bluuebunny/crossref_metadata_2025_split huggingface dataset:
Craniospinal irradiation high dose as independent predictor of permanent alopecia in childhood medulloblastoma survivors: cohort study and literature review
Authors: Satragno Camilla , Verrico Antonio , Giannelli Flavio , Ferrero Alfonso , Campora Sucheeta , Turazzi Marianna , Cavagnetto Francesca , Schiavetti Irene , Garrè Maria Luisa , Garibotto Federica , Milanaccio Claudia , Piccolo Gianluca , Crocco Marco , Ramaglia Antonia , Profio Sonia Di , Barra Salvina , Belgioia Liliana 
Published: September 2022

Abstract
Purpose
Our aim was to determine the main risk factors related to the occurrence of permanent alopecia in adult survivors of childhood medulloblastoma (MB) to improve their quality of life.
Methods
We retrospectively analysed the clinical features of all consecutive survivors of MBtreated at our Institute. We divided the patients into 3 groups depending on the craniospinal irradiation (CSI) dose received and defined permanent alopecia first in terms of the skin region affected (whole skin and nape region) then on the basis of the toxicity degree (G).
Any relationship between alopecia and other characteristics was investigated by a univariate and multivariate analysis and Odds ratio (OR) with confidence interval (CI) was reported.
Results
We analysed data from 41 patients with a 10-year follow-up. High dose of CSI was found to be the independent factor leading to permanent hair loss in both groups: alopecia of the whole skin (G1 p-value 0.030, G2 p-value 0.003) and of the nape region (G1 p value 0.038, G2 p value 0.006).
The posterior cranial fossa (PCF) boost volume and dose were not significant at multivariate analysis neither in permanent hair loss of the whole skin nor only in the nuchal region.
Conclusion
In paediatric patients with MB, the development of permanent alopecia seems to depend only on the CSI dose exceeding 36 Gy. Acute damage to the hair follicle is dose dependent, but in terms of late side effects, constant and homogeneous daily irradiation of a large volume may have a stronger effect than a higher but focal dose of radiotherapy.
Patients’ experience of medication brand changes during hormone therapy for breast cancer. An Interpretative Phenomenological Analysis
Authors: Eraso Yolanda , Moon Zoe , Steinberga Ieva 
Published: September 2022

Abstract

Purpose Medication adherence to hormone therapy (HT) in breast cancer survivors is often suboptimal, and is affected by a range of factors. Patients are usually prescribed different generic formulations of HT drugs and their impact on side effects and on adherence and persistence is poorly understood. This study aimed to explore women’s lived experience of HT medication brand changes (generic substitution), its impact on side effects, quality of life and medication-taking behaviours as well as on adherence and persistence. Methods Nine female breast cancer survivors who had previous experience of HT medication brand changes participated in the study. Individual, online, semi-structured interviews were conducted and analysed using Interpretative Phenomenological Analysis. Results The findings identified three superordinate themes and nine subordinate themes which influenced the lived experience of medication brand changes for these patients: (i) experiencing brand changes; (2) responsiveness of health care providers; and (iii) future expectations. Conclusions Women reported negative physical and emotional experiences of brand changes, which is often compounded by healthcare professionals’ lack of information and reassurances, disbelief in the worsening of side effects, and inconsistent advice regarding generics. This has implications for women’s self-efficacy for medication-taking behaviours, ability to manage side effects, and HT adherence and persistence.
Assessing Camouflaging in the Spanish Population: Cultural Adaptation of the Camouflaging Autistic Traits Questionnaire for Spain
Authors: Mosquera Miguel Lois , Zubizarreta Sabela Conde-Pumpido , Fungueiriño María Tubío , Navarro María Alemany , Hull Laura , Álvarez Angel Carracedo , Gafo Berta Gándara , Prieto Montse Fernández 
Published: September 2022

