bluuebunny/crossref_metadata_2025_split huggingface dataset:
Using outbreak data to estimate the dynamic COVID-19 landscape in Eastern Africa
Authors: Wamalwa Mark , Tonnang Henri E. Z. 
Published: June 2022

Abstract
Background
The emergence of COVID-19 as a global pandemic presents a serious health threat to African countries and the livelihoods of its people. To mitigate the impact of this disease, intervention measures including self-isolation, schools and border closures were implemented to varying degrees of success. Moreover, there are a limited number of empirical studies on the effectiveness of non-pharmaceutical interventions (NPIs) to control COVID-19. In this study, we considered two models to inform policy decisions about pandemic planning and the implementation of NPIs based on case-death-recovery counts.

Methods
We applied an extended susceptible-infected-removed (eSIR) model, incorporating quarantine, antibody and vaccination compartments, to time series data in order to assess the transmission dynamics of COVID-19. Additionally, we adopted the susceptible-exposed-infectious-recovered (SEIR) model to investigate the robustness of the eSIR model based on case-death-recovery counts and the reproductive number (R0). The prediction accuracy was assessed using the root mean square error and mean absolute error. Moreover, parameter sensitivity analysis was performed by fixing initial parameters in the SEIR model and then estimating R0, β and γ.

Results
We observed an exponential trend of the number of active cases of COVID-19 since March 02 2020, with the pandemic peak occurring around August 2021. The estimated mean R0 values ranged from 1.32 (95% CI, 1.17–1.49) in Rwanda to 8.52 (95% CI: 3.73–14.10) in Kenya. The predicted case counts by January 16/2022 in Burundi, Ethiopia, Kenya, Rwanda, South Sudan, Tanzania and Uganda were 115,505; 7,072,584; 18,248,566; 410,599; 386,020; 107,265, and 3,145,602 respectively. We show that the low apparent morbidity and mortality observed in EACs, is likely biased by underestimation of the infected and mortality cases.

Conclusion
The current NPIs can delay the pandemic pea and effectively reduce further spread of COVID-19 and should therefore be strengthened. The observed reduction in R0 is consistent with the interventions implemented in EACs, in particular, lockdowns and roll-out of vaccination programmes. Future work should account for the negative impact of the interventions on the economy and food systems.
Visual outcomes of observation, macular laser and anti-VEGF in diabetic macular edema in type 1 diabetes: a real-world study
Authors: Wirkkala Joonas , Kubin Anna-Maria , Ohtonen Pasi , Yliselä Joona , Siik Taru , Hautala Nina 
Published: June 2022

Abstract
Background
The treatment for diabetic macular edema (DME) has revolutionized during the last 15 years after the introduction of intravitreal anti-VEGF agents. The aim of the current study is to evaluate the real-world visual outcomes of diabetic macular edema (DME) treatment in patients with type 1 diabetes (T1D) in long-term follow-up.

Methods
A real-world, descriptive, population-based cohort and follow-up of all patients with T1D and DME in 2006-2020 in 34 communities of the Northern Ostrobothnia Hospital District. The main outcome measures included age, gender, duration of T1D at the onset of DME, stage of retinopathy, treatment of DME (observation, laser, intravitreal treatments, combination), and visual outcomes.

Results
A total of 304 eyes of 206 T1D patients with DME were included. 75% (n=155) had non-proliferative diabetic retinopathy during the onset of DME. 15% of the cases were observed, 33% had macular laser, 41% intravitreal anti-VEGF and 12% combination of laser and intravitreal injections. Patients in anti-VEGF and in combination groups gained 4.9 and 5.5 ETDRS letters after the initial DME episode (p<0.001 and p<0.001), and the long-term visual improvements were 4.1 and 5.1 ETDRS letters (p<0.001 and p<0.001), respectively. In observation and laser groups the initial gain of 0.1 (p>0.90) and loss of 0.4 ETDRS letter (p=0.61), respectively, was noted. After the follow-up, a 3.7 ETDRS letter decrease was documented in the observation group (p>0.90) and a 1.1 (p=0.14) ETDRS letter decline in the laser group of patients. At the beginning of treatment, eyes subjected to anti-VEGF alone or in combination with laser had lower visual acuity compared to eyes subjected to observation or macular laser. The average of a 6.1±4.8 anti-VEGF injections were needed to dry DME. Visual impairment due to DME decreased from 2.4% to 1.0% during the 15-year period.

