bluuebunny/crossref_metadata_2025_split huggingface dataset:
Use of digital assessment tools to measure health facility readiness to provide the WHO recommended package of care for lymphatic filariasis morbidity
Authors: Bougma Windtaré Roland , Aiogalé Victorino Martinho , Attoumbre Bienvenu Yao , Bartlett Sarah , Brahima Kouma , Coulibaly Mamadou , Coulibaly Yaya Ibrahim , Dicko Boubacar Morou , D’Souza Susan , Doumbia Salif Seriba , Gargannah Gar Mondyu , Musa Balla , Ngom Babacar , Norbert Dje N’Goran , Nwosu Christian , Papique Alberto Luis , Rogers Emerson J. , Sarr Astou , Downs Philip 
Published: December 2024

BackgroundA country claiming to have achieved elimination of Lymphatic filariasis (LF) as a public health problem must undergo and document a quality assessment of the World Health Organization (WHO) recommended essential package of care for patients with lymphedema and hydrocele. This must be done in at least 10% of facilities offering services. In Liberia, Côte d’Ivoire, Mali and Guinea-Bissau the LF programmes used the Hydrocele Facility Assessment Tool (HFAT) and the Lymphedema Facility Assessment Tool (LFAT) to provide an objective assessment of facilities providing LF morbidity management services. Information gathered through these tools is used to improve service delivery and document the number of implementation units with at least one facility providing the essential package of care in the WHO epidemiological reporting form (EPIRF). The development of the HFAT and LFAT digital tools were informed by WHO’s direct inspection protocol (DIP) for lymphedema, WHO’s service availability and readiness assessment (SARA), and WHO’s situational analysis to assess emergency and essential surgical care.MethodsBetween May 2022 and January 2023, 33 hydrocele facility assessments and 102 lymphedema facility assessments were implemented in these four countries. Facility and indicator score benchmarks were set at 75%.ResultsThe LFAT and HFAT indicator results were variable both within and between countries. 26 (79%) facilities scored 75% or better on the assessment for hydrocele surgery and 15 (15%) facilities scored 75% or better on the assessment for lymphedema. Examples of indicators with significant need for quality improvement actions were 1) LFAT indicator ‘Trained staff - Community Health Care Providers trained in lymphoedema management’ which did not achieve the 75% benchmark in any of the countries; 2) HFAT indicator on use of surgical safety checklist which only achieved the 75% benchmark in Liberia.DiscussionThe discussion highlights the current challenges faced by endemic countries to ensure that an essential package of care (of sufficient quality) for lymphedema management and hydrocele surgery is available.
Risk factors for post-stroke spasticity: a retrospective study
Authors: Zhu Chuanxi , Li Lingxu , Qiu Long , Ji Guangcheng 
Published: December 2024

BackgroundPost-stroke spasticity (PSS) is a common complication after stroke and is an important cause of high rates of disability after stroke. At present, modern medicine has made great progress in the treatment of PSS, ‘early detection, early treatment’ has become a general consensus for the treatment of PSS in the clinic. Clarifying the risk factors of PSS can help to detect and treat the functional disorders caused by PSS at an earlier stage.MethodsThis is a retrospective study. 436 stroke patients who visited the Neurology Department of the Third Affiliated Clinical Hospital of Changchun University of Chinese Medicine from June 2020 to November 2020 were selected as study subjects, and finally 257 patients were included in the final analysis, and divided into 101 cases with spasticity and 156 cases without spasticity, depending on whether or not the stroke victim had a spasm at the time of admission.ResultsThe multivariate regression analysis showed that basal ganglia as the cerebral hemorrhage or infarction site (OR = 4.930, 95%CI = 2.743–8.86, p = 0.000), cerebral hemorrhage or infarction volume (OR = 1.087, 95%CI = 1.016–1.164, p = 0.016) and NIHSS scores (OR = 1.232, 95%CI = 1.089–1.393, p = 0.001) are independent influencing factors and independent risk factors for spasticity (p &lt; 0.05). A risk prediction model for spasticity in stroke patients is derived with the multivariate logistic regression analysis Logit (P) = 1.595 * Basal ganglia +0.084 * infarct volume + 0.208 * NIHSS scores – 2.092. An evaluation of the goodness of fit using the ROC curve showed AUC (95% CI) = 0.786 (0.730–0.843), an indication of a high degree of model fit.ConclusionIndependent risk factors for Post-stroke spasticity include basal ganglia as the cerebral hemorrhage or infarction site, cerebral hemorrhage or infarction volume and NIHSS scores.
Association between body roundness index and female infertility: a cross-sectional study of NHANES 2013–2018
Authors: Li Haiyan , OuYang Zhenbo , Ding Ziyao , Hu Xianyue , Bao Yanjing , Gao Tianyang , Hua Wenfeng 
Published: December 2024