Abstract
Purpose: Misdiagnosis or late diagnosis in Autism Spectrum Disorder (ASD), especially for women without intellectual disability, has been partly attributed to camouflaging. However, in Spain there is a need for culturally adapted tools with gender perspective when assessing autism. Therefore, the main object of this study was to adapt the Camouflaging Autistic Traits Questionnaire (CAT-Q) for use in the Spanish population.
Method: A internationally established method for cultural adaptations was carried out. The procedure consisted of direct and back translation process, cognitive interviews in 7 participants from 16 years old diagnosed with ASD living in Spain and a linguistic expert review.
Results: The translation process resulted in a tool culturally adapted to the Spanish population. Cognitive interviews revealed no serious difficulties, with only 3 problematic items.
Conclusion: The CAT-Q-Spanish is conceptually and semantically equivalent to the original tool and provides a camouflage measure for Spanish adolescents and adults diagnosed with ASD.
Pregnancy-specific beta-1-glycoprotein 1-enriched exosomes involves in the regulation of maternal vascular endothelial function during pregnancy
Authors: Jia Linyan , Huang Xiaojie , Peng Hao , Jia Yuanhui , Zhang Ruonan , Wei Yingying , Wei Mengtian , Wang Ruixue , Li Han , He Qizhi , Wang Kai 
Published: September 2022

Abstract
Background
Pregnancy is a dynamic process associated with significant physiological changes in the cardiovascular system. It is well known that during pregnancy, the placenta secretes a variety of molecular signals, including of exosomes into the maternal circulation to adapt to increased blood volume and maintain blood pressure at normotensive levels.
Results
In the present study, we compared the effects of exosomes derived from peripheral blood serum of nonpregnant women (NP-Exo) and normal pregnant women (P-Exo) on endothelial cell function. We also analyzed the proteomic profiles of these two groups of exosomes and the molecular mechanisms underlying the effect of exosome cargoes on maternal vascular function. We found that P-Exo was positively involved in regulating the function of maternal vascular endothelial cells, promoting nitric oxide (NO) release and maintaining maternal blood pressure at normal levels. Furtherly, we revealed that trophoblast-derived pregnancy-specific beta-1-glycoprotein 1 (PSG1)-enriched exosomes treatment induced promotion of human umbilical vein endothelial cells (HUVECs) proliferation and migration, as well as the release of NO. Moreover, we observed that treating mice with P-Exo induced the activation of renin-angiotensin system, although there was no significant change in blood pressure in mice.
Conclusions
These results strongly suggested that PSG1-enriched exosomes derived from maternal peripheral blood regulate the function of vascular endothelial cells and plays an important role in regulating maternal blood pressure during pregnancy.
Effect of compost on the nitrate phytoremediation by the mung bean plant
Authors: Farasati Masumeh , Ferdous Tanveer Saeed , Nazarpoor Reza , moghaddam Ali Nakhzari 
Published: September 2022

Abstract
The present study aims to investigate the effect of compost on the nitrate absorption capability
of the mung bean plant by employing the phytoremediation method. The examined factors at 7
levels include nitrate alone at concentration levels of 10, 30 and 50 mg/L, nitrate at concentration
levels of 10, 30 and 50 mg/l together with compost and control treatment (compost- and
nitrate-free soil) along with soil depth at three levels of 0-10, 10-20 and 20-30 cm.The highest wet
weights of the plant during the pod setting and maturity stages corresponding to the roots, were
estimated as 36.97and 17.69 g in the compost+nitrate treatment at concentration level of
50 mg/L (SCn3), respectively. However, the lowest wet weight during the pod setting
stage was recorded in the plant shoot as 4.87 g (control treatment) while it was measured as
6.41 g for the leaf during the maturity stage in the compost+irrigation treatment with a nitrate
concentration of 30 mg/l (Scn2). Furthermore, the highest plant’s dry weight (103.3 g) was
related to the plant root and irrigation treatment with 50 mg/l nitrate (Sn3) while the lowest
one (26.7 g) was associated with the leaf and control treatment. According to the results obtained,
during the pod setting stage, the nitrate uptake rate by mung bean root and shoot increased
with the increasing compost. Moreover, at high nitrate concentration levels, the effect of compost
on the nitrate uptake rate by the mung bean plant was greater and this matter was eventually transferred to the plant shoot.
Pregnancy through the lens of breast cancer survivors: A qualitative study in an Iranian setting
Authors: Azizi Marzieh , Ebrahimi Elham , Moghadam Zahra Behboodi , Shahhosseini Zohreh , Modarres Maryam 
Published: September 2022

