bluuebunny/crossref_metadata_2025_split huggingface dataset:
Prior Knowledge and Antiretroviral Therapy Prophylaxis are Associated with Mother-To-Child Transmission of HIV/AIDS in Kumasi, Ghana
Authors: Sakyi Samuel Asamoah , Effah Alfred , Enimil Anthony Kwame , Senu Ebenezer , Yeboah Kingsley Takyi , Appiah-Nuamah Judith , Opoku Stephen , Oppong Success Acheampomaa , Kwarteng Samuel , Afari-Gyan Festus Nana , Agordzo Samuel Kekeli , Mensah Oscar Simon Olympio , Akpobi Solomon , Amoani Benjamin , Ayisi-Boateng Nana Kwame 
Published: July 2024

Abstract

Background:Mother to child transmission of Human Immunodeficiency Virus (HIV), persists despite the availability of effective prevention of mother to child transmission (PMTCT) strategies. In Ghana, there is limited data on prevalence and the associated factors of mother to child transmission of HIV existing. The PMTCT strategies in Ghana has not been evaluated. This study therefore assessed the prevalence, knowledge and factors associated with mother to child transmission of HIV in Kumasi, Ghana.
Methods:This retrospective cross-sectional study was conducted at Komfo Anokye Teaching Hospital (KATH) and Aninwaa medical Centre and fertility clinic from May 2023 to September 2023. A total of 103 women living with HIV and have ever given birth were sampled. A well-structured questionnaire was used to collect data on sociodemographic, clinical, lifestyle, knowledge and MTCT transmission rates among study participants. Statistical analysis was performed using Statistical Package for Social Science (SPSS) version 26.0 and GraphPad Prism version 8.0. p-values of < 0.05 and 95% confidence interval were considered significant.
Results:The prevalence of mother-to-child transmission of HIV (MTCT) was 21.4%. MTCT was more prevalent among the age group 36-45 years (50.0%), who had primary education (40.9%) and were married (63.6%) with 2-3 children (50.0%). In the logistic regression model, higher age groups 36- 45 (aOR: 20.1, 95% CI (1.45-278.87); p = 0.025), 46-55 (aOR: 18.33, 95% CI (1.03-325.57); p = 0.048) and 56-74 (aOR: 76.42, 95% CI (1.87-3131.45); p = 0.022) were independent predictors of MTCT. Moreover, mothers not knowing their HIV status prior to pregnancy (cOR=9.13) CI; (3.01-27.68), (p < 0.001) and children not receiving ART prophylaxis (cOR=8.25), CI; (2.91-23.40), (p < 0.0001) were significantly associated with MTCT.
Conclusion:There is high prevalence of MTCT (21.4%) and is influenced by higher age group of 36-74 years, no knowledge of HIV status prior to pregnancy as well as children who do not receive ART prophylaxis. This study’s findings call for an increased awareness on the knowledge of MTCT, availability of HIV pre-exposure prophylaxis for expectant mothers and enhanced HIV testing and treatment for women of reproductive age, including self-testing.
The Quality of Life of Children With Heart Disease in Tanzania: a Single Center Study
Authors: Koster Joëlle R. , Majani Naizihijwa G. , Kalezi Zawadi E. , Hoefnagels Johanna W. , Letara Nuru , Nkya Deogratias , Mongela Stella , Sharau Godwin , Kubhoja Sulende , Mlawi Vivienne , Chillo Pilly , Slieker Martijn G. , Grobbee Diederick E. , Janabi Mohammed 
Published: July 2024

