bluuebunny/crossref_metadata_2025_split huggingface dataset:
Cost‐Effectiveness of Treating Hepatitis C in Clients on Opioid Agonist Therapy in Community Pharmacies Compared to Primary Healthcare in Australia
Authors: Ginnane Joshua F. , Scott Nick , Radley Andrew , Dillon John F. , Hellard Margaret , Doyle Joseph 
Published: October 2024

ABSTRACTMeeting the World Health Organisation 2030 target of treating 80% of people with hepatitis C virus (HCV) in Australia requires accessible testing and treatment services for at‐risk populations. Previous clinical trials, including those in Australia, have demonstrated the efficacy of outreach programmes to community pharmacies offering opioid agonist therapy (OAT). This analysis evaluates the potential cost‐effectiveness of introducing an outreach programme in community pharmacies. Using a decision analytic model, we estimated the impact of adding a temporary hepatitis C outreach and treatment programme in community pharmacies to the standard treatment pathway available through general practice. We compared the expected number of tests, diagnoses, cures and costs occurring through the addition of this outreach and treatment programme to those expected through general practice alone over a 12‐month time horizon. We examined costs from the perspective of the health system and conducted one‐way and probabilistic sensitivity analyses to assess uncertainty in model parameters and test key assumptions. In the model adding the outreach programme pathway increased the number of tests from 4178 to 8737, the number of diagnoses from 615 to 1285 and the number of cures from 223 to 777 among people on OAT over a 12‐month period. Each additional cure achieved through the addition of the outreach programme was estimated to incur $48,964 (AUD 2023) to the health system, with > 85% of these costs attributable to medication and dispensing expenses. The average cost per cure was estimated to be $49,152 through routine care and $49,018 in the outreach programme. Although outreach models of care incur large upfront costs, they can capture otherwise unreached populations and result in comparable or favourable cost per cure, due to higher levels of engagement and lower rates of loss to follow‐up.
Change in Femoral Offset after Closed Reduction and Dynamic Hip Screw Osteosynthesis Via Lateral Approach in Patients with Medial Femoral Neck Fracture: A Retrospective Analysis
Authors: Meier Marc‐Pascal , Seitz Mark‐Tilmann , Saul Dominik , Gera Roland , Roch Paul Jonathan , Jäckle Katharina , Lehmann Wolfgang , Hawellek Thelonius 
Published: October 2024

ObjectiveClosed reduction and dynamic hip screw (DHS) osteosynthesis are preferred as joint‐preserving therapy in case of medial femoral neck fractures (MFNFs). A change in the femoral offset (CFO) can cause gait abnormality, impingement, or greater trochanteric pain syndrome. It is unknown whether the femoral offset (FO) can be postoperatively fully restored. The aim of the study was to investigate the extent of a possible CFO in hip joints after DHS osteosynthesis in the case of an MFNF.MethodsIn this retrospective study, 104 patients (mean age: 71.02 years, men: n = 50, women: n = 54) with MFNF who underwent closed reduction and DHS osteosynthesis were analyzed by postoperative x‐rays to assess CFO between the operated (OS) and nonoperated joint side (NOS). The studies covered the time period 2010–2020. A statistical comparison was performed between the mean values of FO between OS and NOS, taking into account patient age, gender, and fracture severity.ResultsAll operated hip joints showed a CFO. In 76.0% (79 of 104), the FO decreased (FOD), and in 24.0% (25 of 104), the FO increased (FOI). A critical CFO (>15% CFO) was detected in 52.9% (55 of 104). In hip joints with postoperative FOD, the mean FO between NOS (49.15 mm [±6.56]) and OS (39.32 mm [±7.87]) and in hip joints with postoperative FOI the mean FO between NOS (41.59 [±8.21]) and OS (47.27 [±6.68]) differed significantly (p < 0.001). Preoperative FO (r
S: −0.41; p > 0.001) and caput–collum–diaphyseal angle (CCD; r
S: 0.34; p > 0.001) correlated with postoperative CFO. FOD was found in hip joints with a preoperative FO >44 mm and CCD <134° vice versa FOI in hip joints with a preoperative FO <44 mm and CCD >134°.ConclusionClosed reduction and DHS osteosynthesis in patients with MFNF result in a clustered significant CFO. The individual FO should be taken into account pre‐ and intraoperatively to avoid a postoperative extensive CFO.
What is helpful and unhelpful when people try to withdraw from antipsychotics: An international survey
Authors: Read John 
Published: October 2024

