bluuebunny/crossref_metadata_2025_split huggingface dataset:
La réforme du numerus clausus : un long élan brisé ?
Authors: Brunn Matthias , Kharkhordine Masha , Genieys William 
Published: April 2022

La réforme de l’accès aux études de santé inscrite dans la loi du 24 juillet 2019 se situe dans un temps long de réflexions et de paradigmes sur la formation des professionnels de santé. Cet article retrace la genèse de la réforme depuis l’introduction de la « Paces » (première année commune aux études en santé, loi du 7 juillet 2009) qui avait suscité chez certains acteurs du secteur l’initiation d’un processus pour amender, voire remplacer le nouveau système. Assises de la santé (2012), réformes expérimentales de la Paces et Grande conférence de la santé (2016) ont constitué autant de forums de réflexion sur le futur de la formation des professionnels de santé. Les propositions ont abouti sous la présidence Macron à un engagement collectif dit « Ma santé 2022 » et dans la foulée à la loi de 2019 censée mettre fin au numerus clausus . La mise en œuvre de cette grande réforme des études de santé a cependant été éprouvée par les effets conjugués de la situation pandémique de la Covid-19 et d’une « réaction » hostile de certains de ses publics.
Comparing Sleep in Shared and Individual Rooms During Training Camps in Elite Youth Soccer Players: A Short Report
Authors: Costa Júlio A. , Figueiredo Pedro , Lastella Michele , Nakamura Fábio Y. , Guilherme José , Brito João 
Published: April 2022

Context
Athletes' sleep is the most important recovery strategy and has received growing attention. However, athletes may experience sleep disruptions due to numerous factors, such as training and competition workloads, travel, changes in sleep-wake schedules, and sleeping environments. They often spend nights in unfamiliar hotels, and sharing a bed, room, or both with another person might affect sleep duration and quality.

Objective
To analyze the effect of sleeping in shared (SRs) versus individual (IRs) rooms on objective and subjective sleep and on slow-wave-sleep–derived cardiac autonomic activity during an official training camp in elite youth soccer players. Training and match workloads were characterized.

Design
Observational case study.

Setting
Hotel accommodations.

Patients or Other Participants
Thirteen elite male youth soccer players.

Results
Players slept longer in IRs than in SRs (+1:28 [95% CI = 1:18, 1:42] hours:minutes; P &lt; .001). Sleep efficiency was higher in IRs than in SRs (+12% [95% CI = 10%, 15%]; P &lt; .001), whereas sleep latency was shorter in IRs than in SRs (−3 [95% CI = −15, −4] minutes; P &lt; .001). Subjective sleep quality was lower in IRs than in SRs (−2 [−3 to −2] arbitrary units; P &lt; .001). No differences were found for slow-wave-sleep–derived cardiac autonomic activity or for training or match workloads between training camps.

Conclusions
During soccer training camps, sleep may be affected by whether the athlete is in an SR versus an IR.
A Multiyear Assessment of the Effect of Sport Participation on the Health of Adolescent Athletes During the COVID-19 Pandemic
Authors: McGuine Timothy , Biese Kevin , Hetzel Scott , Schwarz Allison , Reardon Claudia , Bell David R. , Brooks Alison , Dickman James , Watson Andrew M. 
Published: April 2022

Context
Sport cancellations early in the COVID-19 pandemic had a significant negative effect on the health of US adolescents. The effect of restarting sports during the pandemic has not been described.

Objective
To identify the effect of sport participation on the health of adolescents before and during the COVID-19 pandemic.

Design
Cross-sectional study.

Setting
Sample recruited via social media.

Patients or Other Participants
Wisconsin adolescent athletes.

Main Outcome Measure(s)
Participants provided information regarding their age, sex, and sport(s) involvement and completed the Patient Health Questionnaire-9 Item to assess depression symptoms, the Hospital for Special Surgery Pediatric Functional Activity Brief Scale to measure physical activity, and the Pediatric Quality of Life Inventory 4.0 to measure quality of life (QoL). Data were collected in spring 2021 (Spring21; n = 1906, age = 16.0 ± 1.2 years, females = 48.8%), when interscholastic sports had fully resumed, and were compared with similar cohorts of adolescent athletes at 2 time points: (1) spring 2020 (Spring20; n = 3243, age = 16.2 ± 1.2 years, females = 57.9%) when sports were cancelled and (2) 2016–2018 (PreCOVID-19) before the pandemic (n = 5231, age = 15.7 ± 1.1 years, females = 65.0%). Comparisons were conducted via analysis-of-variance models and ordinal regressions with age and sex as covariates.

