bluuebunny/crossref_metadata_2025_split huggingface dataset:
National diagnostic reference levels for digital diagnostic and screening mammography in Uganda
Authors: Odongo Denish , Musisi Alen , Okello Richard Omara , Bongomin Felix , Erem Geoffrey 
Published: August 2024

Introduction
Screening and diagnostic mammography are associated with some risk of radiation-induced breast cancer. This study was conducted to establish the National Diagnostic Reference Levels (NDRLs) for digital diagnostic and screening mammography in Uganda to achieve breast radiation dose optimization.

Methods
A cross-sectional study was conducted among female participants recruited by consecutive sampling from three selected hospitals with digital mammography in Uganda. The study variables extracted from the mammography machines were exposure factors, compressed breast thickness (CBT), and Average Glandular Dose (AGD) of two standard mammogram views. The stratified National DRL was derived by calculating the 75th percentile of the AGD across all the samples at various CBT ranges for both screening and diagnostic mammography in craniocaudal (CC) and mediolateral oblique (MLO) views.

Results
We included 300 participants with mean ages of 50.28±9.32 and 47.45±13.45 years for the screening and diagnostic mammography, respectively. There were statistically significant positive correlations between AGD and exposure factors (mAs, kVp) (all p-values<0.0001). For screening mammography, mAs demonstrated a strong positive correlation (r = 0.8369 in CC, 0.8133 in MLO), whereas kVp showed a positive correlation with relatively lower coefficients (r = 0.3700 in CC, 0.3080 in MLO). For diagnostic mammography, mAs exhibited an even stronger positive correlation (r = 0.8987 in CC, 0.8762 in MLO), and kVp maintained a positive correlation with somewhat lower coefficients (r = 0.4954 in CC, 0.3597 in MLO). In screening mammography, for CBT within the range of (7–39) mm, the NDRLs were (1.5mGy, 1.66mGy) in CC) and MLO views. For CBT in the range of (40–59) mm, the NDRLs were (1.78mGy, 1.87mGy), and for CBT in the range of (60–99) mm, the NDRLs were (2.18mGy, 2.22mGy). For diagnostic mammography, the NDRLs were established as (1.7mGy, 1.91mGy), (2.00mGy, 2.09mGy), and (2.63mGy, 2.81mGy) for CBT ranges of (7–39) mm, (40–59) mm, and (60–99) mm, respectively.

Conclusion
The NDRLs for digital screening and diagnostic mammography in Uganda have been proposed for the first time. The NDRL values in mammography should be specific to CBT ranges and mammographic views for both diagnostic and screening mammography.
C-reactive protein-to-lymphocyte ratio is a novel biomarker for predicting the long-term efficacy of ustekinumab treatment in ulcerative colitis
Authors: Koshiba Ryoji , Kakimoto Kazuki , Mizuta Noboru , Numa Keijiro , Kinoshita Naohiko , Nakazawa Kei , Hirata Yuki , Miyazaki Takako , Higuchi Kazuhide , Nakamura Shiro , Nishikawa Hiroki 
Published: August 2024

Background and aim
Ustekinumab, a new anti-interleukin-12/23 antibody, is an effective treatment for ulcerative colitis; however, data regarding predictive factors of its efficacy are limited. Predicting treatment efficacy in advance would be useful for selecting a therapeutic agent. This study aimed to identify biomarkers that can predict the long-term outcome of ustekinumab treatment.

Materials and methods
We retrospectively reviewed the records of patients with active ulcerative colitis treated with ustekinumab at Osaka Medical and Pharmaceutical University Hospital from June 2020 to January 2023. We divided patients into non-remission and remission groups, and examined whether baseline biomarkers, including C-reactive protein-to-lymphocyte ratio, and early treatment response could predict clinical remission at week 48 of ustekinumab treatment.

Results
Of the 33 patients included in the study, 21 (63.6%) were in clinical remission at week 48 of ustekinumab treatment. Baseline C-reactive protein-to-lymphocyte ratio values were significantly higher in the non-remission than in the remission group. The baseline C-reactive protein-to-lymphocyte ratio value was identified as an independent prognostic factor for clinical remission at week 48 (odds ratio: 10, 95% confidence interval: 1.6–62.4, p = 0.014), with the cutoff value of 3.353 showing excellent prognostic performance (sensitivity: 71.4%, specificity: 83.3%). Furthermore, the clinical response at week 4 (odds ratio: 10, confidence interval: 1.78–56.1, p = 0.009) and that at week 8 (odds ratio: 12, confidence interval: 2.16–66.5, p = 0.005) were significantly associated with clinical remission at week 48.

