bluuebunny/crossref_metadata_2025_split huggingface dataset:
Public satisfaction with the Ethiopian healthcare system: a mixed methods approach
Authors: Getahun Genanew Kassie , Demissie Bemnet Dires , Baraki Semere Gebremariam 
Published: October 2024

IntroductionThe satisfaction of the public with the healthcare system of Ethiopia is a crucial but unanswered question. This is an essential issue since recent trends indicate that the demographic and epidemiological makeup of the population is changing. Therefore, the aim of this study was to assess the overall satisfaction of the public with the Ethiopian healthcare system in Addis Ababa, Ethiopia, in 2022.MethodsA community-based convergent parallel mixed methods study was conducted. Bivariable and multivariable logistic regression analyses were used to determine the factors associated with public satisfaction. A 95% confidence interval along with a p &lt; 0.05 was deemed sufficient to declare a significant association. For the qualitative component, we used thematic analysis.ResultsThe vast majority, 77.2% (95% CI: 76.18–78.22%), of respondents were dissatisfied with the existing healthcare system. Moreover, Community-Based Health Insurance (CBHI) enrollment (2.35; 95% CI: 1.32–4.19), poor linkage to social capital (0.46; 95% CI: 0.25–0.83), poor access to healthcare services (0.39; 95% CI: 0.21–0.76), and absence of satisfactory responses to complaints (0.11; 95% CI: 0.04–0.27) were significantly associated with public dissatisfaction.ConclusionPublic satisfaction with the Ethiopian healthcare system is notably low and is affected by various factors, including enrollment in the CBHI, linkage to social capital, accessibility to healthcare, and satisfactory response to issues. Therefore, the Ethiopian government should focus on expanding CBHI coverage, improving access to healthcare services, and developing an immediate compliant solution strategy.
Paralysis caused by dinotefuran at environmental concentration via interfering the Ca2+–ROS–mitochondria pathway in Chironomus kiiensis
Authors: Wei Fenghua , Gu Weiwen , Zhang Fengru , Wu Shuangxin 
Published: October 2024

IntroductionDinotefuran as the third-generation of neonicotinoid insecticides is extensively used in agriculture worldwide, posing a potential toxic threat to non-target animals and humans. However, the chronic toxicity mechanism related to mitochondria damage of dinotefuran to non-target animals at environmental concentration is unclear.MethodsIn this study, the mitochondria damage and oxidative stress of dinotefuran on Chironomus kiiensis were investigated at environmental concentrations by long-term exposure. At the same time, relevant gene expressions of these toxicity indexes were measured as sensitive ecotoxicity biomarkers to reflect the toxic effects of dinotefuran on Chironomidae.ResultsOur present study showed that chronic exposure to environmental concentrations of dinotefuran resulted in behavioral inhibition in the larvae of Chironomidae. For burrowing inhibition of 10 days, the lowest observed-effect concentration (LOEC) and 50% inhibitory concentration (IC50) were 0.01 (0.01–0.04) and 0.60 (0.44–0.82) μg/L, respectively. Dinotefuran promoted the release of intracellular calcium ions (Ca2+) in Chironomidae via dysregulating the gene expressions of atp2b, camk ii, and calm. Subsequently, the disruption of the Ca2+ signaling pathway induced oxidative stress by raising reactive oxygen species (ROS), hydrogen peroxide (H2O2), and malonaldehyde (MDA) levels. Thus, the over-release of Ca2+ and ROS disordered the normal functioning of mitochondrial-related pathways by dysregulating the expressions of mitochondria-related genes of atpef0a, sdha, and cyt b.ConclusionOur findings showed that low environmental concentrations of dinotefuran caused paralysis of the midge via interfering the Ca2+–ROS–mitochondria pathway. These results provided data support for assessing the potential environmental risk of dinotefuran.
Blood DNA methylation of CRF and its association with amygdala volume and mood in Cushing’s syndrome
Authors: Lee Richard S. , Santos Alicia , Garrison-Desany Henri , Aulinas Anna , Carey Jenny L. , Vives-Gilabert Yolanda , Cox Olivia H. , Cuilan Gabriel , Webb Susan M. , Resmini Eugenia 
Published: October 2024