Results
The prevalence of moderate to severe depression was lower in Spring21 than in Spring20 but higher than in PreCOVID-19 (PreCOVID-19 = 5.3%, Spring20 = 37.8%, Spring21 = 22.8%; P &lt; .001). Physical activity scores (mean [95% CI]) were higher in Spring21 than in Spring20 but lower than in PreCOVID-19 (PreCOVID-19 = 23.1 [22.7, 23.5], Spring20 = 13.5 [13.3, 13.7], Spring21 = 21.9 [21.6, 22.2]). Similarly, QoL scores were higher in Spring21 than in Spring20 but lower than in PreCOVID-19 (PreCOVID-19 = 92.8 [92.5, 93.1], Spring20 = 80.7 [80.3, 81.1], Spring21 = 84.3 [83.8, 84.8]).

Conclusions
Although sports have restarted, clinicians should be aware that physical activity, mental health, and QoL are still significantly affected in adolescent athletes by the ongoing pandemic.
DEFB126 polymorphisms and association with idiopathic asthenozoospermia in China
Authors: He Jiao-Yu , Peng Jian-Ying , Li Qiu-Fu , Lin Xiao-Li , Cui Yan-Ru , Ma Shi-Yu , Fan Shi-Yun , Liu Yi-Ran , Song Zhi-Lin , Deng Jun-Hang , Wei Xia , Ding Xian-Ping 
Published: April 2022

ABSTRACT
Idiopathic asthenozoospermia, a common factor in male infertility, is characterized by altered sperm motility function in fresh ejaculate. Although the β-defensin 126 (DEFB126) protein is associated with asthenozoospermia, DEFB126 gene polymorphisms have not been extensively studied. Therefore, the association between DEFB126 gene polymorphisms and asthenozoospermia requires further investigation. Screening was performed by semen analysis, karyotype analysis, and Y microdeletion detection, and 102 fertile men and 106 men with asthenozoospermia in Chengdu, China, were selected for DEFB126 gene sequence analyses. Seven nucleotide mutations and two nucleotide deletions in the DEFB126 gene were detected. rs11467417 (317–318 del/del), rs11467497 (163–166 wt/del), c.152T>C, and c.227A>G were significantly different between the control and asthenozoospermia groups, likely representing high-risk genetic factors for asthenozoospermia among males. DEFB126 expression was not observed in sperm with rs11467497 homozygous deletion and was unstable in sperm with rs11467417 homozygous deletion. The rs11467497 four-nucleotide deletion leads to truncation of DEFB126 at the carboxy-terminus, and the rs11467417 binucleotide deletion produces a non-stop messenger RNA (mRNA). The above deletions may be responsible for male hypofertility and infertility by reducing DEFB126 affinity to sperm surfaces. Based on in silico analysis, the amino acids 51M and 76K are located in the highly conserved domain; c.152T>C (M51T) and c.227A>G (K76R) are predicted to be damaging and capable of changing alternative splice, structural and posttranslational modification sites of the RNA, as well as the secondary structure, structural stability, and hydrophobicity of the protein, suggesting that these mutations are associated with asthenozoospermia.
Epidemiology, Risk Factors, and Major Outcomes in Post Kidney Transplant Infections at National Hospital Kandy
Authors: Nayanamali M. A. Ayesha , Athapaththu A. M. Muditha Piyumali , Basnayake B. M. Duminda Bandara , Gunarathne T. G. Nadeeka Shyamali , Wazil Abdul W. M. , Mahanama R. M. Buddhisha S. S. , Thangarajah U. E. W. D. R. Thangarajah , Nanayakkara Nishantha 
Published: April 2022

Background:
Postkidney transplant (PKT) infections are associated with significant morbidity and mortality, especially in the early posttransplant period. The type of infection, associated risk factors, and predicted outcomes of the infections are essential for targeted appropriate management. Scientific published data, especially in local settings, are lacking. This study was conducted to assess the epidemiology, risk factors, and major outcomes of PKT infections requiring hospitalization.

Methods:
This was a prospective observational study, conducted at the Nephrology and Transplant Unit, National Hospital Kandy, Sri Lanka, for a period of 2 months from December 1, 2018, to January 30, 2019.

