bluuebunny/crossref_metadata_2025_split huggingface dataset:
HIV prevention – Challenges in reaching Libyan women: A narrative review
Authors: Hamidi Abier 
Published: February 2022

Introduction: The need to effectively communicate HIV/AIDS prevention messages in Libya, where HIV prevalence is relatively low yet increasing, cannot be overstressed. A review of the literature on HIV prevalence, risk factors, stigma and awareness found that there is a lack of HIV research, information and support in the country. This is particularly true regarding women, who account for 25%–30% of people living with HIV in Libya. Aim: Drawing on the various literature, this narrative review will (1) present a historical trajectory of Libyan women and their role in society and (2) identify some challenges that HIV prevention programmes face in reaching Libyan women. Methods: Medline, PubMed, Web of Science, ScienceDirect, Scopus and Cochrane Library were searched for English and Arabic language articles. Primary research studies and official reports indicating a discussion or research on HIV in Libya and Libyan women were considered. Reference lists of articles were reviewed to identify additional studies. Thirty-seven articles dating from 1987 to 2021 were selected and critically appraised. Results: There is a lack of sufficient information within the existing literature, but the gathered literature did reveal some significant insights. Factors such as limited sexual health education, inadequate medical services, social and cultural restrictions and stigma, as well as limited agency, were identified as potential barriers to women accessing crucial information on HIV. Conclusion: The article found that the HIV prevention efforts that have been carried out in Libya may be compromised as they were not designed to recognize and adhere to sociocultural norms that impact on Libyan women’s scope for choice and agency. By understanding the interplay between gender, social and structural factors in Libya, a model of better adjusted prevention and early intervention activities could be developed; a toolkit that conceptualizes the culture and that appreciates the role of a Libyan woman is changing.
Clinicopathological characteristics and prognosis of breast cancer patients with isolated central nervous system metastases in the multicentre ESME database
Authors: Carausu Marcela , Carton Matthieu , Cabel Luc , Patsouris Anne , Levy Christelle , Verret Benjamin , Pasquier David , Debled Marc , Gonçalves Anthony , Desmoulins Isabelle , Lecouillard Isabelle , Bachelot Thomas , Ferrero Jean-Marc , Eymard Jean-Christophe , Mouret-Reynier Marie-Ange , Chevrot Michaël , De Maio Eleonora , Uwer Lionel , Frenel Jean-Sébastien , Leheurteur Marianne , Petit Thierry , Darlix Amélie , Bozec Laurence 
Published: February 2022

Background: As a result of progress in diagnosis and treatment, there is a growing prevalence of metastatic breast cancer (MBC) with isolated CNS metastases. This study describes the largest-to-date real-life cohort of this clinical setting and compares it to other clinical presentations. Methods: We retrospectively analysed the French Epidemiological Strategy and Medical Economics (ESME) MBC database including patients who initiated treatment for MBC between 2008 and 2016. Progression-free survival (PFS) and overall survival (OS) were estimated using the Kaplan–Meier method. Descriptive statistics and multivariate Cox model were used. Results: Of 22,266 patients, 647 (2.9%) and 929 (4.2%) patients had isolated first-site CNS metastases or combined with extra-CNS metastases, with longer OS for the group with isolated CNS metastases (16.9 versus 13.9 months, adjusted HR = 1.69 (95% CI: 1.50–1.91), p < 0.001). Among the 541 (2.4%) patients with isolated CNS metastases and no intrathecal therapy (excluding leptomeningeal metastases), HER2+ cases were preponderant over TN or HR+ /HER2− cases (41.6% versus 26.1% versus 28.5%, respectively, p < 0.01). The treatment strategy consisted of a combination of local treatment and systemic therapy (49.2%), local treatment only (35.5%) or systemic therapy only (11.4%), or symptomatic therapy only (3.9%). Median PFS was 6.1 months (95% CI: 5.7–6.8). Median OS was 20.7 months (95% CI: 17.3–24.3), reaching 37.9 months (95% CI: 25.9–47.6) in the HR+ /HER2+ subgroup. Older age, TN subtype, MBC-free interval of 6–12 months, lower performance status, and WBRT were associated with poorer survival. Patients who received systemic therapy within 3 months from MBC diagnosis had longer OS (24.1 versus 16.1 months, p = 0.031), but this was not significant on multivariate analysis [HR = 1.0 (95% CI: 0.7–1.3), p = 0.806]. Conclusions: Patients with isolated CNS metastases at MBC diagnosis represent a distinct population for which the role of systemic therapy needs to be further investigated in prospective studies.
Molecular landscape of osimertinib resistance in patients and patient-derived preclinical models
Authors: Lim Sun Min , Yang San-Duk , Lim Sangbin , Heo Seong Gu , Daniel Stetson , Markovets Aleksandra , Minoo Rafati , Pyo Kyoung-Ho , Yun Mi Ran , Hong Min Hee , Kim Hye Ryun , Cho Byoung Chul 
Published: February 2022

