bluuebunny/crossref_metadata_2025_split huggingface dataset:
Impact of hospital outpatients’ experiences of patient safety on fear of infection: a secondary analysis of national data
Authors: Kwon Hyunjeong , Lee Miseon 
Published: November 2024

IntroductionAmid the COVID-19 pandemic, outpatients’ concerns about infection risk have increased. It is crucial to understand the factors that contribute to this fear of infection to promote patient safety and encourage outpatients to seek proper follow-up treatment without fear. This study aims to understand the relationship between outpatients’ experiences of patient safety and their fear of infection.DesignThis was a secondary analysis of national data from the Healthcare Service Experience Survey in 2020.Setting and participantsA total of 4416 patients with experience using outpatient services in the past year were included in South Korea.Primary and secondary outcome measuresDemographic characteristics, fear of infection and safety experiences were assessed in the original survey. Fear of infection served as the dependent variable, with safety experiences—specifically, patient identification, preinjection explanations, hand hygiene, proper use of injection supplies, skin disinfection and adverse drug reactions—as the independent variables.ResultsApproximately 14% of outpatients had a fear of infection when receiving medical care. The unadjusted model showed that all patient safety categories were determinants of fear of infection, and the multivariate logistic model identified hand hygiene and medication safety experiences as significant factors associated with fear of infection.ConclusionsThis study revealed that patient safety experiences are associated with fear of infection in outpatient settings. Improving healthcare professionals’ hand hygiene and managing adverse drug reactions are crucial for enhancing patient safety.
Population-level trends over a decade in geographical inequality for opportunity in access to maternal care services: a cross-sectional analysis from the National Family Health Surveys in India
Authors: Dandona Rakhi , Majumder Moutushi , Kumar G Anil 
Published: November 2024

ObjectivesThe objective of this study is to examine the trends in geographical inequality of opportunity in maternal health services in India considering the Every Newborn Action Plan (ENAP) 2025 coverage targets.SettingIndia.ParticipantsWomen in the National Family Health Survey (NFHS)—NFHS-4 (2014–2015) and NFHS-5 (2019–2021).Primary and secondary measuresDistrict-level coverages of 4+antenatal care (ANC) visits, institutional delivery with skilled birth attendant, postnatal care (PNC) services within 48 hours of delivery, continuum of care (CoC) services for women with most recent live births were considered. Human Opportunity Index (HOI) documented the opportunities for equitable access to these services, ranging from 0 (high inequality) to 100 (universal access). HOI was compared between the survey rounds and wealth index (WI) quintiles that the women belonged to.ResultsCoverages of 4+ANC visits, institutional delivery, PNC and CoC in India increased by 22.8% (95% CI 22.1% to 23.5%), 12.6% (95% CI 12.2% to 12.9%), 28.5% (95% CI 28.0% to 29.0%) and 38.6% (95% CI 37.6% to 39.6%) between NFHS-4 and NFHS-5, respectively. The HOI for 4+ANC visits was 48.4 in NFHS-5, ranging from 11.3 to 92.4 in states and from 31.1 to 70.5 for WI I–V. The HOI for institutional delivery was 80.4 in NFHS-5, ranging from 37.4 to 99.7 in the states and from 21.0 to 100 for WI I–V. The HOI for PNC services was 73.5 in NFHS-5, ranging from 37.5 to 95.6 in the states and from 61.2 to 88.3 for WI I–V. The HOI for CoC was 37.1, ranging from 6.5 to 88.8 in the states and from 19.8 to 62.7 for WI I–V for CoC in NFHS-5.ConclusionThough significant improvements in the geographical inequity of maternal health services have been made in India, the geographical inequity for 4+ANC visits coverage lags significantly behind resulting in CoC coverage inequity to achieve the ENAP targets for these services.
Cost of delivering childhood RSV prevention interventions to the health system in Kenya: a prospective analysis
Authors: Baral Ranju , Otiang Elkanah , Odiyo Joseph , Nyawanda Bryan O , Nyiro Joyce U , Munywoki Patrick , Jalang'O Rose E , Pecenka Clint 
Published: November 2024

