bluuebunny/crossref_metadata_2025_split huggingface dataset:
The burden of headache disorders among adults in Peru: national estimates and a health-care needs assessment from a population-based door-to-door survey
Authors: Quispe Guiovanna , Loza Cesar , Limaco Luis , Gallegos Ruth , Palomino-Diaz Carlos , Cruz Ivett , Miranda Jacqueline , Rodriguez Liliana , Husøy Andreas , Steiner Timothy J. 
Published: November 2024

Abstract
Background
We have previously found that almost two thirds (64.6%) of adults in Peru have an active headache disorder. Here, using data from the same sample, we present attributed burden at individual and population levels. We use these data to assess need for headache-related health care among this population.

Methods
We used the standard methodology of the Global Campaign against Headache. Cluster-sampling from five geographical regions of Peru (Cajamarca, Lima, Piura, Puno, San Martín) generated a sample representative of the population aged 18–65 years. At unannounced visits to households, we interviewed one adult from each using the HARDSHIP questionnaire. We assessed symptom burden in terms of headache frequency and usual duration and intensity, and impaired participation in paid work, household work and social or leisure activities using the HALT index. To assess need for health care, we counted all those with headache on ≥ 15 days/month (H15+), those with migraine on ≥ 3 days/month, and those with migraine or tension-type headache meeting either of two criteria: a) proportion of time in ictal state (pTIS) > 3.3% and intensity ≥ 2 (moderate-to-severe); b) ≥ 3 lost days from paid and/or household work during the preceding 3 months. We derived population-level estimates by factoring in prevalences.

Results
The sample size was N = 2,149. From individual data, we estimated population-level pTIS at 1.9–2.5%, this proportion of all time among adults in Peru being spent with headache, with migraine the greatest contributor (1.2%). At population level, headache was responsible for 0.5 days lost from paid work and 1.0 days from household work per person per 3 months, with migraine again the biggest contributor (0.2 and 0.5 days). However, at individual level, H15 + was associated with greatest burden (pTIS 14.9–24.9%; 2.3–4.5 lost workdays/3 months). A quarter of the sample (n = 590; 27.5%) fulfilled one or more of our health-care need criteria.

Conclusion
Headache disorders are responsible for high levels of ill health and economic burden in Peru, with a substantial requirement for health care. Health and economic policies balancing health benefits against the cost of providing care should take account of the productivity losses that might be recovered, and the expected cost-offset.
Volume assessment comparing femoral vein and inferior vena cava among chest pain patients presenting to the emergency department
Authors: Nair Neeraja A , Sirur Freston Marc , Krishnan S Vimal 
Published: November 2024

Abstract
Background
Inferior vena cava (IVC) diameter measurement using ultrasound for volume status assessment has shown satisfactory results and is being adopted in Emergency and critical care settings. IVC diameter can vary depending on the cardiac function, respiratory efforts, intraabdominal pressure, and mechanical ventilation. Due to these factors, IVC measurement cannot be considered a stand-alone technique appropriate for every patient. The femoral vein (FV), a more superficial vein than IVC, can be considered an alternative method for assessing fluid responsiveness in patients presenting to the Emergency department. It is easily accessible and can be used in scenarios where IVC cannot be visualized or reliable.

Methods
This was a single-center diagnostic study where 85 patients who presented to the ED with chest pain were enrolled prospectively. IVC and femoral vein collapsibility indices, stroke volume, and cardiac output are measured using an ultrasound machine. The measurements were repeated after a passive leg-raising test. These values were compared with each other to assess an intra-class correlation between IVC and femoral vein collapsibility indices. We have also evaluated the relationship between the collapsibility indices of both veins and cardiac output.

Discussion & limitations
Our findings show an insufficient correlation between IVC and FV collapsibility indices. However, both vein diameters significantly increased after passive leg raising (PLR), indicating a response to fluid challenge. Post-PLR reduced IVC, and FV collapsibility index (CI) suggests intravascular volume expansion after a fluid challenge, also reflected in the hemodynamic parameters. Our study was conducted only in a subset of relatively stable patients. The applicability of the study in different subsets of patients presenting to ED is still questionable.

Conclusion
We conclude that femoral vein indices may not be an accurate alternative for volume assessment in the chosen cohort of patients. IVC and FV metrics do not correlate and may not be accurate for volume responsiveness. We may need to explore the utility of FV and its indices in a larger population in multiple settings for a better understanding of its role in volume assessment and responsiveness.