Abstract
Background
As recently the number of breast cancer (BC) survivors has increased, the potential desire to conceive a child after completing treatments is a significant concern among survivors. This study aimed to explore the experiences and perceived needs of pregnancy through the lens of BC survivors.
Methods
This qualitative study with content analysis approach was conducted between August 2021 and February 2022. Data was collected through in-depth semi-structured, face-to-face interviews, and 16 BC survivors were selected by purposive sampling at two referral centers in Sari, Northern Iran. Interviews were audio recorded, transcribed verbatim, and analyzed concurrently. Then interviews were coded and categorized using MAXQDA 12.
Results
As a result of data analysis, six main categories and 13 subcategories were extracted. Six main categories including "pregnancy and childbirth problems", "maternal mental health problems", "social problems", "marital instability", "need to support and need to resort to spirituality".
Conclusions
Since pregnancy is a stressful event in women's life, especially for women with BC, these women need to be counseled and prepared for a healthy pregnancy by their healthcare providers. Also, improving the healthcare professional's knowledge regarding the pregnancy complications of these women is crucial to providing high-quality care for BC survivors.
Cardiovascular Risk Factors Predict Age at Death in 60-year Follow-up of the Seven Countries Study
Authors: Puddu Paolo Emilio , Menotti Alessandro , Jac David R Jr , Adachi Hisashi , Kafatos Anthony , Tolonen Hanna 
Published: September 2022

Abstract
Objectives. To study age at death (AD) and its determinants in cohorts of middle-aged men followed-up until extinction.
Material and Methods. A total of 9063 middle aged men enrolled in 10 cohorts of 6 countries (USA, Finland, the Netherlands, Italy, Greece and Japan) within the Seven Countries Study were examined and then followed-up for 60 years until extinction. AD was computed and a small number of risk factors were tested through multiple linear regression as possibly related to attained AD.
Results. AD ranged across cohorts from 71.8 years in East Finland and 80.5 years in Crete with levels roughly lower in the USA and Northern Europe and higher elsewhere. Across cohorts the correlation coefficients of systolic blood pressure (R=-0.58) and of CVD prevalence (R=-0.65) versus average AD were the only significant ones. At individual level in the pool of all cohorts, a multiple linear regression model showed that age, vigorous physical activity, never and ex-smokers were favorably related to AD, while the reverse was true for systolic blood pressure, heart rate, serum cholesterol, CVD prevalence and silent ECG abnormalities. BMI had a parabolic relationship with AD. The predicting power of single risk factors, expressed in years gained or lost, was relatively small, but arbitrary combinations of several of them produced large differences in AD.
Conclusions. A small number of CVD risk factors were strongly associated with AD in a life-long follow-up.
Chaotic guided local search algorithm for solving optimization problems
Authors: Naanaa Anis 
Published: September 2022

Abstract
Chaos optimization algorithm (COA) can be an interesting alternative in a global optimization problem. Due to the non-repetition and ergodicity of chaos, it can explore the global search space at higher speeds than stochastic searches that depend on probabilities. To adjust the solution obtained by COA, guided local search algorithm (GLS) is integrated with COA to form a hybrid algorithm. The results show that the present algorithms significantly outperforms the existing methods in terms of con- vergence speed, numerical stability and a better optimal solution than other algorithms.
Co-infection at the Time of Hospital Admission in Patients with COVID-19 Infection
Authors: Cherian Susan , Jangla Sunayana Mukesh , Naidu Raji 
Published: September 2022

