bluuebunny/crossref_metadata_2025_split huggingface dataset:
"No Papers, No Treatment": a scoping review of challenges faced by undocumented immigrants in accessing emergency healthcare
Authors: Kisa Sezer , Kisa Adnan 
Published: September 2024

Abstract
Background
Undocumented immigrants face many obstacles in accessing emergency healthcare. Legal uncertainties, economic constraints, language differences, and cultural disparities lead to delayed medical care and thereby exacerbate health inequities. Addressing the healthcare needs of this vulnerable group is crucial for both humanitarian and public health reasons. Comprehensive strategies are needed to ensure equitable health outcomes.

Objective
This study aimed to identify and analyze the barriers undocumented immigrants face in accessing emergency healthcare services and the consequences on health outcomes.

Methods
We used a scoping review methodology that adhered to established frameworks. Utilizing MEDLINE/PubMed, Embase, Web of Science, PsychoInfo, and the Cumulative Index to Nursing and Allied Health Literature (CINAHL), we identified 153 studies of which 12 focused on the specific challenges that undocumented immigrants encounter when accessing emergency healthcare services based on the inclusion and exclusion criteria.

Results
The results show that undocumented immigrants encounter significant barriers to emergency healthcare, including legal, financial, linguistic, and cultural challenges. Key findings were the extensive use of emergency departments as primary care due to lack of insurance and knowledge of alternatives, challenges faced by health professionals in providing care to undocumented migrants, increased hospitalizations due to severe symptoms and lack of healthcare access among undocumented patients, and differences in emergency department utilization between irregular migrants and citizens. The findings also serve as a call for enhanced healthcare accessibility and the dismantling of existing barriers to mitigate the adverse effects on undocumented immigrants' health outcomes.

Conclusions
Undocumented immigrants' barriers to emergency healthcare services are complex and multifaceted and therefore require multifaceted solutions. Policy reforms, increased healthcare provider awareness, and community-based interventions are crucial for improving access and outcomes for this vulnerable population. Further research should focus on evaluating the effectiveness of these interventions and exploring the broader implications of healthcare access disparities.
Correlates of fentanyl preference among people who use drugs in Rhode Island
Authors: Napoleon Siena C. , Park Carolyn J. , Goldman Jacqueline , Li Yu , Buxton Jane A. , Macmadu Alexandria , Biello Katie B. , Noguchi Julia , Marshall Brandon D.L. 
Published: September 2024

Abstract
Background
Fentanyl is increasingly pervasive in the unregulated drug supply and is a driver of drug overdose deaths in the United States. The aims of this study were to characterize and identify correlates of fentanyl preference among people who use drugs (PWUD) in Rhode Island (RI).

Methods
Using bivariate analysis, we examined associations between fentanyl preference and sociodemographic and psychosocial characteristics at baseline among participants enrolled in the RI Prescription Drug and Illicit Drug Study from August 2020-February 2023. Fentanyl preference was operationalized based on responses to a five-point Likert scale: “I prefer using fentanyl or drugs that have fentanyl in them.” Participants who responded that they “strongly disagree,” “disagree,” or were “neutral” with respect to this statement were classified as not preferring fentanyl, whereas participants who responded that they “agree” or “strongly agree” were classified as preferring fentanyl.

Results
Among 506 PWUD eligible for inclusion in this analysis, 15% expressed a preference for fentanyl or drugs containing fentanyl as their drug of choice. In bivariate analyses, preference for fentanyl was positively associated with younger age, white race, lifetime history of overdose, history of injection drug use, past month enrollment in a substance use treatment program, past month treatment with medications for opioid use disorder, and preferences for heroin and crystal methamphetamine (all p < 0.05). Descriptive data yielded further insight into reasons for fentanyl preference, the predominant having to do with perceived effects of the drug and desire to avoid withdrawal symptoms.