Conclusions
The baseline C-reactive protein-to-lymphocyte ratio value and early treatment response are useful biomarkers to predict the long-term efficacy of ustekinumab treatment.
Bioinformatics analysis to identify the relationship between human papillomavirus-associated cervical cancer, toll-like receptors and exomes: A genetic epidemiology study
Authors: Gomes Fabiana de Campos , Galhardo Deizyane dos Reis , Navegante Aline Carvalho Gonçalves , Santos Gabriela Sepêda dos , Dias Helana Augusta Andrade Leal , Dias Júnior José Ribamar Leal , Pierre Marie Esther , Luz Marlucia Oliveira , de Melo Neto João Simão 
Published: August 2024

Introduction
Genetic variants may influence Toll-like receptor (TLR) signaling in the immune response to human papillomavirus (HPV) infection and lead to cervical cancer. In this study, we investigated the pattern of TLR expression in the transcriptome of HPV-positive and HPV-negative cervical cancer samples and looked for variants potentially related to TLR gene alterations in exomes from different populations.

Materials and methods
A cervical tissue sample from 28 women, which was obtained from the Gene Expression Omnibus database, was used to examine TLR gene expression. Subsequently, the transcripts related to the TLRs that showed significant gene expression were queried in the Genome Aggregation Database to search for variants in more than 5,728 exomes from different ethnicities.

Results
Cancer and HPV were found to be associated (p<0.0001). TLR1(p = 0.001), TLR3(p = 0.004), TLR4(221060_s_at)(p = 0.001), TLR7(p = 0.001;p = 0.047), TLR8(p = 0.002) and TLR10(p = 0.008) were negatively regulated, while TLR4(1552798_at)(p<0.0001) and TLR6(p = 0.019) were positively regulated in HPV-positive patients (p<0.05). The clinical significance of the variants was statistically significant for TLR1, TLR3, TLR6 and TLR8 in association with ethnicity. Genetic variants in different TLRs have been found in various ethnic populations. Variants of the TLR gene were of the following types: TLR1(5_prime_UTR), TLR4(start_lost), TLR8(synonymous;missense) and TLR10(3_prime_UTR). The “missense” variant was found to have a risk of its clinical significance being pathogenic in South Asian populations (OR = 56,820[95%CI:40,206,80,299]).

Conclusion
The results of this study suggest that the variants found in the transcriptomes of different populations may lead to impairment of the functional aspect of TLRs that show significant gene expression in cervical cancer samples caused by HPV.
Physical functioning in the lumbar spinal surgery population: A systematic review and narrative synthesis of outcome measures and measurement properties of the physical measures
Authors: Kowalski Katie L. , Mistry Jai , Beilin Anthony , Goodman Maren , Lukacs Michael J. , Rushton Alison 
Published: August 2024

BackgroundInternational agreement supports physical functioning as a key domain to measure interventions effectiveness for low back pain. Patient reported outcome measures (PROMs) are commonly used in the lumbar spinal surgery population but physical functioning is multidimensional and necessitates evaluation also with physical measures.Objective1) To identify outcome measures (PROMs and physical) used to evaluate physical functioning in the lumbar spinal surgery population. 2) To assess measurement properties and describe the feasibility and interpretability of physical measures of physical functioning in this population.Study designTwo-staged systematic review and narrative synthesis.MethodsThis systematic review was conducted according to a registered and published protocol. Two stages of searching were conducted in MEDLINE, EMBASE, Health & Psychosocial Instruments, CINAHL, Web of Science, PEDro and ProQuest Dissertations & Theses. Stage one included studies to identify physical functioning outcome measures (PROMs and physical) in the lumbar spinal surgery population. Stage two (inception to 10 July 2023) included studies assessing measurement properties of stage one physical measures. Two independent reviewers determined study eligibility, extracted data and assessed risk of bias (RoB) according to COSMIN guidelines. Measurement properties were rated according to COSMIN criteria. Level of evidence was determined using a modified GRADE approach.ResultsStage one included 1,101 reports using PROMs (n = 70 established in literature, n = 67 developed by study authors) and physical measures (n = 134). Stage two included 43 articles assessing measurement properties of 34 physical measures. Moderate-level evidence supported sufficient responsiveness of 1-minute stair climb and 50-foot walk tests, insufficient responsiveness of 5-minute walk and sufficient reliability of distance walked during the 6-minute walk. Very low/low-level evidence limits further understanding.ConclusionsMany physical measures of physical functioning are used in lumbar spinal surgery populations. Few have investigations of measurement properties. Strongest evidence supports responsiveness of 1-minute stair climb and 50-foot walk tests and reliability of distance walked during the 6-minute walk. Further recommendations cannot be made because of very low/low-level evidence. Results highlight promise for a range of measures, but prospective, low RoB studies are required.
Reduction in diarrhea cases following implementation of COVID-19 hand hygiene interventions in Ghana: A causal impact analysis
Authors: Adu George Asumah , Amegah Kingsley E. , Addo Henry Ofosu , Andoh Theresa , Duvor Ferguson , Antwi Gladys , Peprah Nana Yaw , Kenu Ernest , Bekoe Franklin Asiedu , Malm Keziah L. 
Published: August 2024