AbstractObjectiveAntipsychotics remain the first‐line treatment for people diagnosed with psychotic disorders despite adverse effects which lead many people to stop their medication. Many stop without the support of the prescriber, who may fear relapse. The objective of this study is to better understand the process of withdrawal from antipsychotics, from the perspective of people taking antipsychotics.DesignOnline survey.MethodsAn international online survey elicited quantitative responses about pre‐withdrawal planning (560) and qualitative responses about what was helpful and unhelpful when withdrawing from antipsychotics (443). Responses came from users of antipsychotics in 29 countries.ResultsForty‐seven per cent did not consult their psychiatrist before discontinuing. Only 40% made preparations, most commonly making a plan, gathering information and informing family. The most frequently reported helpful factors were focussing on the benefits of getting off the drugs (including ending adverse effects and feeling more alive), information about withdrawal symptoms and how to withdraw safely, withdrawing slowly, and support from psychologists, counsellors and psychotherapists. The most common unhelpful factor was the psychiatrist/doctor, largely because of their lack of knowledge, refusal to support the patient's wishes and the threat or use of coercion.ConclusionsEvidence‐based, respectful, collaborative responses to patients' concerns about adverse effects and desires to withdraw would probably reduce relapse rates and improve long‐term outcomes. It would definitely help end pervasive breaching of the principle of informed consent and human rights legislation.
Climate policy support in the UK: An interaction of worldviews and policy types
Authors: Bretter Christian , Schulz Felix 
Published: October 2024

AbstractUnderstanding predictors of climate policy support is important for tackling climate change. Previous research demonstrated that policy support is partially driven by cultural worldviews. Yet, treating policies as a homogeneous concept, this literature neglected the existence of different policy types. Making this distinction is important because each type implies a distinct solution to the same problem (i.e., carbon emissions) with varying degrees of retained freedom for agents. Given that diverging worldviews imply different preferences for individual freedom, we hypothesize an interaction between policy types and cultural worldviews on climate policy support: Policy support is stronger when the retained freedom of a policy type is aligned with the worldview‐based preferences for such freedom. Using a representative sample of the UK population (N = 1991) and actual policy proposals of UK political parties, our results partly support our hypothesized interaction. Although communitarian‐egalitarians, compared to all other worldview groups, indicated stronger support across policy types, contrary to our hypothesis they showed their weakest support for command‐and‐control and their strongest for information‐based policies. Individualist‐hierarchists, in contrast and in line with our argument, showed the weakest support for command‐and‐control policies and strongest support for voluntary policies.
A Welfare Test for Sharing Health Data
Authors: Sen Anindya , Chen Helen , Grossman Maura R. , Tsao Shu‐Feng 
Published: October 2024

AbstractMachine learning and artificial intelligence methods are being increasingly used in the analysis of patient level and other health data, resulting in new insights and significant societal benefits. However, researchers are often denied access to sensitive health data due to concerns on privacy and security breaches. A key reason for reluctance in data sharing by data custodians is the lack of a specific legislative or other methodological framework in balancing societal benefits against costs from potential privacy breaches. Consistent with traditional cost–benefit analysis and the use of Quality Adjusted Life Years (QALYs), this study proposes an economic test that would enable Research Ethics Boards (REBs) to assess the benefits versus risks of data sharing. Our test can also be used to assess whether REBs employ reasonable effort to protect individual privacy and avoid tort liability. Constructing an acceptable welfare test for health data sharing will also lead to a better understanding of the value of data.
Is Warm‐Up Preservation Modulated by Biological Maturation and Sex? Effects on Lower Limbs Performance
Authors: Cuenca‐Fernández Francisco , Ruiz‐Navarro Jesús J. , Arellano Raúl , Marko Đurović , Stojanović Nikola 
Published: October 2024

