bluuebunny/crossref_metadata_2025_split huggingface dataset:
Community Health Worker Outreach to Assess Confounders of Health
Authors: Takallou Armin , Mitchell Emily , Richardson Gina M. , Frank Brian 
Published: November 2024

ABSTRACTBackground and ObjectivesIn July 2020, recognizing the potential conflict between COVID-19 quarantine guidelines and other medical and social needs, a university-affiliated family medicine clinic developed a workflow to support patients who test positive for COVID-19. The workflow relies on Community Health Workers (CHWs) to call patients, identify needs, and connect them to community resources, with the goal of reducing barriers to maintaining COVID-19 isolation. The objective of this study was to understand the design, implementation, and maintenance of the workflow to provide guidance for other primary care practices interested in developing similar workflows.MethodsThis qualitative study was conducted in a federally qualified health center. Key informant interviews were conducted with six personnel involved in the workflow. Using a semi-structured interview guide, interviewers asked participants about the design, implementation, maintenance of the workflow, and benefits and harms. Interviews were analyzed using an immersion-crystallization approach.ResultsAcross all workflow phases, adaptability and content expertise were reported as essential for workflow success. The main barrier was the lack of coordinated COVID-19-related workflows across the system. Delivery of whole-person care was identified as the primary benefit to both patients and the healthcare system.ConclusionsInterview participants felt that integrating CHWs into the workflow benefitted patients and the clinic. For other practices interested in implementing a similar workflow, themes for success include a workflow framework built on patient-centeredness, adaptability, and the unique content expertise of CHWs.
Trend Analysis of Hepatitis B and C Virus Infections among Patients at Ambo General Hospital, West Shoa, Ethiopia: Retrospective Study
Authors: Getachew Mulugeta , Teferi Amanuel , Kebede Edosa 
Published: November 2024

AbstractBackgroundHepatitis B and C viruses affect the liver and can cause wider range of disease outcomes. Chronic HBV and/or HCV infection leaves a person susceptible to major liver diseases such liver cirrhosis or hepatic cell cancer later in life. They bear the greater portion of the mortality and morbidity associated with hepatocellular carcinomas and liver cirrhosis.MethodsA retrospective laboratory record review was conducted at Ambo General Hospital from January 2018 to December 2021. The retrieved data included the date of examination, age, sex and laboratory results of the HBV and HCV. Data were summarized and presented in the form of tables, figures, and frequencies to present the results. The data were analyzed using SPSS and Microsoft Excel.ResultsOver the course of 4 years, a total of 5675 individuals were examined for hepatitis at Ambo general hospital. Of the total individuals examined, 365(6.4%) and 15(2.1%) were positive for HBV and HCV respectively. HBV and HCV mixed infections accounted for 0.6% of the cases. HBV was highest prevalent in males (12.1%) than females (5.72%), while among seropositive of HCV, 7(5.7%) were males and 4(1.0%) were females. HBV and HCV were more prevalent among individuals aged from 45–54 years old 11(11.6%) and 35–44 years old 4(5.6%) respectively. A high percentage of HBV (7.1%) and HCV (5.5%) were seen in the years of 2018 and 2020 respectively.ConclusionAccording to WHO criteria, the total prevalence of hepatitis B and C in our study is moderate, and the prevalence of HBV is significantly higher than that of HCV. Although, there are annual fluctuations in the prevalence. As a result, it is critical to improve coverage of services in healthcare facilities and raise community awareness regarding the means of transmission, prevention and control of hepatitis B and C virus infection.
Pulmonary barotrauma in COVID-19 patients: Experience from a tertiary university hospital
Authors: Chai Jian Hai , Masdar Azlina , Mohamad Yusof Aliza , Wan Mat Wan Rahiza 
Published: November 2024