ObjectivesTo evaluate the cost of delivering childhood respiratory syncytial virus (RSV) prevention interventions to the health system in Kenya.DesignA prospective (cost projection) activity-based costing study.SettingKenya, national introduction of interventions.ParticipantsNot applicable.InterventionsA single-dose RSV maternal vaccine and a single-dose, long-acting monoclonal antibody (mAb).Primary and secondary outcome measuresCost per eligible target population; cost per dose administered; non-commodity cost of delivery. Costs are reported in 2023 USD.ResultsRSV interventions are expected to be delivered using existing systems: maternal vaccine using the antenatal care platform and the mAb delivered similar to existing birth dose vaccines. Assuming a price of US$3 per dose (for both interventions) and baseline coverage rates averaging 50% for the maternal vaccine and 86% for the mAb, the estimated cost of delivering maternal vaccine was US$1.74 (financial) and US$6.60 (economic) per vaccinated woman, and the cost of delivering mAbs was US$1.56 (financial) and US$6.27 (economic) per vaccinated child. Excluding commodity cost, the cost of delivering maternal vaccine was US$1.32 (financial) and US$2.72 (economic) and that for mAb was US$1.23 (financial) and US$2.48 (economic). Cost differences between the two interventions are driven by the anticipated baseline coverage. Health worker training, service delivery and programme planning and coordination were major cost drivers.ConclusionThis study presents the prospective cost of new RSV intervention introduction and delivery in low-income and middle-income country settings, which is largely unknown. Cost estimates incorporate anticipated health system strengthening activities needed to deliver the future RSV interventions. These cost estimates support country-level and global-level decision-makers evaluating implementation feasibility and intervention affordability.
Epidemiology and clinical characteristics of football injuries among academy players in Ghana
Authors: Kwakye Samuel Koranteng , Mostert Karien , Garnett Daniel , Masenge Andries 
Published: November 2024

ObjectiveTo determine the epidemiology and clinical characteristics of match and training injuries among football players at an academy in Ghana.MethodsIn this prospective observational study, we followed 80 youth and adult football players at a Ghanaian academy over a season of 39 weeks. Medical attention and time-loss injuries, as well as exposure times of players, were recorded by resident physiotherapists using a standardised injury surveillance form. The average weekly injury prevalence was calculated. Injury incidence rates were calculated per 1000 exposure hours, with significance indicated as 95% CIs.Results126 injuries were recorded during the season, with an average weekly injury prevalence of 4.1%. The overall injury incidence was 4.5 (95% CI 3.8 to 5.4) injuries per 1000 hours with under 14 (5.8 (3.3 to 10.2)/1000 hours) and under 18 players (5.7 (4.4 to 7.4)/1000 hours) recording a higher incidence than under 16 (5.1 (3.5 to 7.4)/1000 hours) and senior players (2.7 (1.9 to 3.9)/1000 hours). Match injury incidence was 13 times higher than training injury incidence (27.4 (21.5 to 34.9) vs 2.3 (1.8 to 3.0) injuries/1000 hours). Injuries to the lower extremities had the highest incidence (3.9 (2.1 to 7.2) injuries/1000 hours), with the knee being the most commonly injured site (n=30, 23.8%). The most common type of injury was a joint sprain (1.9 (1.5 to 2.5) injuries/1000 hours), and the most common injury mechanism was direct contact with another player (1.5 (1.1 to 2.0) injuries/1000 hours). Most injuries were moderately severe (2.0 (1.5 to 2.6) injuries/1000 hours).ConclusionGhanaian academy football players have a substantial risk of sustaining injuries, especially among younger players. Further studies should focus on developing specific injury prevention programmes in under-researched football-playing populations.
Insurance coverage policies for infertility services in health insurance: a systematic review of global practices and disparities
Authors: Ahmadi Seyed Ahmad , Moeini Sajad , Ketabchi Ensieh , Veysi Sheikhrobat Mohammad , Shamsaei Monireh 
Published: November 2024