ObjectiveThe impact of chronic exposure to stress or glucocorticoids on psychiatric symptoms has been exemplified by cases of iatrogenic or endogenous hypercortisolism such as Cushing’s syndrome (CS). The amygdala plays an important role in mediating both stress and affective responses, and one of the key factors that link stress response and psychiatric symptoms is the corticotropin-releasing factor (CRF). Epigenetic changes, especially those occurring on CpG dinucleotides in DNA of glucocorticoid target genes in blood, have been previously implicated as potential predictors of glucocorticoid-related events in the central nervous system (CNS). In this study, we examined amygdala volume and mood symptoms in CS patients and aimed at evaluating whether these parameters were associated with blood DNA methylation of CRF.MethodsIn this cross-sectional study, 32 CS patients and 32 healthy controls matched for age, sex, and years of education underwent an MRI scan, a Beck Depression Inventory-II, and a State-Trait Anxiety Inventory. Genomic DNA extracted from total leukocytes were used for DNA methylation analysis of several CpG dinucleotides at the CRF promoter region.ResultsSignificant associations between CRF methylation vs. amygdala volume (CpG-1, P = 0.006) and depression scores (CpG-2, P = 0.01) were found. To assess whether the promoter CpG methylation has functional consequences, we examined RNA and DNA extracted from non-CS, postmortem amygdala tissues. A significant association between CpG methylation and gene expression (CpG-1, P = 0.004) was observed.ConclusionThese results demonstrate that methylation levels of the CRF promoter CpGs are associated with amygdala volume in CS and related mood symptoms. Methylation levels may also be associated with CRF expression. This finding supports the feasibility of using epigenetic patterns in blood as a surrogate for assessing GC-related pathologies in the brain.
Knowledge, attitude towards, and utilization of friendly health services among school adolescents in the pastoral community of Guji zone, Ethiopia: an institution-based comparative cross-sectional study
Authors: Godana Gobena , Garoma Silesh , Ayers Nicola , Abera Muluembet 
Published: October 2024

AimAlthough sexual and reproductive health for adolescents is a recognized fundamental human right and a critical component of health policy, it is poorly addressed and seldom researched in pastoral communities. The study aimed to determine the status of sexual and reproductive health knowledge, attitudes, and practice among pastoral school adolescents in Ethiopia.Study designAn Institution-based comparative study was conducted from Nov. 2020 to Jan. 2021.MethodsWe conducted a comparative cross-sectional study at four randomly selected high schools. Seven hundred seventy-three adolescent students participated, with 384 from Gorodola and 389 from Wadara districts, Guji zone Ethiopia. The data was collected using 34 self-administered questions and analyzed using descriptive, t-test, and linear regression models.ResultsThe study found that only 44.2% of all the participants had good knowledge, 46.1% had good attitudes and 35.4% had good utilization of Sexual and Reproductive Health Services. Respondents from Wadara High School had significantly higher mean knowledge scores (49.3% vs. 44.2%, p &lt; 0.01) than those of Gorodola High School. There was no significant difference in mean utilization scores between case and compare (45.08% vs. 37%, p &gt; 0.01). Adolescents who were not communicated on SRH matters, previously utilized FHS, and visited Friendly Health facilities were associated with poor utilization of sexual and reproductive health services.Conclusion and public health contributionsWadera High School adolescents have better Sexual and reproductive health knowledge and utilization than Gorodola high schools. Community public health care providers in Wadara District explain the outcome through their contributions. Within the context of inherent disadvantage in the school environment setting, there is a need to improve sexual and reproductive health education with a greater emphasis on school girls.
Polysomnographically mediated cognitive improvements in individuals with insomnia symptoms following continuous theta-burst stimulation of the default mode network
Authors: Huskey Alisa , Fisher Julia M. , Hildebrand Lindsey , Negelspach David , Henderson-Arredondo Kymberly , Jankowski Samantha , Patel Salma I. , Chou Ying-Hui , Dailey Natalie S. , Killgore William D. S. 
Published: October 2024