AbstractIntroduction: Mechanical ventilation (MV) in COVID-19 patients is often complicated with pulmonary barotrauma. The aim of this study was to determine the incidence and risk factors associated with the development of pulmonary barotrauma in mechanically ventilated COVID-19 patients.Materials and methods:We included all mechanically ventilated COVID-19 patients who were aged 18 and above whom admitted to COVID ICU between January 2021 and June 2022. Patients who developed pulmonary barotrauma prior to or within 24 hours of ICU admission, iatrogenic pneumothorax, readmitted to ICU and ventilated for other causes than respiratory failure due to COVID-19 were excluded. The data for demographic, vaccination status, ventilator settings, laboratory data, steroid and immunomodulator therapies received were analysed. Univariate and multivariate analysis were carried out to determine the risk factors and outcome.Results:Medical records of 204 patients were included. The incidence of pulmonary barotrauma was 22.5%. Lower C-reactive protein (CRP) value on admission to ICU and FiO2prescription in the first week of MV, utilisation of higher PEEP in the second week of MV and longer ventilator days predisposed patients to pulmonary barotrauma (p = 0.039, p = 0.049, p = 0.021, p = 0.036 respectively). Pulmonary barotrauma increased the duration of ICU stay (p = 0.006) and all-cause ICU mortality (p = 0.009).Conclusion:Lower level of CRP and FiO2prescription, higher use of PEEP and longer ventilator days were the independent risk factors in our study population to develop pulmonary barotrauma which increased their duration of ICU stay and all-cause ICU mortality.
Diagnostic value of neutrophil gelatinase-associated lipocalin and neutrophil-to-lymphocyte ratio in type 2 diabetes mellitus individuals with reduced estimated glomerular filtration rate(eGFR): A case-control study in a municipal hospital in Ghana
Authors: Adofo Ayirebi Allwell , Boadu Wina Ivy Ofori , Sackey Benedict , Antwi-Boateng Lilian , Adoba Prince , Adu Patrick , Boachie Joseph , Twumasi Stephen , Frimpong Joseph , Ekow Korsah Emmanuel , Ansah Ezekial , Senu Ebenezer , Arele Ansah Eugene , Nii Martey Antonio Daniel , Marfowaa Afua , Opoku Antwi Isaac , Agyemang Sah John , Baba Domosie Joachim , Khalifah Abiba , Asamoah Evans Adu , Obirikorang Christian , Addai-Mensah Otchere , Anto Enoch Odame 
Published: November 2024

AbstractIntroductionSerum neutrophil gelatinase-associated lipocalin (sNGAL), a renal tubular marker, and Neutrophil-to-Lymphocyte Ratio (NLR), a haematological inflammatory marker are two biomarkers that have recently received attention, because of their association with kidney disease. This study examined the diagnostic value sNGAL and NLR in type 2 diabetes mellitus (T2DM) patients with reduced eGFR.Materials and methodsIn this hospital-based case-control research, 97 T2DM participants and 70 healthy subjects were included. Participants’ information was documented using a structured questionnaire and patient case records. Venous blood was drawn from each participant to evaluate absolute neutrophil and lymphocyte count ratio, glycosylated haemoglobin (HBA1c), creatinine, sNGAL, and fasting blood glucose.ResultssNGAL and NLR were higher in diabetes patients with reduced eGFR than those with normal eGFR and control (p < 0.05). sNGAL level was negative correlated with eGFR among both good (r= -0.317,p= 0.036) and poor (r= -0.544,p< 0.001) glycaemic-controlled T2DM subjects with reduced eGFR. A negative correlation was observed between NLR and eGFR among poor glycaemic-controlled T2DM subjects with reduced eGFR (r= -0.329,p= 0.016). At a cut off of 8.87 µg/L and 2.34 respectively, sNGAL and NLR were found to be good predictors of nephropathy among T2DM patients (AUC=100.0, p< 0.0001 and AUC=76.0, p< 0.0001 respectively) with sNGAL being the superior marker.ConclusionssNGAL and NLR have important diagnostic value for diabetic with reduced eGFR. Whiles sNGAL showed superiority and is recommended, NLR can serve as a less expensive and readily measurable alternative biomarker for diabetic patients with reduced eGFR, particularly in poorly controlled diabetes. These two markers can be added to the available array of tests used to indicate nephropathy in type 2 diabetics to help clinicians in better management of the disease.
Beyond Image Recognition: Applying Deep Learning to List-Type Medical Data for Risk Prediction
Authors: Kondo Gaku 
Published: November 2024