BackgroundThe use of visceral obesity as an indicator for predicting female infertility risk has not been well established. The body roundness index (BRI) is a novel, non-invasive indicator of visceral fat; however, previous reports have not addressed the relationship between the BRI and female infertility. This study sought to fill this research gap by investigating the association between the BRI and the risk of female infertility.MethodsThis cross-sectional study examined 3,528 women aged 18 to 45 who participated in the National Health and Nutrition Examination Survey (NHANES) from 2013 to 2018. Infertility was defined based on responses to the reproductive health questionnaire. The BRI was calculated using waist circumference and height. Covariates included demographic traits, physical exam results, laboratory test findings, and survey data. Weighted multivariable logistic regression models and spline smoothing analysis assessed the relationship between the BRI and infertility. Bayesian statistics were used to examine the robustness of significant associations.ResultsBased on their self-report data, 407 (11.54%) participants were classified as having infertility. A significantly higher percentage of participants with a higher BRI were found to have infertility. Multivariable logistic regression revealed that the BRI was significantly associated with increased female infertility risk, regardless of independent variable analysis by continuous variable or quartile (Q1 to Q4) in the fully adjusted model (Model 3, continuous variable: OR = 1.1, 95% confidence interval [CI] = 1.05–1.16, p = 0.0009; Q4 vs. Q1: OR = 2.16, 95% CI = 1.38–3.39, p = 0.0035, Ptrend = 0.004). Non-linear and threshold effects in the relationship between the BRI and female infertility were identified, with an inflection point of 6.36. Subgroup analyses showed that this positive association remained consistent across most demographic and health-related categories. The Bayesian statistics analyses further confirmed the robustness of these findings.ConclusionA positive non-linear relationship exists between the BRI and the risk of female infertility, suggesting that the BRI could serve as a valuable indicator in female fertility assessments.
Application of Mendelian randomized research method in oncology research: bibliometric analysis
Authors: Chen Jiahao , Wang Yunli , Jiang Rongsheng , Qu Yawei , Li Yan , Zhang Yang 
Published: December 2024

BackgroundCancer has always been a difficult problem in the medical field, and with the gradual deepening of Genome-wide association studies (GWAS), Mendelian randomization methods have been increasingly used to study cancer pathogenesis. In this study, we examine the literature on Mendelian cancer, summarize the status of the research, and analyze the development trends in the field.MethodsPublications on “Mendelian Randomization - Cancer” were retrieved and downloaded from the Web of Science Core Collection database. CiteSpace 6.2.R4, VOSviewer 1.6.19, Scimago Graphica 1.0.38, Bibliometrix R-package, and a bibliometric online analysis platform were used for data analysis and visualization. An in-depth analysis of country or region, authors, journals, keywords, and references was performed to provide insights into the content related to the field.ResultsA total of 836 articles were included in the analysis; 643 authors from 72 countries had published articles related to the field. China and Harvard University (among countries and institutions, respectively) had the highest number of articles. Martin, Richard M and Smith, George Davey were the largest contributors. A total of 27 cancers have been studied, with breast, colorectal, and liver cancers being the most studied.ConclusionThis study is the first to use bibliometric methods to visualize the application of Mendelian randomization analysis in the field of cancer, revealing research trends and research frontiers in the field. This information will provide a strong reference for cancer researchers and epidemiologic researchers.
Differentiation of histological calcification classifications in breast cancer using ultrashort echo time and chemical shift-encoded imaging MRI
Authors: Ayoub Yazan , Cheung Sai Man , Maglan Boddor , Senn Nicholas , Chan Kwok-Shing , He Jiabao 
Published: December 2024