Conclusions
Only a relatively small subset of study participants preferred drugs containing fentanyl. Given the increased prevalence of fentanyl contamination across substances within the unregulated drug market, the result for PWUD is increasingly less agency with respect to choice of drug; for example, people may be forced to use fentanyl due to restricted supply and the need to mitigate withdrawal symptoms, or may be using fentanyl without intending to do so. Novel and more effective interventions for PWUD, including increased access to age-appropriate harm reduction programs such as fentanyl test strips and overdose prevention centers, are needed to mitigate fentanyl-related harms.
Locally obtained autologous bone grafts are effective for achieving arthrodesis while managing foot and ankle charcot’s neuroarthropathy: short to mid-term results from a specialized north African foot and ankle surgery unit
Authors: Osman Ahmed Ekram , EL-Adly Wael , Haroun Kerolos Maged , Khaled Mohamed , Khalifa Ahmed A. 
Published: September 2024

Abstract
Purpose
We aimed to report the union rate after only utilizing a locally obtained autologous bone graft while correcting the deformity and performing joint arthrodesis in patients with foot and ankle Charcot neuropathy (CN) and to report on the radiographic, functional, complications incidence outcomes at a minimum of two years of follow up.

Methods
We included 24 patients having a mean age of 55.4 ± 10.1 years diagnosed with CN of the foot, ankle, or both. Seven (29.2%) cases were classified as Brodsky type 1, 11 (45.8%) as type 3 A, and six (25%) were type 4. Hindfoot and Midfoot bi-columnar arthrodesis was performed in 70.8% and 29.2% of the patients, respectively. Eight (33.3%) cases had preoperative ulcers. Functional outcomes were evaluated using a modified AOFAS score. Arthrodesis site union was assessed clinically and radiographically. All patients were available for a mean follow up of 35.7 ± 9.5 (24–54) months.

Results
Arthrodesis site union was achieved in 23 (95.8%) cases after a mean of 4 ± 1.7 (2-7.5) months. The mean modified AOFAS score was 72.4 ± 10.41 (46–83) points; 79.2% achieved excellent and good scores. Ulcers healed in 87.5% of the patients. Twenty-two (91.7%) patients were satisfied with their functional results. Infection incidence was 12.5%, and no patients required revision or amputation.

Conclusion
Foot and ankle Charcot neuroarthropathy deformity correction by arthrodesis of the affected joint as a salvage management option resulted in acceptable clinical and radiological outcomes. To enhance the local environment for arthrodesis consolidation, locally obtained autografts led to higher union rates and avoided the drawbacks of using other graft types.
Evaluation of a long-lasting microbial larvicide against Culex quinquefasciatus and Aedes aegypti under laboratory and a semi-field trial
Authors: Rique Hyago Luiz , Menezes Heverly Suzany Gouveia , Melo-Santos Maria Alice Varjal , Silva-Filha Maria Helena Neves Lobo 
Published: September 2024

Abstract
Background
Microbial larvicides containing both LysiniBacillus sphaericus and Bacillus thuringiensis svar. israelensis (Bti) insecticidal crystals can display advantages for mosquito control. This includes a broader action against larvae that are refractory to the Binary (Bin) toxin from L. sphaericus, as Bin-resistant Culex quinquefasciatus and Aedes aegypti naturally refractory larvae, which often co-habit urban areas of endemic countries for arboviruses. Our principal goal was to assess the toxicity of a combined L. sphaericus/Bti larvicide (Vectomax FG™) to Cx. quinquefasciatus (susceptible CqS and Bin-resistant CqR) and Ae. aegypti (Rocke) and to determine its persistence in the breeding sites with those larvae.

Methods
The toxicity of a combined L. sphaericus/Bti product (VectoMax FG™) to larvae was performed using bioassays, and persistence was evaluated in simulate field trials carried out under the shade, testing two label concentrations during 12 weeks. A laboratory strain SREC, established with CqS and CqR larvae, was kept during four generations to evaluate the ability of the L. sphaericus/Bti to eliminate resistant larvae.

Results
The L. sphaericus/Bti showed toxicity (mg/L) to larvae from all strains with a decreasing pattern for CqS (LC50 = 0.006, LC90 = 0.030), CqR (LC50 = 0.009, LC90 = 0.069), and Rocke (LC50 = 0.042, LC90 = 0.086). In a simulated field trial, the larvicide showed a persistence of 6 weeks and 8 weeks, controlling larvae from all strains in containers with 100 L of water, using 2 g or 4 g per container (100 L), respectively. The treatment of SREC larvae with L. sphaericus/Bti showed its capacity to eliminate the Bin-resistant individuals using suitable concentrations to target those larvae.