Background: Co-infections with Severe Acute Respiratory Syndrome Corona Virus 2 (SARS-CoV-2) lead to unfavourable outcomes. However, data on prevalence of various co-infections in SARS-CoV-2 positive patients on admission to the hospital is sparse. This study focusses on assessing co-infection rates and common pathogenic bacteria and fungus involved in these patients.
Methods: Patients admitted between April 2020 and December 2020 with Corona Virus Disease-2019 (COVID-19) were included. Criteria for co-infection using definitions were developed. All microbiological investigations of these patients performed within first 48 hours of admission were analysed. Their demographic characteristics along with existing co-morbidities, presenting symptoms, other laboratory findings on admission and clinical outcome were also reviewed.
Results: Of 1566 patients, 60% were males.64% belonged to 13-65 years age-group. 4% of COVID-19 positive patients were co-infected. 451 samples were received for culture of which urine were 66%, blood 23% and sputum 11%. 15% samples showed growth of which urine were 19%, blood 10% and sputum 2%. Bacteria isolated were 91% and fungus 9%. The common bacteria isolated were E. coli 46%, Klebsiella pneumoniae 25%, Stenotrophomonas maltophila 6% and Pseudomonas aeruginosa 4%. The common fungus isolated was Candida species 7%.10% of COVID-19 positive patients with co-infection expired and 90% recovered.
Conclusion: We report a 4% rate of bacterial and fungal co-infection in COVID-19 positive patients on admission mostly related to Enterobacterales, Non-fermenting Gram-negative bacilli and Candida species. This data can be valuable in optimising the use of antibiotics and antifungals in our patients. Similar studies on co-infection and its various aspects are the need of the hour.
To Study the Role of Bone Marrow Aspiration in Etiological categorization of Pediatric Pancytopenia
Authors: Baig Mirza Asif , KB Swamy , Sharaf Fawzia , Mehmood Ibrahim , Baksh Ameen K , Moshrif Yasser , Bahashwan Ahmed , Mahajabeen Sara , El Attar Lama , Al Mutairi Nabeel , Khan Anas , Al Harbi Hajer , Multani Iqbal , Al Mutairi Nawal , Al sulami Mishal , Al Harbi Nader , Al Harbi Marwa 
Published: September 2022

Background: Pancytopenia is a Clinico-hematological entity, characterized by a triad of Anemia, leucopenia, and thrombocytopenia. The criterion for defining Pancytopenia is HGB < 9 g/dl: ANC < 1.5 x 109/L and platelet count <100 x 109/L. The main objective of this study is to categorize pediatric pancytopenia’s on etiological basis and to study the age wise incidence.
Methodology and Results: This is a 5-year study (2016-2021) conducted in tertiary care pediatric referral hospital. All data were expressed as Mean +/ - SD and p value <0.05 is taken as statistically significant. A total of 500 bone marrow smears of pancytopenic patients were studied, of which 60% were boys & 40% girls, 64% constituted Malignant diseases and 36% were benign. Incidence wise, ALL is the most common and pancytopenia being 2nd and together comprises 64% of total cases. Some rare cases like AML –M6 in 2 months old, Chediak higashi syndrome and Familial Hemophagocytic syndrome were noted. Flow cytometry and Molecular genetics were done were ever required.
Conclusion: Bone Marrow Aspiration is a reliable and sensitive test which can be used in investigation of Pediatric pancytopenia’s and if used meticulously with other routine hematological tests can give a high diagnostic accuracy. ALL is most common in our study (other studies showed Aplastic anemia), AML-M6 in 2 months, LD bodies in bone marrow, HPS were amongst the rare cases
Determination of Enterococcal Virulence Factors Expression and Impact of Biofilm Formation on Antimicrobial Susceptibility Pattern
Authors: Patel Kinjal Prashant , Mulla Summaiya 
Published: September 2022

Introduction: Enterococcus spp. has become recognized as a significant cause of hospital-acquired infections. Two main virulence factors namely gelatinase and hemolysin of Enterococci have been proved to cause severe infections. In addition, biofilm formation is causing infection by enhancing the persistence of Enterococci in medical indwelling devices. Therefore, the study aimed to evaluate the presence of hemolysin, gelatinase, and biofilm formation in Enterococcus spp. and the impact of biofilm on antimicrobial susceptibility patterns.
Materials & Methods: Total 104 Enterococcal isolates obtained from different clinical samples were included in the study for expression of virulence factors. All isolates were evaluated for biofilm formation by the tissue culture plate method. Hemolysin production was checked by using 5% sheep blood agar and gelatinase production by peptone yeast extract agar containing 3% gelatin. Antimicrobial susceptibility testing was done by the Vitek2 compact automated system.
Results: Out of 104 isolates, 1(1%) were strong biofilm producers while 4(3.85% %) and 54(52%) were moderate and weak biofilm producers respectively. Hemolysin production was observed in 19(18%) isolates and gelatinase production was universal.
Conclusion: Biofilm-producing strains showed higher resistance to beta-lactam drugs and high-level aminoglycosides. Hence, amongst three virulence factors, studying biofilm formation can be an important tool to develop a hospital’s antibiotic policy and other virulence factors can be helpful to understand the pathogenesis of infection caused by Enterococcus spp. as well as for antimicrobial usage strategies.
Reinterpretation of Health Information in the Context of an Emerging Infectious Disease: A Digital Focus Group Study
Authors: Tan Rayner Kay Jin , Lim Jane Mingjie , Neo Pearlyn Hui Min , Ong Suan Ee 
Published: September 2022