ABSTRACTObjectiveThe purpose of our research was to develop efficient utilization of Deep Learning to the list-type data in which medical characteristics are arranged.Materials and MethodsWe conducted a survey of blood donors, focusing on the rare adverse reaction of falling. In addition to all cases of fainting, we randomly selected a control group of donors who did not fall. This data was then converted into a two-dimensional format suitable for analysis with a convolutional neural network (CNN). We used an under sampling method to randomly divide the dataset into training and testing sets. Finally, we used the CNN and a logistic regression model to predict the probability of fainting, calculate anomaly scores, and rank the risk of falling.ResultsThe convolutional neural network (CNN) identified 3 out of 10 falls among the group with the top 1% of anomaly scores. In contrast, the logistic regression model failed to identify any falls within the same top 1% anomaly score group.ConclusionApplying information converted into two-dimensional data to Deep Learning by using anomaly detection together was useful to narrow down with high-risk group. Although these findings require validation in a larger and more diverse population, the success of this approach in predicting falls after blood donation suggests its potential for predicting other rare adverse events in healthcare, such as adverse drug reactions, complications from medical procedures, or even disease outbreaks.
Engagement in antenatal and HIV care among pregnant women before and after Option B+ policy implementation in South Africa
Authors: Hwang Candice , Jinga Nelly , Dheda Mukesh , Mhlongo Otty , Phungula Pinky , Clouse Kate , Huffman Mark D. , Fox Matthew P. , Maskew Mhairi 
Published: November 2024

ABSTRACTBackgroundSubstantial gains have been made in South Africa in the prevention of vertical transmission of HIV over the past decade.Objectivesto determine whether engagement in antenatal and HIV care among pregnant Women Living with HIV (WLWH) differed after Option B+ implementation.MethodsWe analysed cohort data from a pregnancy and birth defects surveillance system in KwaZulu-Natal (KZN). We report on two co-primary outcomes related to engagement in HIV care: 1) timing and number of ANC visits during the pregnancy period; and 2) timing of ART initiation (both self-reported ART use in interviews and observed initiation of treatment in maternal records). The association of policy era on the timing of ANC presentation was assessed using log-binomial regression modelling. We also report proportions initiating ART before or during pregnancy stratified by policy era.ResultsData from 40,357 women, including 16,016 (40%) WLWH were analysed. During the Option B+ era, 24% of pregnant WLWH attended their first antenatal care visit during the first trimester, compared to 16% during the Option B era (RR=1.52;95%CI=1.41-1.64). The proportion of women living with HIV who initiated ART prior to pregnancy was also higher during the Option B+ era compared to the Option B era, though this result was limited by missingness in the data.ConclusionsEngagement in antenatal and HIV care improved after Option B+ implementation. In the Option B+ era, South Africa has made significant progress towards the goal of eliminating mother-to-child transmission of HIV.What this study addsThere has been an increase in the proportion of pregnant WLWH initiating ART prior to pregnancy and presenting for antenatal care (ANC) during the first trimester.The findings suggest improved timing and frequency of ANC visits during pregnancy, moving towards the UNAIDS 2025 targets.
Immune cell distributions in the blood of healthy individuals at high genetic risk of Parkinson’s disease
Authors: Deecke Laura , Goldeck David , Ohlei Olena , Homann Jan , Demuth Ilja , Bertram Lars , Pawelec Graham , Lill Christina M. 
Published: November 2024

AbstractThe immune system likely plays a key role in Parkinson’s disease (PD) pathophysiology. Thus, we investigated whether immune cell compositions are already altered in healthy individuals at high genetic risk for PD. We quantified 92 immune cell subtypes in the blood of 442 individuals using multicolor flow cytometry. Polygenic risk scores (PGS) for PD were calculated based on genome-wide significant SNPs (n = 87) from a large genome-wide association study (n = 1,530,403). Linear regression analyses did not reveal significant associations between PGS and any immune cell subtype (FDR = 0.05). Nominally significant associations were observed for NKG2C+ B cells (p = 0.026) in the overall sample. Older participants at increased genetic PD risk also showed a higher proportion of myeloid dendritic cells (p = 0.019) and CD27+CD4+ memory T cells (p = 0.043). Several immune cells were nominally statistically associated in women only. These findings suggest that major alterations of immune cells only occur later in the progression of PD.
A Canado-European external validation of the Kidney Transplant Failure Score
Authors: Chatton Arthur , Feugo Kevin Assob , Pilote Émilie , Cardinal Héloïse , Platt Robert W. , Schnitzer Mireille E. 
Published: November 2024