Conclusions
Our results showed the high efficacy and persistence of the L. sphaericus/Bti larvicide to control Cx. quinquefasciatus and Ae. aegypti that might cohabit breeding sites. These findings demonstrated that such larvicides can be an effective tool for controlling those species in urban areas with a low potential for selecting resistance.

Graphical Abstract
Identification and function characterization of NcAP2XII-4 in Neospora caninum
Authors: Nan Huizhu , Lu Xin , Zhang Chao , Yang Xin , Ying Zhu , Ma Lei 
Published: September 2024

Abstract
Background
Neospora caninum is a protozoan parasite in the Apicomplexa controlled by complex signaling pathways. Transcriptional control, an important way to regulate gene expression, has been almost absent in the N. caninum life process. However, to date, research on the transcriptional regulation of the AP2 family factors in N. caninum has been extremely limited. A prior study demonstrated that removing rhoptry protein 5 (ROP5), a significant virulence factor, resulted in abnormal expression levels of predicted NcAP2XII-4 in N. caninum, suggesting that the factor may regulate the function of ROP5. This study aimed to identify NcAP2XII-4 and its function in transcriptional regulation.

Methods
The NcAP2XII-4 gene was identified by analyzing the N. caninum genome. A polyclonal antibody against the protein was prepared and purified, and its expression and localization in the parasite were detected using western blot (WB) and immunofluorescence assay (IFA). The ΔNcAP2XII-4 strain was constructed from the Nc1 strain using CRISPR/Cas9 to study its effect on the growth and development of N. caninum, and DAP-Seq and electrophoretic mobility shift assay (EMSA) were used to verify the transcriptional regulatory functions of the gene.

Results
Bioinformatic analysis showed that NcAP2XII-4 consists of 11,976 bp and encodes 3991 amino acids, with a predicted molecular mass of 410 kDa. The protein has two AP2 domains, 1207aa-1251aa and 3453aa-3500aa, and is predicted to be located in the nucleus. The results of PCR, WB, and IFA were in accordance with the bioinformatics analysis. ΔNcAP2XII-4 was successfully constructed, but the strain could not be released and ultimately succumbed within parasitophorous vacuoles (PVs). Plaque assays demonstrated that parasites lacking this gene could not form plaques. One motif was successfully identified using DAP-Seq technique. Two prokaryotic expression vectors containing the AP2 domain of NcAP2XII-4 were successfully constructed, and two prokaryotic expression proteins, AP2-D1 and AP2-D2, and ROP5 biotinylated probes were prepared. Using EMSA, NcAP2XII-4 was shown to regulate ROP5 transcription by binding to its promoter.

Conclusions
NcAP2XII-4 is an essential gene in N. caninum. This study provides a foundation for further research on transcriptional regulation in N. caninum and identifies a new candidate factor for the development of vaccines against N. caninum.

Graphical Abstract
Cross-cultural adaptation and validation to Brazilian Portuguese of the ‘knowledge of gestational diabetes (GDM)’ questionnaire for women with GDM
Authors: Pereira Laura Betat , Schroeder Helena Trevisan , dos Santos Juciela Keller , Capelari Paulo César Brizolla , Schaan Beatriz D. , Bock Patrícia Martins 
Published: September 2024

Abstract
Background
Gestational diabetes mellitus (GDM) is characterized by hyperglycemia during pregnancy. There are many diabetes-specific tools for collecting information validated in Brazilian Portuguese. However, there are no specific instruments to assess knowledge about GDM in Brazilian Portuguese. The aim of this study was to cross-culturally adapt and validate the Brazilian Portuguese version of the Knowledge of Gestational Diabetes Mellitus questionnaire (GDMKQ).

Methods
This study was conducted in southern Brazil from January to December 2023. Women with GDM or diabetes identified during pregnancy were considered eligible based on specific criteria. Clinical and demographic data were obtained through a medical records search. The GDMKQ underwent a multistep adaptation process, including translation, back-translation, content validity assessment, and cognitive interviews. After administration to participants, internal consistency, item-total correlation, and intraclass correlation were assessed. Confirmatory factor analysis was also conducted to ensure validity.