Conclusions
Anti-VEGF alone or in combination with macular laser seems to be beneficial in terms of visual outcomes and treatment stability in T1D patients with central DME.
Moreover, satisfying long-term visual outcomes were achieved with anti-VEGF treatment in a real-world setting.
Inequalities in the prevalence of stunting, anemia and exclusive breastfeeding among African children
Authors: Ekholuenetale Michael , Okonji Osaretin Christabel , Nzoputam Chimezie Igwegbe , Barrow Amadou 
Published: June 2022

Abstract
Background
Childhood stunting and anemia are on the increase in many resource-constrained settings, without a counter increase in proper feeding practices such as exclusive breastfeeding. The objective of this study was to explore the prevalence of stunting, anemia and exclusive breastfeeding across African countries.

Methods
Demographic and Health Survey (DHS) data from 39 African countries was analyzed. Data from under 5 children were analyzed. Forest plot was used to determine inequalities in the prevalence of the outcome variables.

Results
The prevalence of stunting was highest in Burundi (56%), Madagascar (50%) and Niger (44%). In addition, Burkina Faso (88%), Mali (82%), Cote d’Ivoire and Guinea (75% each) and Niger (73%) had the highest prevalence of anemia. Furthermore, Burundi (83%), Rwanda (81%) and Zambia (70%) had the highest exclusive breastfeeding. We found statistical significant difference in the prevalence of stunting, anemia and exclusive breastfeeding (p < 0.001). Higher prevalence of stunting and anemia were estimated among the male, rural residents, those having mothers with low education and from poor household wealth.

Conclusion
Concerted efforts are required to improve childhood health, survival and proper feeding practice. Reduced stunting and anemia could be achieved through sustained socioeconomic improvement that is shared in equity and equality among the population. Interventions aimed at increasing food availability can also aid in the reduction of hunger, particularly in impoverished communities.
Study protocol: cohort event monitoring for safety signal detection after vaccination with COVID-19 vaccines in Iran
Authors: Aliyari Roqayeh , Mahdavi Sepideh , Enayatrad Mostafa , Sahab-Negah Sajad , Nili Sairan , Fereidooni Mohammad , Mangolian shahrbabaki Parvin , Ansari-Moghaddam Alireza , Heidarzadeh Abtin , Shahraki-Sanavi Fariba , Amini Moridani Mohammadreza , Fateh Mansooreh , Khajeha Hamidreza , Emamian Zahra , Behmanesh Elahe , Sharifi Hamid , Emamian Mohammad Hassan 
Published: June 2022

Abstract
Background
New vaccines that are initially approved in clinical trials are not completely free of risks. Systematic vaccine safety surveillance is required for ensuring safety of vaccines. This study aimed to provide a protocol for safety monitoring of COVID-19 vaccines, including Sputnik V, Sinopharm (BBIBP-CorV), COVIran Barekat, and AZD1222.

Methods
This is a prospective cohort study in accordance with a template provided by the World Health Organization. The target population includes citizens of seven cities in Iran who have received one of the available COVID-19 vaccines according to the national instruction on vaccination. The participants are followed for three months after they receive the second dose of the vaccine. For each type of vaccine, 30,000 people will be enrolled in the study of whom the first 1,000 participants are in the reactogenicity subgroup. The reactogenicity outcomes will be followed seven days after vaccination. Any hospitalization, COVID-19 disease, or other minor outcomes will be investigated in weekly follow-ups. The data are gathered through self-reporting of participants in a mobile application or phone calls to them. The study outcomes may be investigated for the third and fourth doses of vaccines. Other long-term outcomes may also be investigated after the expansion of the follow-up period. We have planned to complete data collection for the current objectives by the end 2022.