BackgroundInfertility affects about 10% of the global population, imposing significant economic and psychosocial burdens. This systematic review examines disparities in insurance coverage for infertility services worldwide, assessing how these disparities affect access to care and fertility outcomes.MethodsFor this systematic review, scientific databases (PubMed, EMBASE, Web of Science and Scopus) were searched from the beginning of 1990 to 2022 to identify literature related to insurance coverage for infertility services by health insurance organisations worldwide. Two researchers screened titles and abstracts, extracted data from full-text articles and assessed their quality using the Joanna Briggs Institute Critical Appraisal Tool.Results11 studies, primarily from high-income countries, met the inclusion criteria. Findings show a substantial increase in access to infertility services in countries with comprehensive insurance policies, such as the USA, where Medicaid coverage led to a 27% increase in first births among women over 35 years. Disparities in coverage, particularly in advanced treatments such as assisted reproductive technology and in vitro fertilisation (IVF), were notable, with limited coverage in countries such as Japan. Low-income countries generally lack sufficient insurance policies, exacerbating access disparities.ConclusionInsurance coverage policies for infertility services are associated with improved fertility outcomes, especially through increased access to infertility services. However, coverage disparities remain, emphasising the need for comprehensive policies to reduce economic barriers and support equitable access across regions.
Human blood cell transcriptomics unveils dynamic systemic immune modulation along colorectal cancer progression
Authors: Martinez-Usatorre Amaia , Ciarloni Laura , Angelino Paolo , Wosika Victoria , Conforte Alessandra Jordano , Fonseca Costa Sara S , Durandau Eric , Monnier-Benoit Sylvain , Satizabal Hector Fabio , Despraz Jérémie , Perez-Uribe Andres , Delorenzi Mauro , Morgenthaler Stephan , Hashemi Brian , Hadadi Noushin , Hosseinian-Ehrensberger Sahar , Romero Pedro J 
Published: November 2024

BackgroundColorectal cancer (CRC) is the second leading cause of cancer-related deaths worldwide. CRC deaths can be reduced with prevention and early diagnosis. Circulating tumor DNA-based liquid biopsies, are emerging tools for cancer detection. However, the tumor-signal-dependent nature of this approach results in low sensitivity in precancerous and early CRC stages. Here we propose the host immune response to the onset of cancer as an alternative approach for early detection of CRC.MethodsWe perform whole transcriptome analysis of peripheral blood mononuclear cells (PBMCs) isolated from individuals with CRC, precancerous lesions or negative colonoscopy in two independent cohorts using next-generation sequencing.ResultsWe discover and validate novel early CRC RNA biomarkers. Taking into account, and adjusting for, the sensitivity of PBMCs transcriptomes to processing times, we report distinct transcriptomic changes in the periphery related to specific CRC stages. Activation of innate immunity is already detectable in the peripheral blood of individuals with pre-malignant advanced adenomas. This immune response is followed by signs of transient B-cell activation and sustained inhibition of T-cell responses along CRC progression, whereby at late stages, protumoral myeloid cells, wound healing and coagulation processes prevail. Moreover, some biomarkers show similar dysregulation in tumors and are implicated in known pathways of CRC pathophysiology.ConclusionsThe strong systemic immune modulation triggered during CRC progression leads to previously unnoticed alterations detectable in PBMCs, paving the way for the development of an early CRC screening blood test, incorporating 226 validated biomarkers identified through immunotranscriptomics.
Prevalence of medial tibial stress syndrome in the British Armed Forces: a population-based study
Authors: Farquharson Emma , Roberts A J , Warland A I , Parnis N , O’Connell N E 
Published: November 2024

IntroductionMedial tibial stress syndrome (MTSS) is common in the Armed Forces due to the physical demands placed on service personnel (SP). There are no large studies reporting the extent to which MTSS affects the Armed Forces. A retrospective cross-sectional study design was used to report the annual prevalence of MTSS in the British Armed Forces and in training units and healthcare utilisation.MethodsSecondary data were sourced from the electronic medical records for all SP with MTSS (20 257) between 1 January 2010 and 31 December 2018. Prevalence was calculated annually across the Armed Forces and in recruits. Healthcare utilisation (number of contacts and days under the care of a healthcare professional) was reported according to characteristics of SP (sex, age, ethnicity, service branch, body composition measurement and medical discharge).ResultsOver 9 years, 20 257 SP were seen for MTSS. Prevalence of MTSS decreased across the Armed Forces, from 2.19% (95% CI 2.12 to 2.26) in 2013 to 1.61% (95% CI 1.55 to 1.68) in 2018. The prevalence of MTSS was 2.7 times higher in recruits, affecting 4.34% (95% CI 4.00 to 4.69) in 2018. In 2018, the prevalence in female recruits was over four times higher (7.03%, 95% CI 5.74 to 8.32) than trained female SP (1.60%, 95% CI 1.39 to 1.81) and higher than male recruits (4%, 95% CI 3.65 to 4.35). Comparing service branches, royal marines had the least healthcare input (median contacts (IQR): 3 (1–7.5)) over the least number of days (median days (IQR): 17 (0–154)), with the royal air force receiving the most (median contacts (IQR): 5 (2–13)) over the greatest number of days (median days (IQR): 76 (4–349)).ConclusionThe prevalence of MTSS has reduced; however, it remains high in subsections of the Armed Forces, particularly in female recruits. There is a large variation in the amount and duration of healthcare input SP received for MTSS.
Biomechanical determinants of rheumatoid arthritis severity and excess cardiovascular disease: common origins of two complex diseases
Authors: Oakley Stephen Philip , Stott Samantha , Gill Kerri , Weston Lyanne 
Published: November 2024