Trial registration
(EC/NEW/INST/2021/1707). Registered 03 January 2023.
The impact of the COVID-19 pandemic on hospital-acquired infections and multi-drug resistant organisms, in comparison to seasonal influenza
Authors: Dabaja-Younis Halima , Silman Zmira , Tarabeia Jalal , Hussein Khetam 
Published: November 2024

Abstract
Background
While effective preventive measures reduce hospital-acquired infections (HAIs) and the spread of multi-drug resistant organisms (MDROs), studies on the impact of the COVID-19 pandemic and its associated preventive measures remain inconclusive.

Objective
To assess the impact of COVID-19 on HAIs and MDROs and to compare it with the effect of seasonal influenza.

Methods
A retrospective cohort study analyzed prospectively collected data from a tertiary hospital in Haifa, northern Israel, from 2016 to 2021. It compared pre/during COVID-19 and influenza (Dec-Feb)/non-influenza (Mar-Nov) seasons. Studied parameters: hospital-acquired bloodstream infections (HA-BSI), MDROs, nosocomial Clostridioides difficile infections (CDI) per 10,000 hospital days (HD), central line-associated BSI (CLABSI) per 1000 catheter days (CD) and hand hygiene compliance (HHC).

Results
During the COVID-19 period, rates of HAIs and MDROs decreased compared to the pre-COVID era for methicillin-resistant Staphylococcus aureus (MRSA) (4.2 vs. 6.9/10,000 HD; p < 0.001), carbapenem-resistant Acinetobacter baumani (CRAB) (2.2 vs. 3.1/10,000 HD; p = 0.02), and nosocomial CDI (3 vs. 4.6/10,000 HD; p < 0.001). However, there was a higher rate of carbapenem-resistant Enterobacteriaceae (CRE) (4.6 vs. 2.7/10,000 HD; p < 0.001) and HA-BSI (29.7 vs. 27.3/10,000 HD; p = 0.006) during the COVID-19 era. CLABSI rates showed no significant difference (2.3 vs. 2.7/1000 CD; p = 0.910). HHC rate remained at 70% in both eras (p = 0.151). No significant differences were observed in MDROs, CDI, HA-BSI, or CLABSI rates (p = 0.233, 0.675, 0.267, and 0.563, respectively) between influenza and non-influenza seasons.

Conclusions
In the COVID-19 era, HAIs and MDROs rates significantly declined, while CRE rates increased, possibly due to a national trend in Israel since 2016. Steady HHC rates suggest additional factors like enhanced environmental cleaning, personal protective equipment usage, and increased infection prevention awareness contributed to this decline. Influenza had no noticeable impact, likely due to healthcare workers’ varying perceptions and the brevity of the influenza season, making it challenging to assess impact.
Evaluation of high school-based dengue solution model in Southern Thailand: a community participatory action research
Authors: Suwanbamrung Charuai , Mehraj Sandeep Kumar , Kercho Melkamu Worku , Stanikzai Muhammad Haroon , Ageru Temesgen Anjulo , Jaroenpool Jiraporn , Pibul Panatda , Shohaimi Shamarina , Israel Eskinder 
Published: November 2024

Abstract
Introduction
By the time the globe started to tackle the COVID-19 pandemic, Southeast Asian countries had faced an increased dengue incidence, which has eventually become an important public health problem. However, effective and sustainable disease control measures in the area are still lacking. Therefore, the current study is aimed to evaluate the development and implementation of high school-based dengue solution model in Southern Thailand.

Methods
Integrated community participatory action research (CPAR) was employed using preparation, planning, implementation, and evaluation. Data was collected using quantitative and qualitative methods from high school students. Descriptive statistics such as frequency and percentage, chi-square and fisher’s exact test were used to summarize and compare quantitative data before and after intervention. Similarly, qualitative data was collected through interviews and focus group discussion (FGD) and then analyzed through thematic analysis.

Results
Two hundred and thirty-nine (96.3%, n = 239/248) and 232 (93.5, n = 232/248) participants were included in the interventions before and after, respectively. School-based dengue prevention was developed with input from a variety of stakeholders, including students, community leaders, health educators, district officials, and community health volunteers. As demonstrated by pre- to post-test results, students understanding of dengue and the larval indices surveillance system has increased. Students who received the training were not only inspired but created a sense of community responsibility with a high commitment to teaching and sharing information in their circle to enhance overall community wellbeing. Being female and higher educational attainment was associated with students understanding of dengue and larval indices surveillance.