IntroductionInsomnia is associated with mild cognitive impairment, although the mechanisms of this impairment are not well-understood. Timing of slow-wave and rapid eye movement sleep may help explain cognitive impairments common in insomnia. This investigation aimed to determine whether cognitive changes following continuous theta-burst stimulation (cTBS) are attributable to active stimulation, polysomnographic parameters of sleep, or both.MethodData presented here are part of a pilot clinical trial aiming to treat insomnia by targeting a node in the default mode network using an inhibitory 40-s (cTBS). A double-blind counterbalanced sham-controlled crossover design was conducted. Participants (N = 20) served as their own controls on two separate in-laboratory visits—one with active cTBS and the other with sham cTBS. Each visit included cognitive assessments before and after stimulation and following a night of sleep in the lab monitored with polysomnography.ResultsSlow wave sleep duration influenced working memory in the active cTBS condition, with shorter duration predicting improvements in working memory post sleep (B = −0.003, p = 0.095). Onset latency to rapid eye movement sleep predicted subsequent working memory, regardless of treatment condition (B = −0.001, p = 0.040). Results suggest that changes in attention and processing speed were primarily due to slow wave sleep onset (B = −0.001, p = 0.017) and marginally predicted by slow wave sleep duration (B = 0.002, p = 0.081) and sleep efficiency (B = 0.006, p = 0.090).ConclusionsFindings emphasize the important role that timing of slow-wave and rapid eye movement sleep have on information processing. Future work using larger sample sizes and more stimulation sessions is needed to determine optimal interactions between timing and duration of slow wave and rapid eye movement throughout the sleep period.Clinical trial registrationThis study is registered on ClinicalTrials.gov (NCT04953559). https://clinicaltrials.gov/study/NCT04953559?locStr=Arizona&amp;country=United%20States&amp;state=Arizona&amp;cond=insomnia&amp;intr=tms%20&amp;rank=1
How the digital economy enhances the grain supply chain resilience in China: exploring the moderating effects of government innovation-driven
Authors: Chang Jinrui , Jiang Huiming , Liu Jianbo , Li Mingyang 
Published: October 2024

IntroductionEnsuring food security in the new development paradigm urgently requires increasing the grain supply chain resilience. In order to clarify how can significantly enhance grain supply chain resilience, to demonstrate the relationship between the digital economy, government innovation-driven and grain supply chain resilience is necessary. To specify how the government can effectively perform its macro-regulatory functions, the government innovation-driven is reflected by government innovation-driven planning and government innovation-driven investment, respectively.MethodsThe data of 31 provinces in China from 2011 to 2021 have been used. The panel fixed effects model, moderating effects model and threshold effects model have been selected to analyze.ResultsDigital economy has a stronger enhancement effect on grain supply chain resilience; Government innovation-driven has an increased moderating effect on digital economy enhance grain supply chain resilience; The enhancement effect of digital economy and the moderating effect of government innovation-driven are differentiated between China’s functional zones of grain production; And the threshold effect of government innovation-driven planning shows a process of digestion and absorption, which accumulating to 0.018 will emerge a multiplier effect. Government innovation-driven investment is higher than 0.026, which can have a promoted moderating effect.DiscussionTo expand the depth of integration of the digital economy, accurately government innovation-driven, the focus should be on attracting innovative talent, who can construct the perpetual motion machine mode of “external promote + internal drive,” so as to strengthen the robustness of the grain supply chain.
Comorbidity profiles among sputum-positive tuberculosis patients in Cameroon
Authors: Magha Chefor , Nchang Lucy Cho , Weldeslassie Michael , Nkimbeng Desmond Akumtoh , Tchatat Nancielle Mbiatong , Meriki Henry Dilonga , Deribe Kebede , Nietcho Frank Noel , Foyet Juluis Visnel , Fombad Fanny Fri , Katcho Tatiana Djikeussi , Cho Jerome Fru , Gebremeskel Eyoab Iyasu , Waddell Simon J. , Bobosha Kidist , Newport Melanie J. , Hoerauf Achim , Ritter Manuel , Wanji Samuel 
Published: October 2024