ABSTRACTChildren and adults may react differently to warm‐up preservation due to different physical characteristics. This study aimed to: (i) assess the impact of different rewarm‐up routines in swimmers during a transition phase (20–25 min), including passive rest (SWU) or dynamic activities (RWU), on countermovement jump and swimming start performances, and (ii) explore potential RWU adaptations considering maturity offset (peak height velocity—PHV) and sex. Performance was analyzed using mixed effect ANCOVA, considering protocol, maturity offset (pre‐PHV, mid‐PHV, post‐PHV, and adv. post‐PHV), and sex. Results favored RWU over SWU with substantial magnitudes for jump height: pre‐PHV (min‐20, ES = 1.21; min‐25, ES = 1.65), mid‐PHV (min‐20, ES = 1.23; min‐25, ES = 1.14), post‐PHV (min‐20, ES = 1.37; min‐25, ES = 0.73), and adv. post‐PHV (min‐20, ES = 1.03; min‐25, ES = 0.65). Significant interactions at 25 min (p = 0.033, 0.047) showed that RWU outperformed SWU, especially in younger groups (pre‐PHV, mid‐PHV). RWU was superior to SWU for the reactive strength index at 20 min (p = 0.042) and 25 min (p = 0.047), with females having lower RSI than males at 20 min (p = 0.008, p = 0.015) and 25 min (p = 0.049) in later developmental stages. The flight distance (p = 0.009) and horizontal hip velocity (p = 0.014) revealed significant three‐way interactions, with the male adv. post‐PHV group responding better to RWU. Knee angular velocity was also higher after RWU, with male adv. post‐PHV group showing more pronounced improvements (p = 0.016). These results suggest that though RWU had higher influence in male adults, it is a valuable approach for varying ages athletes.
Shared decision‐making for patients with vaccine‐related concerns of blood transfusion: A single institution experience
Authors: Cho David J. , Klompas Allan M. , Gonzalez Jessica A. , Petsch Jamie L. , Burt Jen M. , Kor Daryl J. , Winters Jeffrey L. , van Buskirk Camille M. , Warner Matthew A. 
Published: October 2024

AbstractBackgroundSome patients express concerns regarding receipt of allogeneic blood transfusions from donors potentially vaccinated against SARS‐CoV‐2 (COVID‐19). However, limited information exists about patients' expression of these concerns or how to address them during the blood transfusion consent process. In this study, we describe our experience of working collaboratively with patients with vaccine‐related transfusion concerns prior to elective surgery, summarizing treatment decisions and clinical outcomes.Study Design and MethodsThis observational descriptive study includes patients seen in our Bloodless Medicine and Surgery clinic between June 2022 and June 2024 for vaccine‐related transfusion concerns prior to elective surgery. A shared decision‐making framework was employed to foster conversation, share information, provide reassurance, reconcile conflict, and match preferences with available care options. Patient characteristics, treatment decisions, and surgical outcomes were reviewed and summarized.ResultsThirty‐five patients were included, with median (1st, 3rd quartile) age of 61 (53, 69) years. Cardiac surgery was the most common type of surgery (29%). Twelve patients (34%) were anemic preoperatively, and all received preoperative treatment. After discussion with a Bloodless Medicine specialist, 24 (68.6%) decided to consent to the use of all blood products, 5 (14.3%) accepted only red blood cells, and 6 (17.1%) declined all blood products. Among 28 patients undergoing surgery, only 4 (14%) received allogeneic transfusion perioperatively.ConclusionMany patients concerned about the vaccination status of blood donors may ultimately consent to allogeneic blood products after shared decision‐making with a Bloodless Medicine specialist, highlighting the importance of patient empowerment and collaborative care.
Modeling the dependency structure between quality characteristics in multi-stage manufacturing processes with copula functions
Authors: Toktaş Pelin , Gebizlioğlu Ömer Lütfi 
Published: October 2024