ObjectivesThe determinants of rheumatoid arthritis (RA) severity and excess cardiovascular disease (CVD) are incompletely understood. Biomechanical factors are known to influence RA severity. Articular stiffness correlates with arterial and skin stiffness. This study explored the hypothesis that constitutional stiffness is a common determinant of RA severity and excess CVD.MethodsFifty-eight patients with anti-CCP antibody (ACPA) positive RA and 57 controls were enrolled noting age, sex, body mass index, alcohol and tobacco exposure, Shared Epitope status and in RA disease duration, disease activity, ACPA titre and radiographic damage. Severe RA was defined as radiographic progression >1.3 mSharp points/year or requiring biological disease-modifying antirheumatic drugs (bDMARDs). Articular stiffness (Beighton Score and right 5th metacarpophalangeal (MCP) joint stress–strain responses), carotid-femoral pulse wave velocity and skin extensibility (percent increase distance two dots with manual traction dorsum right hand) were assessed.ResultsRight 5th MCP stiffness correlated with Beighton Score and with arterial and skin stiffness. High radiographic rate was associated with greater MCP articular (t test p 0.014), arterial (p 0.044) and, in RA <5 years duration, greater skin stiffness (p 0.002) with similar trends in subjects requiring bDMARDs. In RA, arterial stiffness correlated with age (ß p<0.005), articular (ß p<0.001) and skin stiffness (ß p 0.037) and inversely with alcohol consumption (p 0.035).ConclusionsArticular, arterial and skin stiffness correlated with each other and with RA severity. As skin is not affected by RA, this association suggests that constitutional stiffness might be a common determinant of RA and CVD. Prospective studies of at-risk preclinical and early RA are required to determine if this relationship is causal.Trials registration numberACTRN12617000170325.
Effect of aquatic worms and straw amendments on the geotechnical and biogeochemical properties of oil sands tailings
Authors: Kuznetsov Petr , Balaberda Amy-lynne , Pardo Miguel de Lucas , Ulrich Ania 
Published: November 2024

Aquatic Oliogochaete worms ( Lumbriculus variegatus) combined with straw led to improved geotechnical properties of fluid fine tailings (FFT) and thickened tailings (TT) in large-scale column studies. Gravity settling caused 19.9% and 20.6% consolidation of FFT and TT over 125 and 127 days, while the addition of straw and worms increased consolidation to 22.0%–24.3% for FFT and 28.1%–28.9% for TT. Solids content and yield stress were up to 1.1x and 6.6x higher in straw and worm columns, with greatest improvements seen in the top tailings layers where worm tunnels were visually observed. Surviving worms were only found in one column, suggesting the worms provide benefits extending past their depth of penetration and lifespan. The addition of straw stimulated methanogenic activity, decreasing pH, increasing alkalinity, and creating strictly anaerobic conditions (−300 mV), which may have impacted the survivability of the worms but provided another bioconsolidation pathway.
Non-minimally coupled teleparallel scalar field reconstruction of matter bounce scenario
Authors: Tripathy S. K. , Pal Sasmita , Mishra B. 
Published: November 2024

AbstractTeleparallel description of gravity theories where the gravity is mediated through the tetrad field and consequent torsion provide an alternative route to explain the late time cosmic speed up issue. Generalisation of the teleparallel gravity theory with different functional forms of the torsion scalar T leads to f(T) gravity. The role of scalar field played in addressing issues in cosmology and astrophysics has developed an interest in the inclusion of a scalar field along with an interaction potential in the action. Such a generalised gravity theory is dubbed as $$f(T,\phi )$$

f
(
T
,
ϕ
)

theory. We have explored such a gravity theory to reconstruct the interaction potential of the scalar field required for an extended matter bounce scenario. The cosmological implications of the reconstructed scalar field potential are studied considering two viable and well known functional forms of $$f(T,\phi )$$

f
(
T
,
ϕ
)

