad de que se celebrara en el lugar y fecha previstos: Bruselas, 30 de agosto del 2021. En carta a la directora de Archivos de Prevención de Riesgos Laborales del 15 de julio de 2021 ya se explicaron las características del examen y ventajas para los candidatos, animándolos a la participación.
En relación a los grupos de trabajo, se acordó reformularlos después de las elecciones. Será necesario mantener un grupo de trabajo para nutrir de preguntas el examen de la especialidad, y también se tendrá que instaurar un grupo para la revisión de los requisitos de formación europeos. ICOH mostró su interés en el examen, por tanto existe la posibilidad de que la iniciativa se amplíe globalmente, más allá de Europa.
La Sección es socio oficial de la Campaña "Lugares de Trabajo Saludables" de EU-OSHA, la Agencia Europea, siendo la temática del periodo 2020-2022 los trastornos musculoesqueléticos.
La segunda reunión tuvo lugar de forma presencial en Luxemburgo el 16 de octubre de 2021 después de un año y medio de no presencialidad debido a la pandemia.
A ella asistieron 13 representantes de 12 estados: Alemania, Austria, Bélgica, Dinamarca, Eslovenia, Grecia, Irlanda, Italia, Luxemburgo, Polonia, Portugal y Suiza. En esta ocasión no hubo representación española.…