Introduction: Osimertinib is a third-generation EGFR tyrosine kinase inhibitor (TKI) that is approved for the use of EGFR-mutant non-small cell lung cancer (NSCLC) patients. In this study, we investigated the acquired resistance mechanisms in NSCLC patients and patient-derived preclinical models. Methods: Formalin-fixed paraffin-embedded tumor samples and plasma samples from 55 NSCLC patients who were treated with osimertinib were collected at baseline and at progressive disease (PD). Next-generation sequencing was performed in tumor and plasma samples using a 600-gene hybrid capture panel designed by AstraZeneca. Osimertinib-resistant cell lines and patient-derived xenografts and cells were generated and whole exome sequencing and RNA sequencing were performed. In vitro experiments were performed to functionally study the acquired mutations identified. Results: A total of 55 patients and a total of 149 samples (57 tumor samples and 92 plasma samples) were analyzed, and among them 36 patients had matched pre- and post-treatment samples. EGFR C797S (14%) mutation was the most frequent EGFR-dependent mechanism identified in all available progression samples, followed by EGFR G824D (6%), V726M (3%), and V843I (3%). Matched pre- and post-treatment sample analysis revealed in-depth acquired mechanisms of resistance. EGFR C797S was still most frequent (11%) among EGFR-dependent mechanism, while among EGFR-independent mechanisms, PIK3CA, ALK, BRAF, EP300, KRAS, and RAF1 mutations were detected. Among Osimertinib-resistant cell lines and patient-derived models, we noted acquired mutations which were potentially targetable such as NRAS p.Q61K, in which resistance could be overcome with combination of osimertinib and trametinib. A patient-derived xenograft established from osimertinib-resistant patient revealed KRAS p.G12D mutation which could be overcome with combination of osimertinib, trametinib, and buparlisib. Conclusion: In this study, we explored the genetic profiles of osimertinib-resistant NSCLC patient samples using targeted deep sequencing. In vitro and in vivo models harboring osimertinib resistance revealed potential novel treatment strategies after osimertinib failure.
Can a Brief Online Interdisciplinary Program Enhance the Understanding of Musculoskeletal Pain amongst Primary Care Staff? A Prospective Study
Authors: Ng Khim Siong , Goh Bandy Qiuling , Tang Woh Peng , Lee Angela Wing Yan , Lee Samantha , Koh Kim Hwee , Shah Mitesh 
Published: February 2022

Background Primary care staff do not provide consistent education on musculoskeletal pain management to patients in accordance with the recommendations of clinical practice guidelines. We have developed a concise online learning program to bridge this gap. Objectives To investigate (1) the effectiveness of 1-hour musculoskeletal pain neurophysiology education program conducted by a physiotherapist on primary care staff; (2) the correlation between demographic factors of staff and the interdisciplinary learning performances. Methods We piloted a multicenter single-blind prospective study on sixty-four staff from the pharmacy department in eight public primary care clinics. Participants in the intervention group attended the 1-hour online program compared to a control group. The Neurophysiology of Pain Questionnaire (NPQ) to assess learning and the 10-point Likert scale program evaluation form to assess learning reaction of participants after the program were used. Results The participants reacted positively to the online learning program. The intervention group significantly improved in their musculoskeletal pain knowledge by a greater mean NPQ score difference 2.39 ( p < 0.001) compared with the control group. There were poor correlations between the demographic factors and their learning. Conclusion The pilot study shows that primary care staff may still utilize a biomedical approach in managing musculoskeletal pain. The improvement in knowledge demonstrates that short online programs could be a valuable part of interdisciplinary education in primary care because it is easily accessible by healthcare professionals and can benefit other healthcare staff regardless of their background.
Preclinical efficacy of African medicinal plants used in the treatment of snakebite envenoming: a systematic review protocol
Authors: Bala Auwal A. , Mohammed Mustapha , Umar Saifullahi , Ungogo Marzuq A. , Hassan Mohammed Al-Kassim , Abdussalam Umar S. , Ahmad Mubarak Hussaini , Ishaq Daha U. , Mana Dillos , Sha’aban Abubakar , Jatau Abubakar I. , Jibril Murtala , Kurfi Binta , Raji Ismaila , Malami Sani , Michael Godpower C. , Chedi Basheer Z. A. 
Published: February 2022