. The energy conditions of these model are discussed to assess the viability of the cosmological models.
Anisotropic extension of the Kohler–Chao–Tikekar cosmological solution with like Wyman IIa complexity factor
Authors: Siza B. , Andrade J. , Santana D. , Naseer Tayyab 
Published: November 2024

AbstractWe construct a new stellar compact object model in the regime of anisotropic pressure using the framework of gravitational decoupling via minimal geometric deformation, with the particularity that the seed solution used is the known Kohler–Chao–Tikekar cosmological solution. As an extra condition to close the Einstein’s field equations resulting for this construction, we use a generalised complexity factor for self-gravitating spheres to the well-known Wyman IIa solution. The resulting model fulfils the fundamental physical acceptability stellar conditions for a compactness factor of a pulsar SMC X-1. The stability of the model is also investigated.
Review of Long-Term Sequelae and Management in Paediatric Lower Limb Replantation
Authors: HO Xin Nee , LIAO Janice Chin-Yi , PUHAINDRAN Mark E. , CHONG Alphonsus K. S. 
Published: November 2024

Major limb amputation in a child is a rare but devastating injury associated with significant psychosocial and financial burden. This, combined with the higher growth and remodelling potential despite segmental limb loss, decreases the threshold for replantation in children. Advances in microsurgical techniques and a better understanding of such injuries have led to lower limb replantation becoming a feasible option, with good long-term functional outcomes, even in bilateral amputations. However, long-term sequelae such as limb length discrepancy (LLD) are common, and patients are often subject to multiple surgical interventions. We present a case of replantation in a 2-year-old child following traumatic right below knee amputation, followed up over a period of 5 years. After multiple surgeries, the patient gained good functional recovery and sensibility of the replanted limb. We reviewed and discussed the management of subsequent long-term sequelae, including LLD, lower limb contractures and valgus deformity. Level of Evidence: Level V (Therapeutic)
Bioinformatics and Machine Learning–Based Identification of Critical Biomarkers and Immune Infiltration in Venous Thromboembolism
Authors: Li Yajing , Deng Hongru 
Published: November 2024

Objective: This study aims to use bioinformatics and machine learning algorithms to screen and analyze the key genes involved in venous thromboembolism (VTE) and explore the relationship between these biomarkers and immune cell infiltration.Methods: The gene expression profile with the identifier GSE19151 was downloaded from the GEO database. Differential expression analysis using the limma package was conducted to identify genes that were differentially expressed between VTE and normal samples. Biological activities of these genes were then investigated through GO analysis utilizing the R language package. KEGG and GSEA were also performed to identify key signaling pathways. Furthermore, machine learning techniques were employed to determine hub gene signatures related to VTE, and ROC curves were used to validate the findings. To compare the immune infiltration of healthy and VTE samples, single sample gene set enrichment analysis (ssGSEA) was applied. Lastly, the Spearman correlation coefficient was used to assess the relationship between the expression of hub genes and immune cell infiltration.Results: A total of 628 differentially expressed genes (DEGs) were discovered between the VTE samples and normal samples. GO analysis identified protein polyubiquitination, lysosomal lumen acidification, organellar ribosome, mitochondrial ribosome, ammonium transmembrane transporter activity, and immunoglobulin binding as the processes with the highest abundance of DEGs. KEGG pathway analysis revealed that DEGs were enriched in ribosome, COVID‐19, viral infection, oxidative phosphorylation, Parkinson’s disease, nonalcoholic fatty liver disease, apoptosis, and cancer. The most prominent KEGG pathways associated with VTE were ribosome, Parkinson’s disease, oxidative phosphorylation, Alzheimer’s disease, and Huntington’s disease according to GSEA findings. DLST and LSP1 were identified as hub gene signatures in VTE by machine learning integrative analysis, and ROC curves confirmed their diagnostic value. Results from ssGSEA indicated a significant difference in the degree of immune cell infiltration between VTE and normal samples, with the expression of DLST and LSP1 positively correlated with the content of some immune cells. The R package, code, and analysis results used in this paper are available on https://github.com/doctorlaby/my-project.Conclusion: Our research is the first to utilize machine learning techniques in identifying DLST and LSP1 as significant biomarkers of VTE. With our findings, we have uncovered new insights into the underlying causes of VTE and potential treatments for affected patients.