Background
Misinformation related to the COVID-19 pandemic has accelerated global public concern and panic. The glut of information, or “infodemic,” has caused concern for authorities due to its negative impacts on COVID-19 prevention and control, spurring calls for a greater scholarly focus on health literacy during the pandemic. Nevertheless, few studies have sought to qualitatively examine how individuals interpreted and assimilated health information at the initial wave of COVID-19 restrictions.

Objective
We developed this qualitative study adopting chat-based focus group discussions to investigate how individuals interpreted COVID-19 health information during the first wave of COVID-19 restrictions.

Methods
We conducted a qualitative study in Singapore to investigate how individuals perceive and interpret information that they receive on COVID-19. Data were generated through online focus group discussions conducted on the mobile messaging smartphone app WhatsApp. From March 28 to April 13, 2020, we held eight WhatsApp-based focus groups (N=60) with participants stratified by age groups, namely 21-30 years, 31-40 years, 41-50 years, and 51 years and above. Data were thematically analyzed.

Results
A total of four types of COVID-19 health information were generated from the thematic analysis, labeled as formal health information, informal health information, suspicious health information, and fake health information, respectively. How participants interpreted these categories of information depended largely on the perceived trustworthiness of the information source as well as the perceived veracity of information. Both factors were instrumental in determining individuals’ perceptions, and their subsequent treatment and assimilation of COVID-19–related information.

Conclusions
Both perceived trustworthiness of the information source and perceived veracity of information were instrumental concepts in determining one’s perception, and thus subsequent treatment and assimilation of such information for one’s knowledge of COVID-19 or the onward propagation to their social networks. These findings have implications for how policymakers and health authorities communicate with the public and deal with fake health information in the context of COVID-19.
The association between iron deficiency anemia and obesity in children
Authors: Atrushi Akrem M. , Armishty Farhad , Saleh Sirwan A. , Abdulrahman Mehvan Sh. 
Published: September 2022

Objectives: To examine the association between obesity and iron status and the presence of iron deficiency anemia in children.
Methods: This case-control study included 100 children between 2-14 years of age who were divided into two age- and sex- matched equal groups of 50 children each. Children with a body mass index (BMI) greater than or equal to 95th centile were categorized as obese while the other 50 children with a BMI greater than or equal to 5th centile but less than 95th centile were considered the normal weight group. Children with cardiac disease, liver disease, chronic gastrointestinal disease and chronic hematologic disorders except iron deficiency (with or without anemia) and those taking Vitamin or mineral supplements regularly during the previous year were excluded. Each participant was sent for serum iron, ferritin, total iron binding capacity (TIBC), transferrin saturation TS and complete blood count. Iron deficiency is defined as Transferrin Saturation (TS) lower than 16% and IDA is defined as TS lower than 16% and hemoglobin (Hb) concentration lower than 120 g/l or 12 mg/dl for children. The data were analyzed using SPSS-23 software and for all data normal distribution was tested so that P-value<0.05 is the level of threshold for statistical significance.
Results: The gender distribution between the both group is reversed with male being more common in obese group but no statistical difference. The age distribution shows dominance of the age group 5-10 years in the both group with some differences which are of no statistical significance (P=0.294). The values of Hemoglobin, serum iron, serum ferritin, total iron binding capacity and transferrin saturation are obviously similar between the both genders of the whole study population with no statistically significant differences (P=0.084, 0.469, 0.48,0.4, 0.571 respectively). Obese children have higher level of Hemoglobin(P=0.069), Ferritin(P=0.5) and total iron binding capacity(P=0.449) but lower levels of serum iron (P =0.234) and transferrin saturation(P=0.45) but with no statistical significance.
Conclusion: There is no significant association between obesity and iron status and the presence of iron deficiency anemia despite a lower level of serum iron and lower transferrin saturation in obese than normal weight children.