IntroductionDuctal carcinoma in situ (DCIS) accounts for 25% of newly diagnosed breast cancer cases with only 14%–53% developing into invasive ductal carcinoma (IDC), but currently overtreated due to inadequate accuracy of mammography. Subtypes of calcification, discernible from histology, has been suggested to have prognostic value in DCIS, while the lipid composition of saturated and unsaturated fatty acids may be altered in de novo synthesis with potential sensitivity to the difference between DCIS and IDC. We therefore set out to examine calcification using ultra short echo time (UTE) MRI and lipid composition using chemical shift-encoded imaging (CSEI), as markers for histological calcification classification, in the initial ex vivo step towards in vivo application.MethodsTwenty female patients, with mean age (range) of 57 (35–78) years, participated in the study. Intra- and peri-tumoural degree of calcification and peri-tumoural lipid composition were acquired on MRI using UTE and CSEI, respectively. Ex vivo imaging was conducted on the freshly excised breast tumour specimens immediately after surgery. Histopathological analysis was conducted to determine the calcification status, Nottingham Prognostic Index (NPI), and proliferative activity marker Ki-67.ResultsIntra-tumoural degree of calcification in malignant classification (1.05 ± 0.13) was significantly higher (p = 0.012) against no calcification classification (0.84 ± 0.09). Peri-tumoural degree of calcification in malignant classification (1.64 ± 0.10) was significantly higher (p = 0.033) against no calcification classification (1.41 ± 0.18). Peri-tumoural MUFA in malignant classification (0.40 ± 0.01) was significantly higher (p = 0.039) against no calcification classification (0.38 ± 0.02). Ki-67 showed significant negative correlation against peri-tumoural MUFA (p = 0.043, ρ = −0.457), significant positive correlation against SFA (p = 0.008, ρ = 0.577), and significant negative correlation against PUFA (p = 0.002, ρ = −0.653).ConclusionThe intra- and peri-tumoural degree of calcification and peri-tumoural MUFA are sensitive to histological calcification classes supporting future investigation into DCIS prognosis.
A portrait of germline pathogenic variants in high and moderate penetrance breast cancer genes in Brazil
Authors: Oliveira Leandro Jonata de Carvalho , Rodrigues Amanda Muniz , Fernandes Carolina de Bustamante , Ramos do Rego Fernanda Orpinelli , Koyama Fernanda Christtanini , Souto Andreza Karine de Barros Almeida , Santana Thaiana Aragão , Gonzaga de Faria João Paulo , Lima Bulcão Marcela , Nascimento Ivana Lucia de Oliveira , Silva Ana Carolina Branco Neves , Gonçalves Isabela Pessoa Elias , Maia Rayana Elias , Azevedo Renata Gondim Meira Velame de , Galindo Layla Testa , Pachito Daniela Vianna , Cury Adriana , Zalis Mariano Gustavo , Ferrari Bruno Lemos , Garicochea Bernardo , Dienstmann Rodrigo 
Published: December 2024