Discussion
The results of this study will be published in different articles. A live dashboard is also available for managers and policymakers. All data will be available on reasonable requests from the corresponding author.The use of the good and comprehensive guidelines provided by WHO, along with the accurate implementation of the protocol and continuous monitoring of the staff performance are the main strengths of this study which may be very useful for policymaking about COVID-19 vaccination.
Primary hyperparathyroidism in Saudi Arabia revisited: a multi-centre observational study
Authors: Al-Saleh Yousef , AlSohaim Abdullah , AlAmoudi Reem , AlQarni Ali , Alenezi Raed , Mahdi Layla , Alzanbaqi Hend , Nawar Samah M. , AlHarbi Hibah , ALMulla Abdulrhman , Al Qahtani Maryam , Salih Salih Bin , Al Anazi Faisal , Saleh Najla , Saleh Seham , AlAklabi Ali , Sabico Shaun , Al-Daghri Nasser M. 
Published: June 2022

Abstract
Purpose
Primary hyperparathyroidism (PHPT) is a common cause of hypercalcemia and remains understudied within the Arabian population. The present study, the largest of its kind within the Gulf Cooperation Council (GCC) countries, aims to determine the demographics and clinical presentation of PHPT in Saudi Arabia.

Methods
In this multi-center retrospective study involving three tertiary hospitals in different geographic locations of Saudi Arabia namely, Riyadh, Al Ahsa and Jeddah, a total of 205 out of 243 confirmed PHPT cases aged 16 to 93 years old were included (N = 96 from Riyadh; N = 59 from Al Ahsa and N = 50 from Jeddah). Demographics, clinical manifestations and surgical outcomes were recorded as well as laboratory and radiologic investigations including serum parathyroid hormone (PTH), 25(OH)D, adjusted calcium, estimated glomerular filtration rate (eGFR) and nuclear scan outcome.

Results
PHPT cases appeared to increase over time when compared to other local studies published so far, with 12.8 cases per 100,000 hospital population. Females outnumber males (3:1) with 86% seen as out-patients. The average age was 59.8 ± 15.5 years. Abnormal PTH scan was seen in 171 patients (83.4%). Kidney stones was the most common renal manifestation (32 cases, 15.6%) and osteoporosis was the most common skeletal manifestation (67 cases, 32.7%). Al Ahsa had the highest prevalence of multiple comorbidities at 54% and the highest prevalence of obesity as a single comorbidity (17%) compared to other regions (p < 0.05). Jeddah recorded the highest prevalence of osteoporosis with bone and joint pains (30%) (p < 0.05).

Conclusion
Comparison of present data with previous local studies suggest an increasing trend in PHPT cases in Saudi Arabia. Regional variations in the clinical presentation of PHPT were observed and warrant further investigation.
Implications of regulator of G-protein signaling 5 expression in the pathogenesis of primary and secondary hyperparathyroidism
Authors: Li Xin , Lu Yao , Zhang Ling , Song Aiping , Zhang Honglei , Pang Bo , Liu Jun , Sun Xiaoliang , Ji Haoyang , Huang Linping , Yang Meng 
Published: June 2022

Abstract
Objective
To study the protein and mRNA expressions of regulator of G-protein signaling 5 (RGS5) in the pathogenesis of hyperparathyroidism.

Methods
The expression of RGS5 protein in 20 primary hyperparathyroidism (PHPT), 31 secondary hyperparathyroidism (SHPT), and 20 control cases were studied by immunohistochemistry (IHC). The expression of RGS5 mRNA in 15 PHPT, 102 SHPT, and 7 normal parathyroid tissue were measured by quantitative real-time PCR (qRT-PCR) method.

Results
The expressions of RGS5 in PHPT tissues were significantly higher than that in SHPT and normal parathyroid tissues (P < 0.05). While the differences in RGS5 protein expressions between SHPT and respective control samples were not statistically significant (P > 0.05). Likewise, the RGS5 mRNA expression in PHPT was significantly higher than that in SHPT (P < 0.05) and normal parathyroid (P < 0.05) samples. In a similar line, the differences in RGS5 gene expressions between SHPT and control tissues were not statistically significant (P > 0.05).