Results:
A total of 38 infectious episodes were recorded in 35 kidney recipients. The most common type of infection was urinary tract infection (UTI) noted in 36.6% (n = 14) of cases. The most frequent organisms isolated were coliform (7.9%, n = 3). Seven potential risk factors including age, gender, comorbidities, source of kidney, induction modality, enhancement therapy, and months after renal transplant were evaluated. Among those potential risk factors, age was significantly associated with gastrointestinal tract infections (P = 0.033). There was a significant association between the gender and the severity of infections (P = 0.047). Majority of patients discharged from the hospital following complete recovery. Three patients were offered intensive care, two developed acute renal failure requiring renal replacement therapy and one was expired.

Conclusion:
The most common type of infection in PKT patients is UTI. Patient's age is significantly associated with gastrointestinal infections. Large-scale studies warrant for adequately concluding risk factors, epidemiology, and outcomes.
Clinical Outcome of ABO-Incompatible Kidney Transplant with Low Baseline Anti-A/B Antibody Titer without the Use of Plasma Exchange - A Retrospective Study
Authors: Jeloka Tarun Kumar , Dharaskar Anand , Singh Ravindra 
Published: April 2022

Background:
The outcome of ABO-incompatible (ABOi) transplant (Tx) may be compromised because of the need for added immunosuppression. Many centers still use plasma exchange (PEX) even when anti-A/B titers are low. We compared the outcome of ABOi kidney Tx with low baseline anti-A/B titers without PEX to those with high titers managed with PEX and to ABO-compatible (ABOc) Tx.

Materials and Methods:
In this retrospective study, all adult kidney Tx done at our institute were eligible. Patients <18 years of age, deceased donor transplant recipients, and those with hepatitis B, C or HIV infections at the time of transplant were excluded from this analysis. Outcomes including biopsy-proven AR, estimated glomerular filtration rate (eGFR) (Modification of Diet in Renal Disease equation), infections, and patient and graft survival were determined in ABOi kidney Tx with low baseline anti-A/B antibody titers managed without PEX (Group A). These outcomes were compared to a contemporary cohort of those with high titers and use of PEX (Group B) and ABOc Tx (Group C). Continuous variables were compared by Student's t-test and categorical variables with Chi-square test. Patient and graft survival was calculated by Kaplan–Meier curve and compared between the groups by log-rank test.

Results:
Baseline characteristics reveal no difference in recipients and donor factors such as age, gender, and HLA match. Initial immunoglobulin G anti-A/B titers were higher in Group B as compared to Group A (P = 0.04), but final titers pretransplant were similar (P = 0.6). Biopsy-proven rejections were not different between Groups A and B or Groups A and C. Serum creatinine and eGFR at 1 month and at last follow-up were also similar in all the groups. Infections were seen in 22.2% of the patients in Group A, 44.4% in Group B, and 27.7% in Group C. Patient survival and death-censored graft survival were similar in all three groups.

Conclusion:
This retrospective study shows that patients with low baseline anti-ABO antibodies managed without PEX are safe and have similar outcomes such as patient and graft survival, rejections, infections, and renal function.
Outcomes of Supraflex Sirolimus Eluting Coronary Stents
Authors: Singh Vishal Virendra , Tahir Sheikh Mohammad , Sharma Sanjiv 
Published: April 2022

Background:
The introduction of Sirolimus Eluting Coronary Stents (SES) was a major breakthrough in interventional cardiology. The large, randomized, clinical trials using SES have shown a remarkable reduction in angiographic restenosis and target vessel revascularization (TVR) compared with bare-metal stents as well as other drug-eluting stents (DESs). However, there is only limited data on the outcome of Indian patients treated by DES of Indian origin. The purpose of the study was to evaluate the outcomes of the supraflex sirolimus-eluting coronary stents for the treatment of coronary artery disease and to determine major adverse cardiovascular and cerebrovascular events (MACCE).

Materials and Methods:
This was a single-centre, observational, nonrandomized study that enrolled unselected real-world patients at a tertiary care center who had undergone implantation with supraflex sirolimus-eluting stents. The primary end-point of the study was MACCE, which is a conglomeration of cardiac death, target lesion revascularization (TLR), TVR, cerebrovascular accident (CVA), and heart failure at 1-year follow-up.