Conclusion
This participatory action research not only improved students' understanding of dengue but also empowered them to be proactive in various community health initiatives. The positive correlation between educational attainment and students understanding of dengue solution and larval indices surveillance underscores the need for tailored educational interventions that address diverse learning needs within the community. Collaborative efforts to establish dengue health information center based at primary schools and above can better improve reduction of dengue incidence.
Validating anti-inflammatory and cytotoxic properties of Fagonia cretica L. through metabolic, in vitro, and in silico profiling
Authors: Mohamed Enas I. A. , Elwekeel Ahlam H. , Mohamed Dalia El Amir , Zaki Mohamed A. , Hassan Marwa H. A. 
Published: November 2024

Abstract
Background
Fagonia cretica L. (Family: Zygophyllaceae), is a wild shrub mostly found in Mediterranean districts and extensively used in folk medicine for a vast array of purposes such as antidiabetic and anticancer during the early stages. The goal of the current study was to validate the antioxidant, anti-inflammatory, and cytotoxic properties of Egyptian F. cretica using in vitro studies, metabolic profiling, and in silico approaches.

Methods
The plant was collected from the Egyptian desert and the alcoholic extract was prepared from its aerial parts, total phenolic and total flavonoid contents were evaluated spectrophotometrically. Antioxidant potential was assessed via 1,1 diphenyl-2-picrylhydrazyl (DPPH) scavenging activity. Anti-inflammatory activity was validated through in vitro COX-2, COX-1, and nitric oxide inhibition. Cytotoxicity was tested against liver (HepG2), breast (MCF-7), and intestinal (CACO2) carcinoma cell lines followed by assessment of its impact on the levels of apoptotic markers namely topoisomerase I and caspase 9 enzymes. Chemical profiling of the extract was performed using LC-HRMS technique. Saponin rich extract was prepared and tested for affecting topo I and caspase 9 enzymes. In silico studies were conducted on anti-inflammatory (COX-2 and COX-1) and cytotoxicity (topoisomerases I, IIα, and IIβ) targets using Autodock vina in PyRx platform.

Results
Total phenolic and total flavonoid content of the extract were 2.4 ± 0.12 mg GAE/g and 0.18 ± 0.01 mg RE/g, respectively. In vitro results revealed antioxidant activity calculated as 1.4 ± 0.1 mg AEAC/g. In vitro anti-inflammatory assays unveiled inhibition of COX-2 and COX-1 enzymes with IC50 values of 13.02 ± 0.61 and 26.51 ± 0.83 µg/ml, respectively and nitric oxide with IC50 of 147.05 ± 9.61 µg/ml. Cytotoxicity on MCF-7, HepG2, and CACO2 cell line with IC50 values of 6.9 ± 0.53, 7.6 ± 0.42, and 9.2 ± 0.35 µg/ml, respectively, in addition to in vitro topoisomerase I inhibition (IC50 = 13.57 ± 0.71 µg/ml) and caspase 9 induction by 5.66 folds. Metabolic profiling using LC-HRMS technique resulted in dereplication of 21 compounds including triterpenoid saponins, flavonoids, diterpenoids, etc. Interestingly, saponin rich fraction and non-saponin fraction exhibited similar effects on topoisomerase I and caspase 9. In silico investigation unveiled high binding affinities of almost all the detected metabolites to the active sites of COX-2, COX-1, topo I, IIα, and IIβ enzymes.

Conclusion
Collectively, we can conclude that F. cretica is a new source of many phytochemicals, and a significant natural source as cytotoxic and anti-inflammatory agent.
Factors influencing the intention of doctors to emigrate: a cross-sectional study of Ghanaian doctors
Authors: Wutor Baleng Mahama , Sarfo Francisca Nyarko , Nkrumah Louisa Afia , Bakuoru Luki Daniel , Amanze Chinenye Nneoma , Osei Isaac 
Published: November 2024

Abstract
Background
The migration of healthcare professionals from developing countries to more developed nations poses a significant challenge to healthcare systems in low- and middle-income countries. This study aimed to determine the proportion of doctors in Ghana who intend to migrate abroad and to identify the sociodemographic and "pull and push" factors that influence their intention.

Methodology
A cross-sectional survey was conducted among doctors in Ghana between March 1, 2024, and March 15, 2024, via an online-based semi-structured questionnaire. Doctors working in Ghana, regardless of nationality, were included. Descriptive statistics and logistic regression analyses were conducted to identify factors associated with the intention to emigrate. Statistical significance was set at a p-value of < 0.05.