Conclusions
The characteristic RGS5 protein and mRNA levels in hyperparathyroidism might be helpful in discovering the pathomechanism of hyperparathyroidism and novel therapeutic targets as well.
Factors influencing medical students’ approaches to learning in Qatar
Authors: Qureshi Sheila S. , Larson Adam H. , Vishnumolakala Venkat R. 
Published: June 2022

AbstractBackgroundThis study investigated the relevance of the revised 2-factor study process questionnaire (R-SPQ-2F) for exploring medical students’ approaches to learning in Qatar and identify how factors like gender, age, educational attainment, and prior experience with health care influence students’ adoption of deep approaches to learning.MethodsThe sample consisted of 108 medical students (44% male, 56% female) from all four years of medical school at Weill Cornell Medicine-Qatar (WCM-Q). Participants completed the 20-item R-SPQ-2F questionnaire to measure their learning approaches through a structural model contrasting deep and surface learning. Participants also completed a survey collecting demographic information.ResultsStatistical analysis revealed significant differences in deep learning approaches across year levels for both men and women. Additionally, educational attainment played a significant role in students’ approaches to learning.ConclusionsBased on structural equation modeling, this cross-verification study supports the R-SPQ-2F instrument and offers additional evidence for its robustness and application to medical education. These findings may help educational and program leaders in Qatar better understand medical students’ learning approaches to enhance their pedagogical practices.
Coping strategies adopted by medical residents in dealing with work-related stress: a mixed-methods study
Authors: Manzoor Shamaila , Sajjad Madiha , Anwar Idrees , Rafi Aisha 
Published: June 2022

Abstract
Background
This study was carried out to identify and explore the difference in coping strategies for dealing with stress; adopted by medical residents in surgical and nonsurgical specialties.

Methods
A mixed methods approach, was chosen for this study. In phase one (quantitative); data were collected by a web-based survey, using a structured questionnaire. This survey was carried out in five major teaching hospitals of Rawalpindi & Muzaffarabad in 2020. Purposive sampling was done and data were analysed using SPSS, recording frequencies and major trends. In phase two (qualitative); six focus group discussions were carried out with 24 participants, using semi-structured questions and prompts. Convenient sampling was done from the cohort of phase 1. These focus group discussions, explored the various coping strategies adopted by medical residents. Later, the data were analysed manually for development of codes, sub-themes and themes.

Results
Out of 250 (100%) participants, 146 (58%) participants responded to the online survey. Surgical residents had a higher response rate (60%, n = 87) than nonsurgical residents. Moreover, female participation (54%, n = 79) was greater than male participation (46%, n = 67). The Mann-Whitney U test was statistically significant only for seeking medical advice to cope with stress (P = .029). There was no statistically significant difference found between the coping strategies, employed by medical residents.
In focus group discussions, female involvement was more (58% n = 14) than their counterparts. Four main themes were developed after data analysis: self-regulation, tailor-made strategies, educational focus and support system. Finally, minor differences were obtained qualitatively; like, socializing is preferred by surgical residents whereas, spiritualism is chosen by nonsurgical residents.

Conclusion
Quantitatively, no significant differences were found between the coping strategies of medical residents, against work-related stress. However, minor differences were obtained qualitatively due to difference in job demands and level of burnout between these two specialities.
A unique self-truncation of bacterial GH5 endoglucanases leads to enhanced activity and thermostability
Authors: Wu Mei-Huey , Kao Mu-Rong , Li Chen-Wei , Yu Su-May , Ho Tuan-Hua David 
Published: June 2022

AbstractBackgroundβ-1,4-endoglucanase (EG) is one of the three types of cellulases used in cellulose saccharification during lignocellulosic biofuel/biomaterial production. GsCelA is an EG secreted by the thermophilic bacteriumGeobacillussp. 70PC53 isolated from rice straw compost in southern Taiwan. This enzyme belongs to glycoside hydrolase family 5 (GH5) with a TIM-barrel structure common among all members of this family. GsCelA exhibits excellent lignocellulolytic activity and thermostability. In the course of investigating the regulation of this enzyme, it was fortuitously discovered that GsCelA undergoes a novel self-truncation/activation process that appears to be common among GH5 enzymes.ResultsThree diverse Gram-positive bacterial GH5 EGs, but not a GH12 EG, undergo an unexpected self-truncation process by removing a part of their C-terminal region. This unique process has been studied in detail with GsCelA. The purified recombinant GsCelA was capable of removing a 53-amino-acid peptide from the C-terminus. Natural or engineered GsCelA truncated variants, with up to 60-amino-acid deletion from the C-terminus, exhibited higher specific activity and thermostability than the full-length enzyme. Interestingly, the C-terminal part that is removed in this self-truncation process is capable of binding to cellulosic substrates of EGs. The protein truncation, which is pH and temperature dependent, occurred between amino acids 315 and 316, but removal of these two amino acids did not stop the process. Furthermore, mutations of E142A and E231A, which are essential for EG activity, did not affect the protein self-truncation process. Conversely, two single amino acid substitution mutations affected the self-truncation activity without much impact on EG activities. InGeobacillussp. 70PC53, the full-length GsCelA was first synthesized in the cell but progressively transformed into the truncated form and eventually secreted. The GsCelA self-truncation was not affected by standard protease inhibitors, but could be suppressed by EDTA and EGTA and enhanced by certain divalent ions, such as Ca2+, Mg2+, and Cu2+.ConclusionsThis study reveals novel insights into the strategy of Gram-positive bacteria for directing their GH5 EGs to the substrate, and then releasing the catalytic part for enhanced activity via a spontaneous self-truncation process.
SRF: a seriously responsible factor in cardiac development and disease
Authors: Deshpande Anushka , Shetty Prithviraj Manohar Vijaya , Frey Norbert , Rangrez Ashraf Yusuf 
Published: June 2022