Background
The human hand has constant contact with the environment, hence requires regular hand hygiene. Hand hygiene has gained recognition because of the COVID-19 pandemic and is a largely effective, affordable preventive measure against infectious diseases. This study used both national and sub-national analyses to evaluate the effect of COVID-19 handwashing guidelines on instances of diarrhea in Ghana.

Methods
Data on diarrhea cases spanning February 2018 and March 2022 were retrieved from the District Health Information Management System (DHIMS 2) using a data extraction guide. The data were summarized using descriptive statistics. The difference in diarrhea cases between the pre-COVID-19 and COVID-19 periods was measured using a two-sample t-test across Ghana’s 16 administrative areas. Causal Impact package in R statistical software was employed to determine the impact of the introduction of COVID-19 hand hygiene protocols on diarrheal disease.

Results
A total of 5,645,533 diarrheal cases reported between February 2018 and March 2022 through the routine MIS (DHIMS2) were examined. Fifty-three percent of the cases occurred before the introduction of the hand hygiene protocol. Descriptive statistics indicated a statistically significant decrease in average diarrheal cases during the hand hygiene implementation era (13,463 cases reduction, p<0.001). Sub-national analyses revealed significant reductions in various regions: Greater Accra, Ashanti, Ahafo, Central, Eastern, Northern, Upper East, Upper West, and Volta (p<0.05). Causal impact analysis confirmed 11.0% nationwide reduction in diarrheal cases attributed to the COVID-19 hand hygiene protocols (p<0.001).

Conclusion
This study underscores the effectiveness of COVID-19 hand hygiene protocols in reducing diarrheal morbidity in Ghana, with varying regional impacts. These findings advocate for the sustenance of investments and commitments made at the COVID hand hygiene protocols, particularly in this era where the pandemic appears controlled.
Insights into hospitalization pattern for drug, medicament, and biological substance poisoning, adverse effect, and underdosing in Australia: An ecological study between 1998 and 2019
Authors: Naser Abdallah Y. 
Published: August 2024

Background
Drug, medicament, and biological substance poisoning, adverse effects, and underdosing are significant public health concerns. Gaining insight into the patterns and trends in hospitalizations caused by these occurrences is essential for the development of preventative initiatives, optimization of treatment regimens, and improvement of patient safety. The aim of this study is to examine the trend of hospitalisation related to poisoning by, adverse effect of and underdosing of drugs, medicaments and biological substances in Australia between 1998 and 2019.

Methods
This is an ecological descriptive study that examined hospitalisation related to poisoning by, adverse effect of and underdosing of drugs, medicaments and biological substances in Australia between 1998 and 2019. A nationwide hospital admissions database was used for this study.

Results
Between 1998 and 2019, a total of 683,869 hospital admission episodes were recorded in Australia. The overall annual number of hospital admissions for various reasons increased by 20.5% from 29,854 in 1998 to 35,960 in 2019, representing a decrease in hospital admission rate of 10.6% [from 158.69 (95% CI 156.90–160.49) in 1998 to 141.91 (95% CI 140.44–143.37) in 2019 per 100,000 persons, trend test, p<0.05]. Overnight-stay admissions accounted for 69.2% of the total number of hospital admissions, and 30.8% were same-day admissions. Rates of same-day hospital admission decreased by 13.3% [from 50.55 (95%CI 49.54–51.57) in 1998 to 43.81 (95%CI 43.00–44.63) in 2019 per 100,000 persons]. Rates of overnight-stay hospital admission decreased by 11.1% [from 108.14 (95%CI 106.66–109.63) in 1998 to 96.17 (95%CI 94.96–97.38) in 2019 per 100,000 persons]. Admissions related to antiepileptic, sedative-hypnotic and antiparkinsonism drugs was the most prevalent hospital admissions type accounting for 26.8%. Females were responsible for 418,751 hospital admission episodes, representing 61.5% of the total number of hospital admission.