Results:
A total of 100 patients were intervened successfully with sirolimus-eluting stents. Out of total patients, diabetes and hypertension were observed in 38% and 35% of patients. According to ACC/AHA classification, there were 68% Type B lesions and 32% Type C lesions. At 1-year follow-up, MACE was found to be 11%, which is a composite of 4% TLR, 3% TVR, 1% CVA, and 5% heart failure. Diabetes (P = 0.02), hypertension (P = 0.01), kidney dysfunction (P = 0.002), and LV function (P = 0.01) strongly correlate with outcome (MACCE).

Conclusion:
There was an acceptable rate of adverse events after implantation of the supraflex sirolimus-eluting stents, although it was slightly higher compared to other studies. Diabetes, hypertension, kidney dysfunction, and LV function strongly correlate with outcome (MACCE).
Dental Decay and Salivary Flow in Patients Taking Systemic Isotretinoin
Authors: Alkanhal Norah A. , Aldaij Mohammed H. , Alkanhal Haya A. , Al-Haddab Mohammed , Alfaifi Fawziah 
Published: April 2022

Abstract

Background:
Isotretinoin causes dryness of the mucous membranes. Medications altering the salivary flow are a risk factor for dental caries.

Purpose:
To prospectively assess caries and salivary flow in patients taking systemic isotretinoin.

Methods:
Twenty-four patients treated with 0.5 mg/kg of isotretinoin every day for 8 months were studied. The control group was the same patients before start taking oral Isotretinoin. Salivary flow, buffer capacity, bacterial tests, and caries status based on the decay, missing, and filled teeth (DMFT) index were assessed.

Results:
At baseline, there was slight to moderate calculus on the teeth. DMFT index, stimulated saliva flow, and bacterial tests for Streptococcus mutans increased during isotretinoin treatment (P < 0.05). There was no significant difference (P > 0.05) in buffering capacity or Lactobacillus.

Conclusion:
Systemic isotretinoin increased the DMFT index and bacteria rate and decreased salivary flow that might lead to dental caries.
Epidemiology of Viral Skin Disease
Authors: Himed Sonia , Muddasani Suraj , Fleischer Alan B. 
Published: April 2022

Abstract

Background:
Viral cutaneous infections have impact globally due to several factors, including changing rates of atopic dermatitis (AD), vaccination rates, and access to trained dermatologists. Furthermore, advancements in treatments and access to vaccinations suggest an association between the wealth of countries and the burden of their disease.

Purpose:
The overall purpose of this study is to better understand the global impact of viral skin disease across differing demographics and time periods, as well as the burden in relation to national wealth.

Methods:
In this article, the prevalence, incidence, and years lived with disability (YLDs) were analyzed for viral cutaneous infections in 195 countries from 1990 to 2019, using the global burden of disease dataset. Furthermore, the disease burden was assessed as a function of gross-domestic product (GDP) and AD.

Results:
The prevalence of individuals affected by viral skin diseases is approximately 154 million globally. Young children (1–9 years old) were more likely to be affected. The age-standardized prevalence rates per 100,000 in the Americas and Asia decreased between 1990 and 2019 from 2819 to 2650 and from 2074 to 1906, respectively. This decrease was outside the 95% uncertainty interval. Increased GDP predicted increased prevalence and YLD (P < 0.0001). There was a relationship between 1 year lived with disability per capita of AD and an increase of 0.14 (0.07, 0.21) cases of viral skin diseases (P = 0.002).

Conclusion:
The increase in disease burden with increased GDP may be correlated to decreased access to dermatologists in developing countries. An increased burden with AD is likely due to skin barrier and immune regulatory dysfunction. The morbidity of skin diseases demonstrates the need for increased access to vaccination campaigns and dermatologic care across developing nations.
Prevalence of Microvascular Complications in Adolescents and Adults with Type 1 Diabetes
Authors: Saiyed Mahira , Saboo Banshi , Pancholi Maitry , Saraf Vishakh , Shah Meet 
Published: April 2022

Objective:
The aim of this work was to study the prevalence of microvascular complications in type 1 diabetes among the young adolescents and adults of Ahmedabad, Gujarat.

Materials and Methods:
This descriptive study was carried out at the diabetes care center from August 1, 2020 to March 31, 2021 by setting the inclusion criteria of patients with type 1 diabetes who had a history of at least 5 years or more and all adolescents and young adults who visited the clinic and who were willingly prepared to undergo for fundoscopy. Patients recently detected with type 1 diabetes and patients with previous retinal examination report and other forms of diabetes were excluded from the study. A total of 530 patients visited the clinic during this screening period, of which 125 patients took part in the screening. Microvascular complications screening consisted of fundoscopy and urine examination for microalbuminuria.