AbstractIn kidney transplantation, obtaining early information about the risk of graft failure helps physicians and patients anticipate a potential return to dialysis or retransplantation. Clinical prediction models are commonly used to obtain such risk estimation, but their performance needs to be continuously evaluated in various contexts. We propose an external validation study of theKidney Transplant Failure Scorein a pooled sample of 3,144 patients transplanted between 2010 and 2015 in France, Belgium, Norway and Canada. This score is used at the first transplantation anniversary to predict the probability of graft failure over the following seven years. The target population was defined as adult recipients of a kidney from a neurologically deceased donor without graft failure in the first year post-transplantation. Graft failure was defined as a return to dialysis. Around 10% of patients returned to dialysis, and 12.6% died during the seven-year follow-up. The KTFS authors fitted a Cox model and then adjusted its coefficients to maximize the discrimination, yielding the KTFS final version. We evaluated the performance of the initial and final versions of the KTFS, as well as the performance of another model we developed to consider death as a competing event. All KTFS versions yielded similarly good discrimination (area under the time-dependant receiver operating curve around from 0.79 [0.76-0.82] to 0.80 [0.77-0.84]), while the discrimination-optimized one presented important miscalibration. Clinical utility, assessed through net benefit, was also the lowest for the discrimination-optimized version. Our results warn against using the current KTFS version and recommend using either the initial coefficients or the competing risk-based ones instead.Lay summaryFrench nephrologists have used the Kidney Transplant Failure Score (KTFS) for nearly fifteen years to predict kidney graft failure eight years after the transplantation. Because predictive performance decreases over time, we first verified that the score could still predict correctly in France and also in other countries. Then, we compared the different KTFS formulas to find that the one currently used is suboptimal and should be avoided. Our findings show that the KTFS is still a reliable source of information for both kidney recipients and nephrologists when using its first version.
Investigating the Role of Zinc in Mitigating Blood Lead Levels Toxicity on Gut Microbiome Diversity: NHANES 2007-2010
Authors: Ayres Kathyrn R , Liuzzi Juan P. , Lewis Freeman C. , Mobarki Huda M. 
Published: November 2024

AbstractIntroductionZinc is an essential micronutrient used in many biological functions including maintaining the gut microbial diversity. Many environmental factors, such as lead exposure, have been shown to disrupt diversity. The purpose of this study was to determine whether zinc serves as a protective factor against elevated blood lead levels (BLL) on gut microbiome diversity.MethodsThe 2007-2008 and 2009-2010 NHANES datasets were utilized to conduct a cross-sectional complex survey analysis aimed at determining whether zinc intake acts as a protective factor against changes in microbiome diversity associated with BLL, using enterolactone (ENL) as a biomarker. A multiple linear regression was conducted to evaluate whether an interaction between BLL and zinc intake could predict ENL. The model included BLL, zinc intake and their interaction, along with additional covariates such as gender, fiber intake and BMI.ResultsBMI, fiber intake, and gender were identified as covariates through diagnostic analysis and stepwise regression and were included in the final model. Sequential variable selection revealed that fiber intake was a confounding variable in the relationship between zinc and ENL levels (p = 0.543), while gender was identified as a confounding factor between BLL and ENL levels (p = 0.173). After controlling for fiber intake, zinc intake was not significantly associated with predicting microbiome diversity (p = 0.101). Additionally, no significant interaction between zinc and BLL was observed in predicting ENL levels (p = 0.079).ConclusionZinc intake did not play a crucial role in mitigating the toxicity of BLL exposure on gut microbiome diversity. However, the model did reveal important confounding variables, such as gender and fiber intake, which should be considered when using ENL as a biomarker. The public health implications suggest that dietary interventions focusing on fiber intake and managing BMI could be key in maintaining a diverse microbiome.
COVID-19 disease and economic burden in adults in six Latin American Countries before nationwide vaccination program: Ministry of Health databases assessment and systematic literature review
Authors: Espinola Natalia , Loudet Cecilia I. , Luxardo Rosario , Moreno Carolina , Kyaw Moe H. , Spinardi Julia , Mendoza Carlos Fernando , Carballo Carolina M. , Dantas Ana Carolina , Abalos Maria Gabriela , Ballivian Jamile , Navarro Emiliano , Bardach Ariel 
Published: November 2024