Conclusion
This study found that while the overall annual number of admissions increased, the rate of admission decreased over the same period. The most common reasons for admissions were antiepileptic, sedative-hypnotic, and anti-parkinsonism drugs. The study also noted increases in admissions related to anaesthetics, therapeutic gases, hormones, and their synthetic substitutes. These findings suggest a concerning rise in the suboptimal use of these medications. In order to combat the increasing incidence of this type of admissions, it is imperative to strengthen public awareness initiatives on medicine safety and abuse.
COVID-19 IgG seropositivity and its determinants in occupational groups of varying infection risks in two Andean cities of Ecuador before mass vaccination
Authors: Leon-Rojas Jose E. , Arias-Erazo Fernanda , Jiménez-Arias Patricia , Recalde-Navarrete Ricardo , Guevara Angel , Coloma Josefina , Martin Miguel , Chis Ster Irina , Cooper Philip , Romero-Sandoval Natalia ,   on behalf of the Seroprevalence ECU-Group
Published: August 2024

Background
The COVID-19 pandemic has caused over 68.7 million infections and 1.35 million deaths in South America. There are limited data on SARS-CoV-2 seropositivity and its determinants from Andean countries prior to mass vaccinations against COVID-19.

Objective
To estimate SARS-CoV-2 seropositivity and its determinants before vaccination in occupational groups of adults presumed to have different levels of exposure and associations with potential symptomatology.

Methods
We measured seropositivity of anti-SARS-CoV-2 IgG antibodies in a cross-sectional study of vaccine-naïve adults aged 18 years and older, recruited within three occupational risk groups (defined as low [LR], moderate [MR], and high [HR]) between January and September 2021 in two Andean cities in Ecuador. Associations with risk factors were estimated using logistic regression.

Results
In a sample of 882 adults, IgG seropositivity for the three different occupational risk groups was 39.9% (CI 95% 35.3–44.6), 74.6% (CI 95% 66.4–81.4), and 39.0% (CI 95% 34.0–44.4) for the HR, MR, and LR groups, respectively. History of an illness with loss of taste and/or smell was significantly associated with seropositivity in all occupational groups, with adjusted ORs of 14.31 (95%CI, 5.83–35.12; p<0.001), 14.34 (95%CI 3.01–68.42; p<0.001), and 8.79 (95%CI 2.69–28.72; p<0.001), for the HR, MR, and LR groups, respectively; while fever was significant for the LR group with an adjusted OR of 1.24 (95%CI, 1.11–4.57; p = 0.025) and myalgia for the HR group with an adjusted OR of 2.07 (95%CI, 1.13–3.81; p = 0.019).

Conclusion
Notable proportions of seropositivity were seen in all occupational groups between January and September 2021 prior to mass vaccination. Loss of taste and/or smell was strongly associated with presence of anti-SARS-CoV-2 IgG antibodies irrespective of presumed occupational exposure risk.
Unveiling Shadows: Investigating women’s experience of intimate partner violence in Ghana through the lens of the 2022 Demographic and Health Survey
Authors: Dickson Kwamena Sekyi , Ayebeng Castro , Okyere Joshua 
Published: August 2024

Introduction
Intimate partner violence (IPV) is a significant public health issue, predominantly among women in sub-Saharan Africa, including Ghana. Existing evidence indicates high rates of IPV perpetration and its associated adverse health outcomes. Despite previous studies, reliance on old data underscores the need for current, nationally representative data to inform policy-making and interventions. Therefore, this study utilizes the 2022 Ghana Demographic and Health Survey (GDHS) to examine IPV experiences and associated factors, aiming to provide updated insights for effective IPV mitigation strategies in Ghana.

Methods
This is a cross-sectional study of a weighted sample of 3,741 women between the ages of 15–49 years old from the 2022 GDHS. Binary logistic regression analysis was used in predicting the outcome.