Abstract

Background
The demand for managing congenital heart disease (CHD) exceeds the available resources in low- and middle-income countries (LMICs). This has resulted in a growing population of children with CHD, with only few receiving surgical interventions, while many more are waiting for intervention. Health-related quality of life (HRQOL) and its impact on the pediatric CHD population in these settings have been largely overlooked, and limited research has been conducted. Therefore, this study aimed to explore HRQOL in the pediatric CHD population in Tanzania by comparing unoperated and operated patients, thus bridging the knowledge gap.
Methods
This cross-sectional study included patients with CHD aged 2 to 18 years, without severe comorbidities, at the outpatient department of the Jakaya Kikwete Cardiac Institute, either pre- or postoperatively, with follow-up of at least six months after cardiac surgery. The Pediatric HRQoL Generic Core Scale (PedsQL™ 4.0 SF15, Swahili Version) was used. The main outcomes were general HRQoL, as reported by parents and patients, and clinical and sociodemographic variables. Questions were scored on a Likert linear analogue scale; a higher score indicated a better HRQoL. The means of the HRQoL scores are summarized. The between-group scores were compared with Student’s t test or the Mann‒Whitney U test. Generalized linear models were used to identify predictors of HRQOL.
Results
The mean age of the children was 6.3 ± 3.7 years, with a female predominance (n = 110, 53.9%). Operated patients had a greater socioeconomic status (0.71/1 vs 0.66/1) and more frequent early diagnosis (< 1 year; 67.8% vs 47.1%). The complexity of cardiac diagnosis was similar between the groups. Operated patients had significantly higher parent-reported HRQOL scores (90.8 ± 10.2 vs 80.5 ± 16.7), with the most noticeable difference in the physical domain (effect size d=-0.813). Operation and higher socioeconomic status were found to be significant predictors of better HRQOL. HRQoL significantly decreased with increasing severity of heart failure symptoms.
Conclusions
The QoL of operated Tanzanian children with CHD differed significantly from that of their unoperated counterparts. Reducing symptoms for those on the waiting list can improve their QoL. In this setting, health-related QoL in children with CHD is strongly predicted and influenced by socioeconomic status, emphasizing the need for interventions to address socioeconomic disparities and improve patient outcomes.
Investigate the therapeutic differences between Temporal Interference Stimulation and Transcranial Alternating Current Stimulation on Post-stroke cognitive dysfunction: A Protocol for Clinical Trial
Authors: MAIMAITIAILI DILINUER , Shi Xiaolong , Wu Jiali , Ren Meng , Zhang Qian , Zhang Sicong , Li Yuanli , Shan Chunlei 
Published: July 2024

Abstract

Introduction
Transcranial alternating current stimulation (tACS) and temporal interference stimulation (TIS) as electrical neuromodulation therapy, have shown promising applications in cognitive impairments. Meanwhile TIS technique is more novel with deep and non-invasive brain stimulation . At present, the therapeutic or neuromodulation differences between TIS with tACS on Post-stroke cognitive dysfunction(PSCI) is still unclear. Here, we aim to compare and analysis the neuromodulation model and clinical performances of TIS and tACS.
Methods and analysis
The prospective, single-blind and randomized controlled trial will be conducted over a two-week period. Through precise statistical sample size calculation,thirty-six eligible participants with mild PSCI will be recruited and randomly allocated to either the tACS or the TIS group. Participants in the TIS group will receive stimulation at frequencies of 2005Hz and 2010Hz with hippocampus target(in the hippocampal region). Those in the tACS group will undergo 5Hz stimulation of the dorsolateral prefrontal cortex (DLPFC). The intervention will last for two weeks, with each participants receiving 25-minute stimulation sessions once a day, five times per week. The primary outcome measure will be the Montreal cognitive assessment (MoCA), while secondary outcomes will include performance on the N-back task, digital span test (DST), shape trails test (STT) and functional near-infrared spectroscopy (fNIRS). All clinical assessments will be collected at two time points: pre-intervention (T1) and post-intervention (T2).
Trial registration
The trial protocol is registered with www.chictr.org.cn under protocol registration number ChiCTR2400081207.Registered February 26, 2024.
Cross-Species Radiomics: Evaluating the Generalizability of Intervertebral Disc MRI-based Radiomics Models between Humans and Experimental Monkeys
Authors: Wang Jianmin , Guo Lei , Li Jianfeng , Cao Xiaodong , Du Wei , Zhou Jiaxiang , Li Haizhen , Li Junhong , Zhu Zhengya , Tang Tao , Li Xianlong , Zhou Zhiyu , Liu Zhiguo , Xi Yongming , Gao Manman 
Published: July 2024