Results
Almost all the doctors who responded to the questionnaire consented to participate (99.4%, 641/645). More than half (53.8%, n = 345) of the respondents were medical officers. Most respondents intended to migrate to practice abroad (71.8%, n = 460). The United States (59.7%), the United Kingdom (39.1%), and Canada (34.8%) were the most preferred destinations. After adjusting for covariates, young doctors between 20–29 years [(Adjusted Odd Ratios) AOR = 2.69, 95% CI = 1.13—6.39)], male doctors (AOR = 1.53, 95% CI = 1.04—2.25), doctors in lower professional ranks, and doctors in the field of diagnostics (AOR = 5.70, 95% CI = 1.16 – 28.03) had significantly higher odds of intending to migrate. In descending order of magnitude, the respondents strongly agreed that better remuneration (1.22 ± 0.63), better quality of life (1.22 ± 0.67), better working conditions (1.26 ± 0.69), and better postgraduate training (1.41 ± 0.80) were pull factors. The push factors were economic challenges (1.17 ± 0.49), a lack of a conducive working environment (1.56 ± 0.86), slow career progression (1.95 ± 1.07), excessive workload (2.07 ± 0.12), personal circumstances (2.26 ± 1.19), and poor postgraduate training (2.48 ± 1.22).

Conclusion
A substantial proportion of doctors in Ghana are considering emigration, driven by a combination of attractive opportunities abroad and challenging conditions in Ghana. Addressing these issues through improved remuneration, better working environments, and enhanced career development and training opportunities is crucial to retaining healthcare professionals.
The association between neutrophil and lymphocyte to high-density lipoprotein cholesterol ratio and metabolic syndrome among Iranian population, finding from Bandare Kong cohort study
Authors: Hashemi Seyyed Mohammad , Kheirandish Masoumeh , Rafati Shideh , Ghazalgoo Arezoo , Amini-Salehi Ehsan , Keivanlou Mohammad-Hossein , Abbaszadeh Shahin , Saberian Parsa , Rahimi Arash 
Published: November 2024

Abstract
Background
Metabolic Syndrome (MetS) is characterized by the co-occurrence of various metabolic risk factors, significantly increasing the risk of cardiovascular diseases (CVD) and type 2 diabetes (T2DM). This study investigates the potential of hematological indices, specifically the neutrophil to high-density lipoprotein cholesterol ratio (NHR) and lymphocyte to high-density lipoprotein cholesterol ratio (LHR), as predictors of MetS in a population from southern Iran.

Methods
Utilizing baseline data from the Bandare-Kong Non-Communicable Diseases (BKNCD) Cohort, part of the Prospective Epidemiological Research Studies in IrAN (PERSIAN), A total of 2,684 participants aged 35–70 years were analyzed. Participants were evaluated using the Iranian National Cholesterol Education Program (NCEP) criteria to diagnose MetS. Receiver operating characteristic (ROC) analysis was conducted to assess the predictive validity of NHR and LHR across different demographic categories.

Results
The mean LHR and NHR values were significantly higher in individuals diagnosed with MetS (P < 0.001). Specifically, the LHR was 0.85 ± 0.26 in MetS patients compared to 0.76 ± 0.23 in those without MetS, while the NHR was 1.33 ± 0.35 in MetS patients compared to 1.20 ± 0.32 in those without MetS. After adjusting for confounding factors, both LHR and NHR remained significantly associated with MetS, with odds ratios (OR) of 6.61 (95% CI: 4.43–9.83) for LHR and 4.76 (95% CI: 3.51–6.45) for NHR. Among MetS components, LHR was associated with low HDL cholesterol and elevated triglycerides, while NHR showed significant associations with central obesity, low HDL cholesterol, and elevated triglycerides. ROC analysis revealed moderate predictive capabilities for both indices, with areas under the curve of 0.60 for LHR and 0.61 for NHR.

Conclusion
The findings suggest that NHR and LHR are promising, easily obtainable hematological markers for predicting MetS. These indices could serve as valuable tools for early detection and ongoing monitoring in clinical settings, aiding in the prevention and management of MetS.
Monitoring circulating tumor DNA liquid biopsy in stage III BRAF-mutant melanoma patients undergoing adjuvant treatment
Authors: Marchisio Sara , Ricci Alessia Andrea , Roccuzzo Gabriele , Bongiovanni Eleonora , Ortolan Erika , Bertero Luca , Berrino Enrico , Pala Valentina , Ponti Renata , Fava Paolo , Osella-Abate Simona , Deaglio Silvia , Marchiò Caterina , Sapino Anna , Senetta Rebecca , Funaro Ada , Ribero Simone , Quaglino Pietro , Cassoni Paola 
Published: November 2024

Abstract
Background
The introduction of adjuvant therapies for patients with resected cutaneous melanoma (CM) has increased the need for sensitive biomarkers for risk stratification and disease monitoring. This study aims to investigate the utility of circulating tumor DNA (ctDNA) assessment in predicting and reflecting disease status during adjuvant therapy.