Results:
Of 125, 10 patients (8%) had diabetic retinopathy and 27 patients (21.6%) showed the presence of albumin in urine. The overall prevalence of microvascular complications was 29.6%. There were five patients with a positive history of both microvascular complications. The mean duration of diabetes was 19.6 years and the mean average glucose levels were 8.5% and 8.8%, respectively.

Conclusion:
We conclude that despite the higher glycemic values the chances of development of complications are negligible during the initial course of type 1 diabetes. With an increase in the duration of diabetes, the prevalence of complications is observed more. Hence, in addition to constant high glycemic values, the course of the disease is also a major responsible factor.
Cognitive Decline in Diabetics
Authors: Tipnis Natasha , Rajadhyaksha Girish , Shah Meghav 
Published: April 2022

Background:
The association between cognitive decline and diabetes mellitus has been evidenced throughout recent decades.

Objectives:
The objective of this study was to determine the prevalence of cognitive decline in diabetics and nondiabetics in association with age, gender, level of education, risk factors, and duration of diabetes mellitus in middle-aged and elderly patients.

Materials and Methods:
A prospective, case-control study was conducted at a tertiary-care center between May 2014 and December 2015. Patients with diabetes (n = 150) and normal patients (n = 150) were compared. Patients were divided into groups according to age, gender, education, and duration of diabetes mellitus. The Hindi mini-mental state examination (HMMSE) was used to detect cognitive decline.

Results:
In diabetics with HMMSE score <27, 24 (46.1%) were aged <60 years, whereas 28 (53.9%) were aged ≥60 years. In diabetics with HMMSE score ≥27, 52 (53.1%) were aged <60 years, whereas 46 (46.9%) were aged ≥60 years. This finding was not statistically significant. In nondiabetics with HMMSE score <27, 13 (34.2%) nondiabetics were aged <60 years, whereas 25 (65.8%) were aged ≥60 years. In nondiabetics with HMMSE score ≥27, 61 (54.4%) were aged <60 years, whereas 51 (45.6%) were aged ≥60 years. This finding was statistically significant.

Conclusion:
Our study findings revealed no statistically significant findings in diabetics. However, specific cognitive domains such as orientation to place, concentration, and drawing displayed statistical significance for cognitive decline.
Nutritional and Glycemic Properties of Brown and White Rice Flakes “Upma”
Authors: Shobana Shanmugam , Gopinath Viswanathan , Kavitha Vasudevan , Kalpana Natarajan , Vijayalakshmi Parthasarathy , Gayathri Rajagopal , Ramya Bai R Mookambika , Ganeshjeevan Raman , Malleshi Nagappa Gurusiddappa , Unnikrishnan Ranjit , Anjana Ranjit Mohan , Henry Christiani Jeyakumar , Krishnaswamy Kamala , Sudha Vasudevan , Mohan Viswanathan 
Published: April 2022

Background and Objectives:
Beaten or flattened rice (flakes) is very popular in India for preparing the meal “upma.” Commonly marketed rice flakes are fiber depleted, starchy, and may be nutritionally poor. Hence, this study aimed at preparing brown rice flakes (BRF) for such “upma” preparation and compared the nutritional and glycemic properties of it with those of white rice flakes (WRF).

Materials and Methods:
Flakes were prepared from brown rice (BR, ADT-45 variety) by steaming and flattening using a roller flaker. The BRF and commercial WRF were analyzed for nutrient composition, and upma prepared from both the flakes was evaluated for glycemic index (GI) in normal healthy volunteers by using a validated protocol.

Results:
BRF contained significantly higher (6.2 g%) dietary fiber as compared with WRF (1.8 g%, P < 0.001). Stereo-zoom microscopic examination of BRF revealed retention of bran and germ. BRF was thicker, firmer, and had a lower surface area compared with WRF. BRF upma exhibited medium GI (63.3 ± 6.2), whereas WRF upma showed high GI (70.4 ± 5.6), though the GI values were not statistically significant.

Interpretation and Conclusions:
BRF upma, a medium GI category meal choice, could be considered a healthier option compared to high GI WRF upma considering the nutritional profile. The BRF described in the study is easy to cook and suitable enough to replace WRF. More trials are required to design and devise innovative protocols for the preparation of BRF with significantly lower glycemic properties.