IntroductionComorbid non-communicable diseases (NCDs) like diabetes, cardiovascular diseases (CVD), kidney diseases, and hypertension, could have implications for tuberculosis (TB) treatment management and increase the disease burden amongst active TB patients.MethodsThis cross-sectional study aimed at profiling comorbidities amongst sputum-positive TB patients in the South West and Littoral regions of Cameroon and was relevant for improving disease management and public health interventions. Diabetes was defined by elevated blood glucose, body mass index (underweight: &lt; 18.5 kg/m2, normal: 18.5– &lt; 25.0 kg/m2, overweight: 25– &lt; 30 kg/m2 and obese: ≥30.0 kg/m2) and hypertension by elevated blood pressure levels (i.e., systolic ≥130 mmHg or diastolic ≥80 mmHg). Socio-demographic and clinical data were collected using case report forms. Descriptive analysis was performed, bivariate logistic regression analysis was computed with at least one comorbidity as the dependent variable (global model) and a multivariable logistic regression analysis was done to provide adjusted odds ratios (final model). The covariate with the highest p-value was removed until p &lt; 0.25 cut-off, using R software version 4.3.1. p-value &lt; 0.05 at 95% confidence interval was considered statistically significant.ResultsFive hundred and forty-nine sputum-positive microscopically confirmed active TB patients were enrolled into this study. Two-thirds (65.8%) of the total patients were male. Overall, 56 sputum-positive TB patients had at least one non-communicable disease, thus a prevalence of 10.2% (95% CI = 7.9–13.0). The most frequently recorded NCD was diabetes 4.4% (95% CI = 3.1–6.7) followed by kidney disease 2% (95% CI = 1.1–3.6), hypertension 0.9% (95% CI = 0.4–2.2), and CVD 0.91% (95% CI = 0.4–2.2). Three TB patients (0.6%) had all four comorbidities examined. Age group (p &lt; 0.001), and level of education (p = 0.049) were factors significantly associated with having at least one comorbidity.DiscussionOur findings showed that diabetes was significantly the most prevalent comorbid NCD amongst sputum-positive TB patients (p &lt; 0.001). HIV status, occupation, body mass index (BMI), and alcohol intake were not significantly associated with having at least one comorbidity. Implementing public health intervention programmes such as systematic screening of TB patients for NCDs especially diabetes is highly recommended for better control of these diseases.
Prevalence and predictors of annual asthma reviews in Scottish primary care data
Authors: Tibble Holly , Chung Alexandria Ming Wai 
Published: October 2024

BackgroundPeople with asthma are recommended to have regular reviews in primary care, with assessment of symptoms, adjustment of treatment and self-management processes, and the delivery of a written action plan for emergencies.AimOur study aimed to investigate the incidence and factors associated with attendance of annual reviews.Design & settingelectronic health records for approximately 50 000 Scottish asthma patients, between 2008 and 2016.MethodMultivariable logistic regression using linked primary care prescription data and primary care registration demographic data.ResultsThere was a median of 381 days between subsequent reviews. Reviews in the index year were strongly associated with reviews in the following year (odds ratio 1.76 [1.68-1.84]). In contrast, asthma consultations (excluding reviews) in the index year were associated with alowerodds of having a review in the following year (0.48 [0.46-0.51]). Those aged 18-35 in the index year, or with missing address in the practice registration data, were the least likely age group to have an asthma review in the following year.ConclusionReviewing the delivery of asthma care identifies patients who may be slipping through the gaps by receiving onlyreactiveasthma care rather than the structured, preventative care which can be delivered through annual reviews. Understanding the risk factors for not receiving an annual review can be leveraged to create more effective review invitations, such as explaining the specific content of reviews, introducing new contact methods to improve health equity, and reviewing the algorithm used to determine who is invited.
Comparative Analysis of Open Surgery and EVAR Method in the Treatment of Aortic Aneurysms: A Literature Review
Authors: Мухаметова Н.Н. , Юсибов М.К. , Акаева А.Г. , Алиев А.С. , Цыбикова Д.З. 
Published: October 2024