This study is about multi-stage manufacturing processes and their control by statistical process control modeling. There are two kinds of dependence structures in a multi-stage manufacturing process: one is the dependence between the stages of the process, and the other is the dependence between the concerned quality characteristics. This study employs state-space models to demonstrate the dependency structure between the process stages and uses the Kalman filter method to estimate the states of the processes. In this setup, copula modeling is proposed to determine the dependence structure between the quality characteristics of interest. A simulation study is conducted to assess the model's accuracy. As a result, it was found that the model gives highly accurate predictions according to the mean absolute percentage error (MAPE) criteria (<10%).
Evidence on the accreditation of health professionals’ education in the WHO Africa region: a scoping review protocol
Authors: Nakidde Catherine , Marletta Debora , McGivern Gerry , O’Keeffe Catherine , Griffin Ann 
Published: October 2024

Objective:
This scoping review aims to map and examine the extent and type of available evidence on health professionals’ education accreditation within Africa.

Introduction:
The demand for health professionals is unprecedentedly high globally. One response to this challenge has been expanding training through more liberal education policies, facilitating private sector participation in education service provision. Some evidence suggests that this is a double-edged sword, increasing quantity but compromising the quality of health professionals produced. Regulation can provide a framework to assure and continuously improve quality, with such regulation in place in 79% of World Health Organization African countries. However, it is unclear how much and what evidence has been generated on how accreditation happens, where it is concentrated, and the prevailing evidence gaps within this region; therefore, we propose to conduct a scoping review.

Inclusion criteria:
This review will include articles and dissertations focusing on the accreditation of health professionals’ education in Africa. All methodological approaches and designs will be included. Conference abstracts and protocols will be excluded.

Methods:
This review will be carried out according to the JBI scoping review methodology. We conducted an initial search of CINAHL and MEDLINE to identify relevant articles. This informed our selection of keywords, along with index terms, to create a comprehensive search strategy for CINAHL (EBSCOhost), MEDLINE (Ovid), Global Health (Ovid), ERIC (EBSCOhost), Web of Science Core Collection, Embase, and Scopus. Sources included will be limited to those published starting from 2000 onwards. Data will be presented using tables and charts, accompanied by a narrative summary.

Detail of this review project can be found in Open Science Framework:

https://doi.org/10.17605/OSF.IO/W5G7T
SARS-CoV-2 NSP6 reduces autophagosome size and affects viral replication via sigma-1 receptor
Authors: Zhang Cuiling , Jiang Qiwei , Liu Zirui , Li Nan , Hao Zhuo , Song Gaojie , Li Dapeng , Chen Minghua , Lin Lisen , Liu Yan , Li Xiao , Shang Chao , Li Yiquan 
Published: October 2024

ABSTRACT

Autophagy is a cellular self-defense mechanism by which cells can kill invading pathogenic microorganisms and increase the presentation of components of pathogens as antigens. Contrarily, pathogens can utilize autophagy to enhance their own replication. Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) NSP6 can interact with ATPase proton pump component to inhibit lysosomal acidification, which was implicated in the autophagy process. However, research on how SARS-CoV-2 NSP6 affected autophagy, and its impact on virus replication is still lacking. Coronavirus NSP6 has been reported to promote coronavirus replication by limiting autophagosome expansion. However, this finding has not been confirmed in coronavirus disease 2019 (COVID-19). We investigated the effect of NSP6 protein on autophagosomes in different mutant strains of SARS-CoV-2 and revealed that the size of autophagosomes was reduced by NSP6 of the wild-type and Delta variant of SARS-CoV-2. In addition, we found that SARS-CoV-2 NSP6 localized to the lysosome and had an inhibitory effect on the binding of autophagosomes to the lysosome, which blocked the autophagy flux; this may be related to endoplasmic reticulum (ER)-related pathways. We also found that sigma-1 receptor (SIGMAR1) knock out (KO) reversed NSP6-induced autophagosome abnormality and resisted SARS-CoV-2 infection, which responds to the fact that SIGMAR1 is likely to be used as a potential target for the treatment of SARS-CoV-2 infection. In summary, we have provided a preliminary explanation of the effects on autophagy of the SARS-CoV-2 NSP6 protein from the pre-autophagic and late stages, and also found that SIGMAR1 is likely to be used as a potential target for SARS-CoV-2 therapy to develop relevant drugs.