Abstract

Experimental monkeys serve as a bridge between basic research and clinical medicine. Accurately assessing the degree of intervertebral disc degeneration (IVDD) in experimental monkeys is crucial for further intervertebral disc related research in these animals. Radiomics promises significant enhancement in quantitative diagnostic precision for IVDD, while the cornerstone of constructing robust and efficient radiomics models (RMs) relies on access to large-scale sample data. In experimental monkey research, however, ethical restrictions and resource constraints typically limit sample sizes. This study addresses this challenge by comparing and analyzing the generalizability of intervertebral disc MRI-based radiomics models between humans and experimental monkeys. The findings reveal that 12.30% (438/3562) of the radiomics features demonstrate high reproducibility between the two species. Leveraging the sufficient human dataset, we built RMs and employed the experimental monkey dataset as a training set to validate the cross-species generalizability of these models. Notably, in the test phase, models constructed based on the inter-species reproducible features achieved AUC values ranging from 0.82 to 0.92, indicative of promising diagnostic performance. This study emphasizes the advantages of leveraging human data for the construction of RMs under conditions of constrained experimental monkey research. We innovatively propose and validate the potential for cross-species application of RMs. This study furnishes strong theoretical underpinnings and practical foundations for the broader application of radiomics in cross-species disease research.
Palatal mucormycosis in an immune-competent infant following dengue haemorrhagic fever. A rare disease entity, treated with a challenging course of IV liposomal amphotericin B for 270+ days; longest duration reported from Sri Lanka
Authors: Pathiraja Hashan , Munasighe Rakitha , Gunapala Rasika , Fernando Jerrad , Gunaratne Sandini , Pemasiri Chethana , Jayasekera Primali 
Published: July 2024

Abstract

Background
Mucormycosis is an emerging global illness with significant morbidity and mortality. Causative fungi can spread through inhalation of sporangiospores or direct inoculation through damaged skin or mucosa in susceptible patients, especially those with impaired immune systems. Here we report a rare occurrence of the disease in an immunocompetent infant following dengue haemorrhagic fever, highlighting the treatment course which is the longest duration reported from Sri Lanka so far.
Case presentation
A 4-month-old infant was admitted to the medical intensive care unit (ICU) after experiencing dengue haemorrhagic fever, which was complicated by multi-organ dysfunction and required intubation. After recovery, he was found to have a necrotic lesion in the palate, which was confirmed to be mucormycosis following biopsy. Computed tomography (CT) and Magnetic resonance imaging (MRI) scans showed erosions of the hard palate and involvement of the paranasal sinuses, orbital floor and soft palate without brain or eye lesions.
The child was started on intravenous (IV) liposomal amphotericin B and required several debridement surgeries. Radiological studies showed persistent active bone lesions and antifungals were continued until radiological, mycological and clinical clearance was achieved. Intravenous amphotericin B was given for 270+ days required central lines and was complicated by venous thrombosis.
A palatal prosthesis was inserted until a definite palatal repair is done. The child is clinically well and thriving. Laboratory evaluations showed normal IgG and subclasses, IgA, IgM, and IgE levels, HIV testing was negative, nitroblue tetrazolium test(NBT) was normal and metabolic screening was negative.
Conclusion
Though mucormycosis usually occur in children with immunosuppression or metabolic syndromes, it can occur in immunocompetent children, especially following a critical illness with high lactic acid levels, as in our case. It’s important to manage these children under multi-disciplinary care and complete treatment until there is evidence of radiological clearance to achieve better outcome.
Economic impact of labor productivity losses induced by heat stress: An agent-based macroeconomic approach
Authors: Kimmich Christian , Weyerstraß Klaus , Czypionka Thomas , Fauster Norman FRM , Kinner Maurice , Laa Elisabeth , Mateeva Liliana , Plank Kerstin , Ulrici Leonhard , Zenz Hannes , Miess Michael , Poledna Sebastian 
Published: July 2024