Results
A total of 155 pregnant women were recruited for the study. Most participants were aged 18–30 years, and hypertension was the main comorbidity (25.2%). Regarding education, most participants (58.7%) attended high school. The Brazilian Portuguese version of the GDMKQ consisted of 32 items. The intraclass correlation was established by two independent interviews with 57 participants, yielding a correlation coefficient of 0.79 (p < 0.01). Internal consistency (Cronbach’s alpha) was 0.81 overall but was less than 0.7 for each domain. Item-total correlations were calculated, and confirmatory factor analysis indicated a good model fit. The final Brazilian Portuguese version of the questionnaire consisted of 32 items.

Conclusions
The Brazilian Portuguese version of the GDMKQ yielded a reliable and valid tool for evaluating diabetes knowledge in pregnant women.
Type 2 diabetes mellitus negatively affects the functional performance of 6-min step test in chronic heart failure: a 3-year follow-up study
Authors: Santos-de-Araújo Aldair Darlan , Bassi-Dibai Daniela , Dourado Izadora Moraes , da Luz Goulart Cássia , Marinho Renan Shida , de Almeida Mantovani Jaqueline , de Souza Gabriela Silva , dos Santos Polliana Batista , Roscani Meliza Goi , Phillips Shane A. , Borghi-Silva Audrey 
Published: September 2024

Abstract
Background
Type 2 diabetes mellitus (T2DM) and chronic heart failure (CHF) present a decrease in functional capacity due to the intrinsic nature of both pathologies. It is not known about the potential impact of T2DM on functional capacity when assessed by 6-min step test (6MST) and its effect as a prognostic marker for fatal and non-fatal events in patients with CHF.

Objective
to evaluate the coexistence of T2DM and CHF in functional capacity through 6MST when compared to CHF non-T2DM, as well as to investigate the different cardiovascular responses to 6MST and the risk of mortality, decompensation of CHF and acute myocardial infarction (AMI) over 36 months.

Methods
This is a prospective cohort study with 36 months of follow-up in individuals with T2DM and CHF. All participants completed a clinical assessment, followed by pulmonary function testing, echocardiography, and 6MST. The 6MST was performed on a 20 cm high step and cardiovascular responses were collected: heart rate, systemic blood pressure, oxygen saturation, BORG dyspnea and fatigue. The risk of mortality, acute myocardial infarction and decompensation of CHF was evaluated.

Results
Eighty-six participants were included. The CHF-T2DM group had a significantly lower functional capacity than the CHF non-T2DM group (p < 0.05). Forced Expiratory Volume in one second (L), ejection fraction (%), gender and T2DM influence and are predictors of functional capacity (p < 0.05; adjusted R squared: 0.419). CHF-T2DM group presented a higher risk of mortality and acute myocardial infarction over the 36 months of follow-up (p < 0.05), but not to the risk of decompensation (p > 0.05).

Conclusion
T2DM negatively affects the functional performance of 6MST in patients with CHF. Gender, ejection fraction (%), FEV1 (L) and T2DM itself negatively influence exercise performance.
Anaemia and associated factors among children aged 6–59 months during the post-ebola period in Sierra Leone: a national cross-sectional survey- 2019
Authors: Mutisya Linet M. , Sserwanja Quraish , Kamara Kassim , Mazzi Micheal , Olal Emmanuel 
Published: September 2024

Abstract
Background
Anaemia is a global public health problem associated with early childhood adverse effects on mental, physical, and social development. Sierra Leone had made progress in reducing the prevalence of anaemia pre-Ebola period however this was affected by the Ebola epidemic which further strained an already struggling health system. Therefore, this study aimed to assess the prevalence and factors associated with anaemia during post-Ebola period among children aged 6–59 months in Sierra Leone.

Methods
We analyzed data from the 2019 Sierra Leone demographic and health survey (SLDHS), a nationally representative cross-sectional study. We used data collected using a stratified two-stage cluster sampling design that resulted in the random selection of a representative sample of 13,872 households. A total sample of 3,459 children aged 6–59 months were included in the study. Multivariable logistic regression was used to calculate the adjusted odds ratios and corresponding 95% confidence intervals.