Results
The study found that 36.4 percent of women in Ghana had experienced some form of IPV, primarily emotional violence (31.5%), physical violence (17.3%), and sexual violence (7.6%). Women with higher levels of education had a significantly reduced risk of 60% of experiencing some form of IPV than those with no formal education. Partner domineering behaviours, such as women whose partners often get jealous for seeing them talk with other men [adjusted OR:1.76, 95%CI:1.25,2.48], accusing them of unfaithfulness [adjusted OR:2.59, 95%CI:1.03,2.46], not permitting them to meet female friends [adjusted OR:1.1.59, 95%CI:1.03,2.46], and limiting their contact with family [adjusted OR:5.75, 95%CI:2.27,13.42], were more likely to experience at least one form of IPV. Similarly, women who justified or endorsed wife beating had a higher likelihood [aOR = 1.57, 95%CI = 1.22,2.02] of experiencing at least one form of IPV than those who did not endorse such behaviour.

Conclusion
Identifying educational attainment, partner dominance, and violence endorsement as IPV predictors underscore targeted interventions. Promoting women’s education bolsters empowerment and IPV prevention. Addressing dominance through education, counselling, and legal frameworks is crucial for fostering safer relationships and challenging violence normalization.
Religious beliefs and practices toward HPV vaccine acceptance in Islamic countries: A scoping review
Authors: Kisa Sezer , Kisa Adnan 
Published: August 2024

Background
Despite the availability of effective HPV vaccines, their acceptance in Islamic countries is often influenced by religious beliefs, practices, and misconceptions.

Objective
This review aimed to identify the current literature on the religious beliefs and any misconceptions toward HPV vaccine acceptance within the Organisation of Islamic Cooperation (OIC) countries.

Method
Using key terms, a systematic search in MEDLINE/PubMed, Embase, and CINAHL yielded 23 studies that met the inclusion and exclusion criteria. The scope of this review included all research articles published in English until October 31, 2023. A form based on the aim of the study was developed and used to extract the data.

Results
The review highlights the complexity of the relationship between religious beliefs and HPV vaccine uptake. The findings reveal significant objections among a number of Muslims. Some of them believe vaccines lead to infertility and sexual promiscuity, defy religious norms, are a sneaky way to inject good Muslims with haram ingredients, and are an abandonment of righteous principles in general.

Conclusions
Vaccine hesitancy is a result of doubts regarding the vaccine’s safety, necessity, and compatibility with religious beliefs. It is recommended to encourage HPV vaccine uptake in Islamic countries by using public health strategies that adopt a holistic approach that incorporates religious, cultural, and social aspects.
Oculomotor outcomes of cranial nerve palsy in patients with skull base tumors
Authors: Moon Yeji , Lee Byung Joo 
Published: August 2024

Objectives
Skull base tumors, can cause oculomotor dysfunction, presenting a management challenge given their proximity to cranial nerves. This study investigated the oculomotor outcomes in patients with skull base tumors presenting cranial nerve palsy due to tumor compression and aimed to identify associated factors.

Methods
This retrospective observational cohort study enrolled patients diagnosed with primary skull base tumors who exhibited cranial nerve palsy due to tumor compression, confirmed by magnetic resonance imaging treated at Asan Medical Center between January 2011 and December 2022. Patients were assessed for oculomotor function pre- and post-treatment, and categorized into recovery and non-recovery groups based on outcomes. Factors associated with oculomotor outcomes were also analyzed.

Results
Fifty-six patients were enrolled, with the majority (n = 37, 66.1%) demonstrating recovery in oculomotor function post-treatment. The duration from symptom onset to treatment initiation was short in the recovery group, suggesting that early treatment may contribute to improved oculomotor outcomes. The type of tumor was significantly associated with oculomotor outcomes, with patients with pituitary adenoma exhibiting better outcomes. In the recovery group, 19/37 (51.4%) patients underwent surgical resection alone. In contrast, in the non-recovery group, 17/19 (89.5%) patients received primary or adjuvant radiosurgery or radiation therapy.

Conclusion
Approximately 70% of patients with skull base tumors experienced recovery in oculomotor function post-treatment. The duration before treatment and the type of tumor were significantly associated with the oculomotor outcome. These findings aid neuro-ophthalmologists in predicting oculomotor outcomes for patients with skull base tumors, guiding management strategies for oculomotor dysfunction.