AbstractIntroduction and objectiveThe COVID-19 pandemic had a significant disease burden on the healthcare system worldwide. There is limited reliable national data on COVID-19 associated morbidity, mortality, and healthcare costs in Latin America. This study explored the COVID-19 disease and economic burden in Argentina, Brazil, Chile, Colombia, Mexico, and Peru in the pre-vaccination period.MethodsWe analyzed national databases and conducted a systematic review of the published literature on COVID-19 in adults aged 18 years and above. We reported cases, death rates, years of life lost, and excess mortality associated with COVID-19 in pre-vaccination period. In addition, we used a cost of illness analysis to estimate the direct medical costs associated with COVID-19. All costs are reported in US dollars as of 2023.ResultsBefore the national COVID vaccination program rollout, the average incidence rate of COVID-19 in adults aged 18 and above was 6,741 per 100,000 persons. Approximately 91% of the cases were mild, 7% were moderate/severe, and 2% were critical. Among 2,201,816 hospitalized cases, 27.8% were in intensive care, and 17.5% required mechanical ventilation. The country-specific data varied greatly across Latin American countries, with hospitalization admission: 469-18,096 per 100,000, excess mortality: 76-557 per 100,000, and years of life lost: 241,089-3,312,346. Direct medical costs ranged from US$258 million to US$10,437 million, representing approximately 2%-5% of national health expenditure.ConclusionCOVID-19 imposed a substantial public health and economic burden on Latin American countries during the pre-vaccination period. The findings should help policymakers to make informed decisions and allocate resources effectively to improve national strategies around surveillance, preventive and treatment strategies to control the spread of COVID-19 disease in the future.
Influence of Factor V Leiden mutation and Protein C/S deficiencies on preeclampsia among Sudanese women
Authors: Abdon Faris , Elamin Maha , Bakheit Khalid Hussein 
Published: November 2024

ABSTRACTBackgroundPreeclampsia (PE) is a serious pregnancy complication that poses significant health risks to both mothers and babies. Genetic factors like thrombophilia mutations and deficiencies in natural anticoagulants might contribute to its development, but their exact roles are not well understood, especially among Sudanese women.ObjectiveTo assess the relationship between the Factor V Leiden (FVL) thrombophilic mutation and reduced levels of natural anticoagulants Protein C (PC) and Protein S (PS) with the occurrence of PE among Sudanese women.Methods and materialsWe conducted a case-control study that included a total of 300 women, divided equally into three groups: 100 with PE, 100 healthy pregnant women, and 100 healthy non-pregnant women. To detect FVL mutations, we used PCR-RFLP analysis. Levels of PC and PS were measured using colorimetric assays. We applied logistic regression analyses to assess the relationships between these variables and the risk of developing PE.ResultsOur findings showed no significant link between FVL mutations and PE (p=.390). PC levels on their own did not emerge as significant independent predictors of PE (OR 1.01, 95% CI 0.99–1.02, p=.419). However, women with low PC and S levels were strongly associated with PE in both univariate and multivariate analyses (OR 77.67, 95% CI 8.97– 672.5, p<.001). This combination was significantly more common in the PE group than in the control group (p<.001). Additionally, reduced PS levels were significantly associated with an increased risk of PE.ConclusionCombined PC/PS deficiencies are strongly associated with PE among Sudanese women, indicating a significant role of these natural anticoagulants in the disease’s pathogenesis. FVL mutation was not significantly linked with PE in this population.