IntroductionThe prevalence of germline pathogenic/likely pathogenic variants (P/LP) in high and moderate penetrance (HMP) genes is approximately 7%–10% among breast cancer (BC) patients. The prevalence and spectrum of BC P/LP variants are affected by several factors. There are limited genetic data from Brazilian patients with BC.MethodsThis is a retrospective cross-sectional study that aims to evaluate the germline profile of P/LP variants in 13 HMP BC genes (BRCA1, BRCA2, PALB2, TP53, CDH1, NF1, PTEN, STK11, CHEK2, ATM, BARD1, RAD51C, and RAD51D) in patients diagnosed with BC in Brazil. All patients were tested using multigene NGS panels covering from 35 to 105 genes. Primary endpoint was the prevalence of P/LP variants in BRCA1/2 and in other HMP genes. Secondary endpoints were stratified analyses according to age and BC subtype.ResultsThis cohort involved 2,208 patients with BC from 2019 to 2023. Most patients (79.7%) were from Southeastern Brazil. The median age at genetic testing was 47 years, and most patients (59.4%) were ≤50 years. The BC subtype was available in 641 cases: 264 patients (41.2%) were HR+/HER2−, 116 (18.1%) were HER2+, and 261 (40.7%) had triple-negative breast cancer (TNBC). Overall, 215 (9.7%) had a P/LP in HMP genes, including 5.8% in BRCA1/2. The most frequent variants were found in BRCA2, BRCA1, and TP53. The founder variant R337H accounted for 79% of all TP53 pathogenic variants, representing 1% of the overall population. Deleterious variants in BRCA1/2 were more common in patients ≤50 years (7.7%) and TNBC (10.7%). In other HMP BC genes, the prevalence of P/LP variants did not significantly vary according to age and BC molecular subtype. The overall VUS rate in HMP genes was 19.6%.ConclusionIn Brazil, the epidemiology of deleterious variants in HMP is comparable to published US and EU cohorts. The Brazilian TP53 R337H is a prevalent variant in BC patients. Deleterious BRCA1/2 variants vary according to age and BC subtype. Our study gives a broader understanding of BC risk genes and has opened doors to optimized testing and surveillance strategies in Brazil.
Mitigating inflammation and fibrosis: the therapeutic potential of quercetin liposomes in COPD
Authors: Yin Changfeng , Tian Yushan , Yan An , Wang Hongjuan , Lu Fengjun , Li Xianmei , Li Xiao , Han Shulei , Miao Ruijuan , Chen Huan , Li Di , Hou Hongwei , Hu Qingyuan 
Published: December 2024

IntroductionChronic obstructive pulmonary disease (COPD) is a disease with severe therapeutic obstacles and high worldwide death rate. COPD progresses predominantly through inflammatory response followed by fibrotic destruction. Quercetin (Que), recognized for its anti-inflammatory effects, presents significant promise as a therapeutic candidate for COPD therapy. However, poor water solubility and low bioavailability of Que hinder its further clinical application. Liposomes are renowned for their unique structure and function, which provided an efficient approach for the delivery of Que in various drug delivery systems. This study was aim to prepare a novel Que liposome (Que-lipo) and administrated via intratracheal (i.t.) with cigarette smoke induced COPD mice. The underlying therapeutic mechanisms against lung damage of Que-lipo were explored.MethodsQue-lipo were prepared based on thin film dispersion method and administrated via intratracheal administration. The cigarette smoke induced COPD mice were established and a comprehensive approach was employed to explore the inflammation, pulmonary function and histopathology of lung after i.t. administration of Que-lipo, including enzyme-linked immunosorbent assay, histopathology and immunohistochemistry, reverse transcription-quantitative polymerase chain reaction.Results and discussionQue-lipo not only improved the solubility and biocompatibility of Que but also demonstrated effective cellular uptake in vitro. The inflammation, pulmonary function and pathological condition of lung were improved after i.t. administration of Que-lipo. Que-lipo also regulated the expression of key apoptosis-associated proteins such as Bcl-2 and caspase-3/7, leading to significant inhibition of apoptotic activity in COPD. Furthermore, Que-lipo markedly enhanced its ability to alleviate lung inflammation and fibrosis symptoms by modulating inflammation-related factors and fibrosis signaling molecules. The potential mechanisms of Que-lipo in treating COPD were elucidated, including the suppression of the NLRP3/IL-1β inflammasome pathway and the TGF-β1-related fibrosis signaling pathway.
Effects of individualized resistance training prescription with heart rate variability on muscle strength, muscle size and functional performance in older women
Authors: Bittencourt Diego , de Oliveira Ramon Martins , da Silva Deivid Gomes , Bergamasco João Guilherme Almeida , Cesar Marcelo de Castro , Godoi Jacomassi Daniela , de Camargo Júlio Benvenutti Bueno , Kingsley J. Derek , Libardi Cleiton Augusto 
Published: December 2024