Abstract

Against the backdrop of rising temperatures, this paper analyzes how prolonged heat affects labor productivity and the corresponding macroeconomic outcomes, using Austria as a case study. While previous research primarily focused on specific industries or used industry aggregates, this study also considers inter-industrial economic connections. We assess the macroeconomic effects of an increase in heat stress triggered by climate change with an emphasis on (1) industry-specific work intensity and (2) the vulnerability to heat-induced impairments resulting in an industry-specific loss of labor productivity. To account for indirect and non-linear economic relationships, we apply an agent-based model of the Austrian economy, which translates heat-induced productivity losses into economy-wide effects via shocks to industry-related input-output structures on the level of economic agents. The findings highlight how in the scenario with the highest temperature increase, the largest average loss in real GDP amounts to 0.8% in the third year compared to the baseline scenario. The largest aggregate effect is found for investments in dwellings. In line with existing literature, industries most affected directly are those that perform intense work in the sun, such as agriculture and construction. Thus, our unique methodological approach, model, and the corresponding EU data sources can serve as a blueprint for further comparative research.
Immune signature in vaccinated versus non-vaccinated aged people with COVID-19 pneumonia
Authors: Ruggiero Alessandra , Caldrer Sara , Pastori Claudia , Gianesini Natasha , Cugnata Federica , Brombin Chiara , Fantoni Tobia , Tais Stefano , Rizzi Eleonora , Matucci Andrea , Mayora-Neto Martin , Uberti-Foppa Caterina , Temperton Nigel , Serio Mariaclelia Stefania Di , Lopalco Lucia , Piubelli Chiara 
Published: July 2024

Abstract

Background
A definition of the immunological features of COVID-19 pneumonia is needed to support clinical management of aged patients. In this study, we characterized the humoral and cellular immune responses in presence or absence of SARS-CoV-2 vaccination, in aged patients admitted to the IRCCS San Raffaele Hospital (Italy) for COVID-19 pneumonia between November 2021 and March 2022.
Methods
The study was approved by local authorities. Disease severity was evaluated according to WHO guidelines. We tested: A) anti-SARS-CoV-2 humoral response (anti-RBD-S IgG, anti-S IgM, anti-N IgG, neutralizing activity against Delta, BA1, BA4/5 variants); B) Lymphocyte B, CD4 and CD8 T-cell phenotype; C) plasma cytokines. The impact of vaccine administration and different variants on the immunological responses was evaluated using standard linear regression models and Tobit models for censored outcomes adjusted for age, vaccine doses and gender.
Result
We studied 47 aged patients (median age 78.41), 22 (47%) female, 33 (70%) older than 70 years (elderly). At hospital admission, 36% were unvaccinated (VACno), whilst 63% had received 2 (VAC2) or 3 doses (VAC3) of vaccine. During hospitalization, WHO score > 5 was higher in unvaccinated (14% in VAC3 vs 43% in VAC2 and 44% VACno). Independently from vaccination doses and gender, elderly had overall reduced anti-SARS-CoV-2 humoral response (IgG-RBD-S, p = 0.0075). By linear regression, the anti-RBD-S (p = 0.0060), B (p = 0.0079), CD8 (p = 0.0043) and Th2 cell counts (p = 0.0131) were higher in VAC2 + 3 compared to VACno. Delta variant was the most representative in VAC2 (n = 13/18, 72%), detected in 41% of VACno, whereas undetected in VAC3, and anti-RBD-S production was higher in VAC2 vs VACno (p = 0.0001), alongside neutralization against Delta (p = 0141), BA1 (p = 0.0255), BA4/5 (p = 0.0162). Infections with Delta also drove an increase of pro-inflammatory cytokines (IFN-α, p = 0.0463; IL-6, p = 0.0010).
Conclusions
Administration of 3 vaccination doses reduces the severe symptomatology in aged and elderly. Vaccination showed a strong association with anti-SARS-CoV-2 humoral response and an expansion of Th2 T-cells populations, independently of age. Delta variants and number of vaccine doses affected the magnitude of the humoral response against the original SARS-CoV-2 and emerging variants. A systematic surveillance of the emerging variants is paramount to define future vaccination strategies.
What is the prognosis for non-displaced femoral neck fractures treated with a strict protocol? Analysis of a prospective cohort treated with internal fixation versus arthroplasty.
Authors: Zamora Tomas , Castro Hari , Silva Francisco , Vidal Catalina , Faundez Jorge , Vial Agustin , Botello Eduardo , Klaber Ianiv , Carmona Maximiliano , Schweitzer Daniel 
Published: July 2024