IMPORTANCE
We have provided a preliminary explanation of the effects on autophagy of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) non-structure protein 6 from the pre-autophagic and late stages, and also found that sigma-1 receptor is likely to be used as a potential target for SARS-CoV-2 therapy to develop relevant drugs.
Conformational change as a mechanism for toxin activation in bacterial toxin-antitoxin systems
Authors: Sanchez-Torres Viviana , Hwang Hyeon-Ji , Wood Thomas K. 
Published: October 2024

ABSTRACT

Toxin/antitoxin (TA) systems are present in nearly every prokaryotic genome and play the important physiological roles of phage inhibition by reducing metabolism (this includes persistence for the extreme case of complete cessation of metabolism), genetic element stabilization, and biofilm formation. TA systems have also been incorporated into other cell systems, such as CRISPR-Cas and phage quorum sensing. For the simplest and best-studied case, proteinaceous toxins and antitoxins (i.e., type II), toxin activity is masked by direct binding of the antitoxin. A long-standing, unresolved question in the TA field is how toxins are activated when bound to antitoxins at nanomolar affinity. The current paradigm envisions preferential degradation of the antitoxin by a protease, but this is highly unlikely in that a protease cannot discriminate between bound toxin and bound antitoxin because both are highly structured. Strikingly, recent results from several studies show one likely mechanism for toxin activation is conformational changes in the TA complex that result in the release or activation of the toxin as a result of a protein trigger, such as that from phages, and as a result of thermally-driven refolding dynamics.
Comparison of pathogenicity and host responses of emerging porcine reproductive and respiratory syndrome virus variants in piglets
Authors: Zhang Wenli , Wang Xinrong , Zhang He , Pan Yu , Ma Wenjie , Xu Yunfei , Tian Zhijun , Xia Changyou , Fu Lizhi , Wang Yue 
Published: October 2024

ABSTRACT

Porcine reproductive and respiratory syndrome virus (PRRSV) is a highly variable virus with genetic diversity. This study comparatively examines the pathogenicity and immunological impact of two emergent PRRSV strains, SD53 and HuN4, in piglets. Our results indicate that SD53 strain induces milder clinical syndromes and less severe tissue damage than HuN4, despite similar replication rates. Hematological tests showed less perturbations in peripheral blood cell profiles after SD53 infection, suggesting a less systemic impact. The neutrophil-to-lymphocyte ratio was notably lower in SD53-infected piglets, suggesting a less intense inflammatory reaction. Moreover, SD53 infection led to lower levels of pro-inflammatory cytokines, further supporting a less pronounced inflammatory profile. Both strains induced the production of PRRSV-specific antibodies. However, transcriptomic analysis of lung and lymph node tissues from infected piglets disclosed a more moderate up-regulation of core genes, including
ISGs
, in the SD53 group. Further analysis indicated that SD53 primarily enhanced immune-related signaling, particularly in T cell response modules, while HuN4 caused a more robust pro-inflammatory reaction and a dampening of T cell functionality. Flow cytometry analyses confirmed these findings, showing higher CD4/CD8 ratios and increased CD4+ T cell percentages in SD53-infected piglets, implying a more robust T cell response. Collectively, these findings broaden our comprehension of PRRSV pathogenesis and may inform the development of future therapeutic or prophylactic strategies for controlling PRRSV infections more effectively.

IMPORTANCE

The high mutation rate of porcine reproductive and respiratory syndrome virus (PRRSV) poses significant challenges to its accurate diagnosis and the implementation of effective control measures. This research explores the pathogenic profiles of two emerging PRRSV stains: the NADC30-like strain SD53 and the highly pathogenic strain HuN4. Our investigation reveals that SD53 initiates distinct immunopathological responses
in vivo
compared with those provoked by HuN4. By conducting a transcriptome analysis of differential gene expression in the lungs and lymph nodes of infected piglets, we unveil the intricate molecular mechanisms underlying the contrasting pathogenicity of these two strains. The comprehensive insights yielded by this study are instrumental in advancing our understanding of the dominant NADC30-like PRRSV strain, which has become increasingly prevalent in China’s swine industry.