В статье проводится сравнительный анализ двух основных методов лечения аневризмы аорты: открытой хирургии и эндоваскулярных методов. Исследование основывается на последних данных клинических испытаний и публикаций, целью которых было выявление преимуществ и недостатков каждого из методов. Рассмотрены такие аспекты, как кумулятивная выживаемость, частота осложнений, качество жизни после операции. Открытая хирургическая операция, несмотря на высокую инвазивность и длительный период восстановления, показывает хорошие долгосрочные результаты, тогда как эндоваскулярные методы предлагают меньшую травматичность и более короткую госпитализацию, но требуют дальнейшего наблюдения на предмет возможных поздних осложнений. Целью данной статьи является сравнительный анализ открытой хирургической операции и эндоваскулярного вмешательства (Endovascular aneurysm repair – EVAR) на основе последних клинических исследований. Это позволит медицинским специалистам выбирать оптимальное лечение для каждого конкретного случая и более полно понимать каждый метод, учитывая его плюсы и минусы. Особое внимание уделяется анализу клинической эффективности, безопасности процедур и долгосрочной выживаемости пациентов после лечения.
The article conducts a comparative analysis of two main methods for treating aortic aneurysm: open surgery and endovascular approaches. The study is based on the latest clinical trials and publications aimed at identifying the advantages and disadvantages of each method. Aspects such as long-term survival, complication rates, quality of life post-operation, and cost-effectiveness of the methods are discussed. Open surgery, despite its high invasiveness and long recovery period, shows good long-term results, while endovascular methods offer less invasiveness and shorter hospital stays but require further monitoring for potential late complications. The aim of this article is to conduct a comparative analysis of open surgery and endovascular aneurysm repair (EVAR) methods based on the latest clinical studies. This will allow medical professionals to choose the optimal treatment for each specific case and to understand more fully each method, considering the advantages and disadvantages of each. Special attention is given to analyzing clinical effectiveness, the safety of procedures, and the long-term survival of patients after treatment.
Применение белковой смеси для лечебного питания у пациентов с раком желудка
Authors: Гасанова У.Ф. 
Published: October 2024

Введение. Рак желудка остается одной из самой распространенных форм злокачественных опухолей человека. При хирургическом лечении у пациентов с раком желудка важная роль принадлежит устранению белково-энергетической недостаточности. Цель. Сравнение результатов лабораторных исследований у пациентов с раком желудка, получавших белковую смесь во время хирургического лечения. Материалы и методы. Клинические результаты изучены у 95 пациентов, в том числе 52 лиц основной группы, получавших лечебное питание, и 43 пациентов, получавших только стандартное питание. Результаты. При поступлении пациентов уровень общего белка, альбумина и трансферрина в обеих группах был одинаковым. С 1-го дня после операции и до выписки уровень общего белка в основной группе был выше, чем в группе сравнения. При обследовании пациентов через месяц лечения отмечалась разница в уровнях общего белка, альбумина и трансферрина. Общий белок в основной группе составил 3,5 г/л, альбумин – 3,8 г/л, трансферрин – на 0,4 г/л выше, чем в группе сравнения. Заключение. При использовании белково-композитной смеси в лечебном питании у пациентов с раком желудка во время хирургического лечения количество белка, трансферрина и альбумина заметно увеличилось.
Introduction. Gastric cancer remains one of the most common forms of malignant tumors in humans. In patients with gastric cancer during surgical treatment an important role belongs to the elimination of protein-energy deficiency. Purpose. Comparison of laboratory test results in patients with gastric cancer who received a protein mixture during surgery. Materials and methods. Clinical outcomes were investigated in 95 patients Including 52 main group patients who received therapeutic nutrition and 43 comparison group who received only standard medical nutrition. Results. Upon admission of patients, the level of total protein, albumin and transferrin in both study groups was the same. From the 1-st day after surgery until discharge, total protein levels in the main group were higher than in the comparison group. When examining patients after one month treatment a difference was noted in the levels of total protein, albumin and transferrin. Total protein in the main group was 3.5 g/l, albumin was 3.8 g/l, transferrin was 0.4 g/l higher than in the comparison group. Conclusion. The use of protein composite mixture in medical nutrition for patients with gastric cancer during surgical treatment, amount of protein, transferrin and albumin were increased.