Results
The prevalence of anaemia was 68.9%, that of mild anaemia was 35.8%, moderate anaemia was 30.3% and for severe anaemia was 2.8%. Children aged 6–36 months were 1.83 times more likely to have anaemia compared to those above 36 months, while boys 1.33 times more likely to be anaemic compared to girls. Children born in poor households, to mothers who had anaemia and had a history of fever had 65%, 85% and 38% increase in likelihood of childhood anaemia respectively. In addition, children living in rural areas and stunted were 1.55 and 1.38 times more likely to be anaemic respectively compared to those living in urban areas and not stunted. Children born to younger mothers (15–24 years) were 1.45 times more likely to be anaemic compared to older mother (35–49 years.

Conclusion
The current study demonstrated the predominant existence of anaemia among children aged 6–59 months in Sierra Leone. Owing to the adverse effects of anaemia on the development of children in the future, there is an urgent need for effective and efficient remedial public health interventions to prevent further complications.
Spatial patterns of causality in temperate silvopastoral systems: a perspective on nitrification stability in response to flooding
Authors: Mettauer Romane , Emily Mathieu , Bednar-Konski Zita , Widmer Anaïs , Godinot Olivier , Beule Lukas , Le Cadre Edith 
Published: September 2024

Abstract
Background
Extreme rainfall and flooding events are projected to increase in frequency and disturb biogeochemical cycles such as the nitrogen (N) cycle. By combining trees and grasses, silvopastoral agroforestry is expected to increase the stability of this cycle in response to flooding. However, little is known about the response of nitrification to flooding in silvopastoral systems. Aim of this study was to assess nitrification stability in response to flooding and identify the main causal relations that drive it in temperate silvopastures.

Methods
The nitrification stability (i.e., resistance and resilience) was assessed in two silvopastoral systems (i.e., hedgerows and alley cropping) at three positions relative to the trees. The resistance and resilience of nitrification potential were measured in the laboratory after four weeks of flooding stress and four weeks after the end of the stress, respectively. For the first time, we used multigroup latent structural equation modeling (ML-SEM) to explore the spatial structure of causal relations between nitrification stability and soil properties across all positions of the two silvopastoral systems.

Results
Tree rows of both systems favored nitrification resistance, while the mean nitrification potential under flooded conditions was on average 27% and 35% higher as compared to non-stressed soils at the two positions assessed in the grass alleys. ML-SEM revealed that the causal relations that explained these results differed between the two systems. The ML-SEM models tested were unable to explain the causal relations in the hedgerow system. However, the model that considered a covariance between soil physical properties and soil resources availability (model A) was able to explain them in the alley-cropping system. It revealed that causal relations explaining nitrification stability varied according to the position relative to the trees: in the tree rows nitrification stability was associated with higher soil organic carbon concentration and earthworm abundance; in the grass alleys it was associated with higher soil organic carbon concentration and soil bulk density.

Conclusions
This study indicates that silvopastoral systems help regulate the N cycle near the trees. The results further imply that improvements in soil organic carbon concentration and soil bulk density favor the regulation of N-related processes in grasslands.
Fault geometry invariance and dislocation potential in antiplane crustal deformation: physics-informed simultaneous solutions
Authors: Okazaki Tomohisa , Hirahara Kazuro , Ueda Naonori 
Published: September 2024

AbstractEarthquake-induced crustal deformation provides valuable insights into the mechanisms of tectonic processes. Dislocation models offer a fundamental framework for comprehending such deformation, and two-dimensional antiplane dislocations are used to describe strike-slip faults. Previous earthquake deformation analyses observed that antiplane dislocations due to uniform fault slips are influenced predominantly by fault tips. Here, we state a general principle of fault geometry invariance in antiplane dislocations and exploit its theoretical consequence to define dislocation potentials that enable a streamlined crustal deformation analysis. To demonstrate the benefits of this theory, we present an analytical example and construct a rapid numerical solver for crustal deformation caused by variable fault slip scenarios using physics-informed neural networks, whose mesh-free property is suitable for modeling dislocation potentials. Fault geometry invariance and the dislocation potential may further the analysis of antiplane crustal deformation, particularly for uncertainty quantification and inversion analysis regarding unknown fault geometries in realistic crustal structures.