Background: Snakebite envenoming (SBE) is a high-priority, neglected, tropical disease that affects millions of people in developing countries annually. The only available standard drug used for the treatment of SBE is antisnake venom (ASV) which consists of immunoglobulins that have been purified from the plasma of animals hyper-immunized against snake venoms. The use of plants as alternatives for treatment of poisonous bites particularly snakebites is important in remote areas where there might be limited, or no access to hospitals and storage facilities for antivenom. The pharmacological activity of some of the medicinal plants used traditionally in the treatment of SBE have also been scientifically validated. Method: A systematic review will be conducted according to the Collaborative Approach to Meta-Analysis and Review of Animal Data from Experimental Studies checklist for study quality in animal/ in vivo studies. The tool will be modified and validated to assess in vitro models and studies that combine in vivo and in vitro studies. The systematic review will be reported according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses. English published articles on African medicinal plants used in the treatment of snakebite envenoming will be searched in Medline, Embase, and Scopus from 2000 to 2021. Dissemination: The findings of the study will be communicated through publication in peer-reviewed journal and presentation at scientific conferences. Medicinal plants have been important sources for the development of many effective drugs currently available in orthodox medicine. Botanically derived medicines have played a major role in human societies throughout history. Plants components used in traditional medicine gained much attention by many toxinologists as a tool for designing potent antidotes against snake envenoming. Our systematic review will provide a synthesis of the literature on the efficacy of these medicinal plants. We will also appraise the prospects of African medicinal plants with pharmacologically demonstrated activity against snakebite and envenoming.
Spinopelvic Alignment as a Risk Factor for Poor Balance Function in Low Back Pain Patients
Authors: Cha Eunsil , Park Jung Hyun 
Published: February 2022

Study Design Retrospective, observational study. Objectives This study aimed to examine the association between spinopelvic parameters and balance function in low back pain (LBP). Methods Among patients in the rehabilitation medicine department, the data of 182 patients (mean age, 47.8 years; M/F = 64/118) was obtained retrospectively. Spinopelvic parameters were measured through a whole-body low-dose biplanar radiography using the EOS imaging system, and balance function was evaluated by the center of pressure (COP) movement using the Zebris treadmill system. Pearson correlations were used to determine the relationship between radiographic and balance function. Stepwise multiple linear regression analyses were conducted with the balance function as a dependent variable and age and spinopelvic parameters as independent variables. Results Increased age, knee flexion (KF), pelvic tilt (PT), C7-central sacral line (C7-CSL) and C7 sagittal vertical axis (SVA), and decreased spino-sacral angle (SSA) were associated with both poor static and dynamic balance. Moreover, increased Cobb’s angle and decreased thoracic kyphosis (TK) and lumbar lordosis (LL) was associated with poor static balance. Increased pelvic incidence (PI) was related to poor dynamic balance. Increased age, Cobb’s angle, SVA, and decreased TK were risk factors for poor static balance. For dynamic balance, increased age, C7-CSL, and PT were risk factors for poor sagittal balance, whereas increased CAM-plumb line and PT were risk factors for poor coronal balance. Conclusions Balance function was associated with spinopelvic parameters in patients with LBP. Increased SVA, followed by increased PT, was the strongest independent factor associated with poor static and dynamic balance.
Determining a Cutoff Value for Hand Grip Strength to Predict Favorable Outcomes of Adult Spinal Deformity Surgery
Authors: Kwon Ohsang , Ham Dae-Woong , Kim Ho-Joong , Lee Sanghoon , Park Sang-Min , Yeom Jin S. 
Published: February 2022