Methods
We enrolled 32 patients with resected BRAF-mutated stage III CM receiving adjuvant targeted therapy or immunotherapy. Plasma samples of patients were collected at the baseline (treatment initiation) and during the therapy, and BRAF-mutated ctDNA was quantified by droplet digital PCR (ddPCR).

Results
Baseline ctDNA was detected in 11/32 (34.4%) patients and predicted postoperative high risk of relapse [HR 3.79, 95% CI 1.20–12.00, p = 0.023]. The three-year overall survival (OS) rate was 54.6% (95% CI 22.9–77.9) versus 95% (95% CI 69.5–99.3) in ctDNA-positive and negative groups, respectively, with significantly worse OS for ctDNA-positive patients [HR 7.92, 95% CI 1.56–40.36, p = 0.013]. Among the baseline ctDNA-positive group (high-risk patients), longitudinal ctDNA detection during adjuvant therapy reflected the clinical outcomes. Only non-relapsing patients cleared their plasma ctDNA by the end of the treatment, while persistent ctDNA detection provided early evidence of disease recurrence.

Conclusions
ctDNA detection shows promising results in the post-operative setting for identifying cutaneous melanoma patients at the highest risk of relapse and for real-time monitoring of patients’ clinical status and treatment response.
Ixekizumab: an alternative for HIV-positive psoriasis patients
Authors: Liu Fanghua , Liu Zhou , Yang Rongming , Huang Dandan , Han Yongzhi 
Published: November 2024

AbstractPsoriasis is a recurrent and protracted inflammatory disease. Generalized erythema, plaques, and silvery scales on the surface mainly characterize its skin lesions. Biologics bring new hope to psoriasis patients. However, HIV infection is a major concern before receiving biologics. Here, we present a case of the efficacy and safety of Ixekizumab, an interleukin 17 inhibitor, in the treatment of psoriasis patients living with HIV (PPLHIV).
Neurocognitive functioning in adults with neurofibromatosis type 1- a nationwide population-based study
Authors: Doser Karoline , Jepsen Jens Richardt Møllegaard , Kenborg Line , Miskowiak Kamilla Woznica , Albieri Vanna , Dalton Susanne Oksbjerg , Krøyer Anja , Hove Hanne , Østergaard John R. , Johansen Christoffer , Sørensen Sven Asger , Mulvihill John , Falck Winther Jeanette , Bidstrup Pernille Envold 
Published: November 2024

Abstract
Background
Neurofibromatosis type 1 (NF1) is a genetic condition characterized by various somatic manifestations and cognitive impairments, but the latter are sparsely described in adults. This study aimed at characterizing potential impairments of neurocognitive functions using neuropsychological tests as well as a self-report questionnaire.

Methods
In a nationwide, population-based study including 103 adults with NF1 and 38 age- and gender-matched NF1-free comparisons, we used a comprehensive neurocognitive test battery to assess intelligence and visual short-term memory, immediate visuospatial recall, reaction time, sustained attention, motor speed, planning, planning time, working memory as well as multitasking and a questionnaire to assess executive functions. Descriptive statistics, multivariate analysis of variance (MANOVA), and general linear models with repeated measure analysis of variance (ANOVA) were used.

Results
We observed a statistically significant difference in overall performance-based cognitive functioning. Adults with NF1 showed significant, moderate-to-severe impairments in intelligence, visual short-term memory, immediate visuospatial recall, sustained attention (p < 0.0001–0.002), and some executive functions (p = 0.008 − 0.001), whereas other cognitive functions (multitasking, reaction time, motor speed, spatial working memory, planning time, and planning efficacy as well as some self-reported executive functions) were unimpaired.

Conclusions
This is the first study with a population-based sample of persons with NF1 and the results show impairments of intelligence and other cognitive functions. The pattern of both significant cognitive impairments and non-significantly different cognitive functions suggests a cognitive profile of selective rather than generalized cognitive deficits in NF1.