IntroductionThis study aimed to investigate whether individualizing autonomic recovery periods between resistance training (RT) sessions (IND) using heart rate variability (HRV), measured by the root mean square of successive R-R interval differences (RMSSD), would lead to greater and more consistent improvements in muscle strength, muscle mass, and functional performance in older women compared to a fixed recovery protocol (FIX).MethodsTwenty-one older women (age 66.0 ± 5.0 years old) were randomized into two different protocols (IND: n = 11; FIX: n = 10) and completed 7 weeks of RT. Measurements of RMSSD were performed within a five-day period to establish baseline values. The RMSSD values determined whether participants were recovered from the previous session. The assessments included muscle cross-sectional area (CSA), one-repetition maximum (1RM), peak torque (PT), rate of force development (RFD), chair stand (CS), timed up and go (TUG), 6-minutes walking (6MW), and maximum gait speed (MGS).ResultsThere were no significant (P &gt; 0.05) group vs. time interactions. There were significant main effects of time (P &lt; 0.05) for CSA, 1RM, PT, TUG, CS, 6MW, and MGS, while no significant changes were observed for RFD (P &gt; 0.05).ConclusionIND does not seem to enhance responses in muscle mass, strength, and functional performance compared FIX in healthy older women.
“We are not ready for this”: physicians’ perceptions on climate change information and adaptation strategies - qualitative study in Portugal
Authors: Ponte Nidia , Alves Fátima , Vidal Diogo Guedes 
Published: December 2024

BackgroundClimate change presents several challenges to public health and its professionals. This article aims to fill a significant gap in the current literature by understanding physicians’ perceptions of their role in educating others about health adaptation to climate change. It also explores their knowledge of health policies related to this issue in Portugal and their perceived influence on the development of adaptation policies at both local and national levels within the health sector.MethodsTo this end, we applied a qualitative and case study approach, interviewing 13 physicians in Portugal, including general practitioners and specialists. The data was collected using a semi-structured interview script, and a content analysis was performed to categorize the responses and gain a comprehensive understanding of the phenomenon.ResultsThe main results of this study highlight the need for a more systematic approach to training physicians, including the relationship between climate change and health. Concerning policies, this research highlights the need for more consistent communication and precise guidelines for dealing with the impacts of climate change on public health.ConclusionAs the first exploratory study focusing on Portuguese physicians, this research provides unique insights into their views on the potential to influence patient behavior and health policy. Importantly, it offers valuable recommendations for health policy strategies, particularly in awareness-raising and training plans for these professionals, thereby demonstrating the research’s practical implications.
Humanising processes after harm part 2: compounded harm experienced by patients and their families after safety incidents
Authors: Ramsey Lauren , Hughes Joanne , Hazeldine Debra , Seddon Sarah , Gould Mary , Wailling Jo , Murray Jenni , McHugh Siobhan , Simms-Ellis Ruth , Halligan Daisy , Ludwin Katherine , O’Hara Jane K. 
Published: December 2024

BackgroundHealthcare organisations risk harming patients and their families twofold. First, through the physical, emotional and/or financial harm caused by safety incidents themselves, and second, through the organisational response to incidents. The former is well-researched and targeted by interventions. However, the latter, termed ‘compounded harm’ is rarely acknowledged.AimsWe aimed to explore the ways compounded harm is experienced by patients and their families as a result of organisational responses to safety incidents and propose how this may be reduced in practice.MethodsWe used framework analysis to qualitatively explore data derived from interviews with 42 people with lived or professional experience of safety incident responses. This comprised 18 patients/relatives, 16 investigators, seven healthcare staff and one legal staff. People with lived and professional experience also helped to shape the design, conduct and findings of this study.FindingsWe identified six ways that patients and their families experienced compounded harm because of incident responses. These were feeling: (1) powerless, (2) inconsequential, (3) manipulated, (4) abandoned, (5) de-humanised and (6) disoriented.DiscussionIt is imperative to reduce compounded harm experienced by patients and families. We propose three recommendations for policy and practice: (1) the healthcare system to recognise and address epistemic injustice and equitably support people to be equal partners throughout investigations and subsequent learning to reduce the likelihood of patients and families feeling powerless and inconsequential; (2) honest and transparent regulatory and organisational cultures to be fostered and enacted to reduce the likelihood of patients and families feeling manipulated; and (3) the healthcare system to reorient towards providing restorative responses to harm which are human centred, relational and underpinned by dignity, safety and voluntariness to reduce the likelihood of patients and families feeling abandoned, de-humanised and disoriented.