AbstractThe molecular mechanisms that regulate embryogenesis and cardiac development are calibrated by multiple signal transduction pathways within or between different cell lineages via autocrine or paracrine mechanisms of action. The heart is the first functional organ to form during development, which highlights the importance of this organ in later stages of growth. Knowledge of the regulatory mechanisms underlying cardiac development and adult cardiac homeostasis paves the way for discovering therapeutic possibilities for cardiac disease treatment. Serum response factor (SRF) is a major transcription factor that controls both embryonic and adult cardiac development. SRF expression is needed through the duration of development, from the first mesodermal cell in a developing embryo to the last cell damaged by infarction in the myocardium. Precise regulation of SRF expression is critical for mesoderm formation and cardiac crescent formation in the embryo, and altered SRF levels lead to cardiomyopathies in the adult heart, suggesting the vital role played by SRF in cardiac development and disease. This review provides a detailed overview of SRF and its partners in their various functions and discusses the future scope and possible therapeutic potential of SRF in the cardiovascular system.
Interleukin-20 is involved in dry eye disease and is a potential therapeutic target
Authors: Wang Hsiao-Hsuan , Chen Wei-Yu , Huang Yi-Hsun , Hsu Sheng-Min , Tsao Yeou-Ping , Hsu Yu-Hsiang , Chang Ming-Shi 
Published: June 2022

Abstract
Background
Dry eye disease (DED) is a common disease in ophthalmology, affecting millions of people worldwide. Recent studies have shown that inflammation is the core mechanism of DED. IL-20 is a proinflammatory cytokine involved in various inflammatory diseases. Therefore, we aimed to explore the role of this cytokine in the pathogenesis of DED and evaluate the therapeutic potential of the anti-IL-20 monoclonal antibody (mAb) 7E for DED treatment.

Methods
Clinical tear samples from patients with DED and non-DED controls were collected and their IL-20 protein levels were determined. We established three DED animal models to explore the role of IL-20 and the efficacy of IL-20 antibody in DED. Benzalkonium chloride (BAC)-induced over-evaporative DED, extra-orbital lacrimal gland excision (LGE)-induced aqueous tear-deficient DED, and desiccating stress (DS)-induced combined over-evaporative and aqueous tear-deficient DED animal models were established to investigate the role of IL-20. The anti-IL-20 antibody 7E was established to neutralize IL-20 activity. The effects of IL-20 or 7E on human corneal epithelial cells and macrophages under hyperosmotic stress were analyzed. 7E was topically applied to eyes to evaluate the therapeutic effects in the DED animal models.

Results
IL-20 was significantly upregulated in the tears of patients with DED and in the tears and corneas of DED animal models. Under hyperosmotic stress, IL-20 expression was induced via NFAT5 activation in corneal epithelial cells. 7E suppressed hyperosmotic stress-induced activation of macrophages. IL-20 induced cell death in corneal epithelial cells and 7E protected cells from hyperosmotic stress-induced cell death. Blocking IL-20 signaling with 7E protected mice from BAC-induced, LGE-induced, and DS-induced DED by reducing DED symptoms and inhibiting inflammatory responses, macrophage infiltration, apoptosis, and Th17 populations in the conjunctiva and draining lymph nodes.

Conclusions
Our results demonstrated the functions of IL-20 in DED and presented a potential therapeutic option for this condition.

Graphical Abstract