Study Design Retrospective review. Objectives To establish a cutoff value for hand grip strength and predict the favorable outcomes of adult spinal deformity surgery. Summary of Background Data Hand grip strength (HGS) has been suggested to predict surgical outcomes in various fields, including adult spinal deformity (ASD). However, to the best of our knowledge, no study has established a cutoff value for HGS in patients with ASD. Methods This study included 115 female patients who underwent reconstructive spinal surgery for ASD between September 2016 and September 2020. HGS was measured preoperatively. The Oswestry Disability Index (ODI), EuroQOL-5-dimension (EQ-5D), and visual analog scale (VAS) scores for back pain were all recorded both before and after surgery. Patients were dichotomized either into favorable or unfavorable outcome groups using an ODI cutoff score of 22 at 1 year after surgery. Multivariate logistic regression analysis was done to identify significant factors leading to favorable outcomes. A receiver operating characteristic (ROC) curve was drawn to define the cutoff value of HGS for favorable outcomes. Results Multivariate logistic regression analysis showed that HGS is significantly associated with favorable surgical outcomes in ASD ( P = .031). The ROC curve suggested a cutoff value of 14.20 kg for HGS (area under the curve (AUC) = .678, P = .013) to predict favorable surgical outcomes in ASD. The surgical complications were not significantly affected by HGS. Conclusion The HGS of patients with ASD can be interpreted with a cutoff value of 14.20 kg. Patients with HGS above this cutoff value showed superior surgical outcomes at 1 year after surgery compared to those below this cutoff value.
A Validated Score for Evaluating Spinal Instability to Assess Surgical Candidacy in Active Spinal Tuberculosis—An Evidence Based Approach and Multinational Expert Consensus Study
Authors: Rajasekaran Shanmuganathan , Soundararajan Dilip Chand Raja , Reddy Gurijala Jyotheswara , Shetty Ajoy P. , Kanna Rishi Mugesh 
Published: February 2022

Study design Modified Delphi Consensus and Observational Study. Objective Instability in spinal tuberculosis (STB) leads to disabling spinal deformity and neurodeficit. Identifying and estimating instability remains subjective, mainly based on experience. This study aims to develop an objective scoring system to determine instability in STB. Materials and Methods The study included 4 phases. (1) A panel of 10 experienced spine surgeons developed a questionnaire based on literature. (2) 68 spine surgeons from 12 countries opined on the importance of each factor in a survey. Five factors deemed important by >70% of participants were further analyzed (3) 60 representative cases of STB were analyzed for instability. A preliminary scoring system was developed, a threshold score for determining instability was derived, and (4) Results were validated. Results All the 5 factors (“Spine at risk” signs, severity of vertebral body loss, Cervicothoracic/Thoracolumbar junction involvement, age ≤15, and kyphotic deformity ≥30°) considered important by >70% of participants were associated with instability and included in scoring: age ≤15 years ( P-value, 0.05), cervicothoracic/thoracolumbar junction involvement ( P-value, 0.028), sagittal deformity angle ratio (DAR) ≥ 15° ( P-value, <.001), vertebral body loss-segmental ratio ≥.5 ( P-value, <.001), and presence of spine at risk signs ( P-value, <.001). A total score of ≥3/09 indicated definite instability with good sensitivity (77%) and excellent specificity (100%). Repeatability assessment showed a good agreement (.9625), and Cohen’s kappa coefficient was strong (.809). Conclusion A simple objective scoring system for predicting instability in STB has been developed using 5 main factors; young age, junctional involvement, severity of the deformity, vertebral body loss, and presence of spine at risk signs.
Lumbar Disc Degeneration Affects the Risk of Rod Fracture Following PSO; A Finite Element Study
Authors: Vosoughi Ardalan Seyed , Shekouhi Niloufar , Joukar Amin , Zavatsky Michael , Goel Vijay K. , Zavatsky Joseph M. 
Published: February 2022

Study Design Finite element (FE) study. Objective Pedicle subtraction osteotomy (PSO) is a surgical method to correct sagittal plane deformities. In this study, we aimed to investigate the biomechanical effects of lumbar disc degeneration on the instrumentation following PSO and assess the effects of using interbody spacers adjacent to the PSO level in a long instrumented spinal construct. Methods A spinopelvic model (T10-pelvis) with PSO at the L3 level was used to generate 3 different simplified grades of degenerated lumbar discs (mild (Pfirrmann grade III), moderate (Pfirrmann grade IV), and severe (Pfirrmann grade V)). Instrumentation included eighteen pedicle screws and bilateral primary rods. To investigate the effect of interbody spacers, the model with normal disc height was modified to accommodate 2 interbody spacers adjacent to the PSO level through a lateral approach. For the models, the rods’ stress distribution, PSO site force values, and the spine range of motion (ROM) were recorded. Results The mildly, moderately, and severely degenerated models indicated approximately 10%, 26%, and 40% decrease in flexion/extension motion, respectively. Supplementing the instrumented spinopelvic PSO model using interbody spacers reduced the ROM by 22%, 21%, 4%, and 11% in flexion, extension, lateral bending, and axial rotation, respectively. The FE results illustrated lower von Mises stress on the rods and higher forces at the PSO site at higher degeneration grades and while using the interbody spacers. Conclusions Larger and less degenerated discs adjacent to the PSO site may warrant consideration for interbody cage instrumentation to decrease the risk of rod fracture and PSO site non-union.
Migration, Insecured Childhood and Social Exclusion: Issues and Challenges in Front of the Dalits in Urban Guwahati, Assam
Authors: Bhattacharjee Somenath 
Published: February 2022

Urbanization is a global phenomenon, and rapid urban growth can be noticed in different parts of India. Significantly, in search of better livelihood and income, a large section of people are getting migrated from rural to urban areas. However, is it becoming detrimental to their livelihood and socio-economic condition? In the modern world, the rights of the weaker sections of population in a nation-state, those of minorities, of the poor and the displaced people, are often ignored or encroached upon by the coercive state machinery or by the powerful class. Even sometime a few political circumstances play a major role, whether a community will have accessibility to the land and natural resources or not. Such a situation can be observed among a section of Bangladeshi refugees. Due to partition of India and after that during the formative period of Bangladesh, they were forced to get displaced and they came to India. A section of them and their children are struggling for livelihood in the slum areas of Guwahati, the largest urban centre of entire Northeast India. They are recognized as an undocumented migrant population group. They are deprived in every aspect from the fundamental rights of livelihood, and they have to face all sorts of livelihood obstacles, which are collectively excluding them from the developmental mainstream.
Periconception and Prenatal Exposure to Maternal Perceived Stress and Cord Blood DNA Methylation
Authors: Polinski Kristen J , Putnick Diane L , Robinson Sonia L , Schliep Karen C , Silver Robert M , Guan Weihua , Schisterman Enrique F , Mumford Sunni L , Yeung Edwina H 
Published: February 2022

Background: Maternal prenatal stress is associated with physiologic and adverse mental health outcomes in the offspring, but the underlying biologic mechanisms are unknown. We examined the associations of maternal perceived stress, including preconception exposure, with DNA methylation (DNAm) alterations in the cord blood buffy coats of 358 singleton infants. Methods: Maternal perceived stress was measured prior to and throughout pregnancy in a cohort of women enrolled in Effects of Aspirin in Gestation and Reproduction Trial (EAGeR) trial. Perceived stress assessments based on a standardized Likert-scale were obtained in periconception (~2 months preconception and 2-8 weeks of gestation) and pregnancy (8-36 weeks of gestation). Cumulative perceived stress was estimated by calculating the predicted area under the curve of stress reported prior to and during pregnancy. DNAm was measured by the Infinium MethylationEPIC BeadChip. Multivariable robust linear regression was used to assess associations of perceived stress with individual CpG probes. Results: Based on a 0 to 3 scale, average reported preconception and early pregnancy stress were 0.76 (0.60) and 0.67 (0.50), respectively. Average mid- to late-pregnancy stress, based on a 0 to 10 scale, was 4.9 (1.6). Neither periconception nor pregnancy perceived stress were associated with individual CpG sites in neonatal cord blood (all false discovery rate [FDR] >5%). Conclusion: No effects of maternal perceived stress exposure on array-wide cord blood neonatal methylation differences were found.