Abstract

Introduction
Non-displaced femoral neck fractures (FNF) are common in elderly patients, but the best treatment approach is still uncertain. The decision should be based on several factors, including fracture angulation and comminution, to ensure the best possible clinical and functional outcomes in the mid-to long-term. In this study, we report on the treatment of non-displaced FNF in elderly patients using a personalized protocol with either internal fixation or arthroplasty. Our objectives were to evaluate the clinical and functional outcomes of both treatment options and to compare the results between the two groups.
Methods
Analysis of a prospectively collected cohort of patients treated from 2010 to 2022 with a geriatric non-displaced femoral neck fracture. Patients were treated with internal fixation if no significant angulation, cortical gap, comminution, or significant osteoarthritis was observed. In case any of the later was present, a joint replacement was selected. Primary outcomes recorded were complications, reoperations, and mortality.
Results
One hundred and nineteen patients were included. 75% were female. Nintynine patients were treated with internal fixation, while eighteen had a partial or total hip replacement. Two patients did not undergo surgery because of their general condition. Patients were followed for a median of 4 years.
Severe complications were observed in 5% of cases, while reoperations were performed in 4%. 30-day mortality and one-year mortality were 1% and 6%, respectively. There were no significant differences in reoperations, complications, or mortality between the internal fixation group and the arthroplasty group.
Conclusions
Surgical management of non-displaced femoral neck fractures with internal fixation or arthroplasty is both safe and effective as long as a strict protocol is followed, and careful analysis of radiographic features is performed.
A stakeholder-driven approach to designing a peer recovery coach role for implementation in community-oriented primary care teams in South Africa
Authors: Myers Bronwyn , Regenauer Kristen S. , Johnson Kim , Brown Imani , Rose Alexandra , Ciya Nonceba , Ndamase Sibabalwe , Jacobs Yuche , Anvari Morgan , Hines Abigail , Dean Dwayne , Baskar Rithika , Magidson Jessica 
Published: July 2024

Abstract

Introduction:
In South Africa (SA), community-oriented primary care (COPC) teams work to re-engage out-of-care people with HIV (PWH) in treatment, many of whom have substance use (SU) concerns. SU stigma is high among these teams, limiting care engagement efforts. Integrating peer recovery coaches (PRCs) into COPC teams could shift SU stigma and improve patients’ engagement in care. The PRC role does not exist in SA and represents a workforce innovation. To enhance acceptability, feasibility, and appropriateness for the local context, we engaged multiple stakeholder groups to co-design a PRC role for COPC team integration.
Methods
We used a five-step human-centered design process: (i) semi-structured interviews with healthcare worker (HCW, n = 25) and patient (n = 15) stakeholders to identify priorities for the role; (ii) development of an initial role overview; (iii) six ideation workshops with HCW (n = 12) and patient (n = 12) stakeholders to adapt this overview; (iv) refinement of the role prototype via four co-design workshops with HCW (n = 7) and patient (n = 9) stakeholders; and (v) consultation with HIV and SU service leaders to assess the acceptability and feasibility of integrating this prototype into COPC teams.
Results
Although all stakeholders viewed the PRC role as acceptable, patients and HCWs identified different priorities. Patients prioritized the care experience through sharing of lived experience and confidential SU support. HCWs prioritized clarification of the PRC role, working conditions, and processes to limit any impact on the COPC team. A personal history of SU, minimum 1 year in SU recovery, and strong community knowledge were considered role prerequisites by all stakeholders. Through the iterative process, stakeholders clarified their preferences for PRC session structure, location, and content and expanded proposed components of PRC training to include therapeutic and professional work practice competencies. Service leaders endorsed the prototype after the addition of PRC integration training for COPCs and PRC mentoring to address community and COPC dynamics.
Conclusion
Stakeholder engagement in an iterative HCD process has been integral to co-designing a PRC role that multiple stakeholder groups consider acceptable and that COPC teams are willing to implement. This offers a methodological framework for other teams designing SU workforce innovations.
Symptom network connectivity of PTSD comorbid with depression in bereaved Chinese parents
Authors: Eli Buzohre , Liu Xuanang , Xiao Fei , Liu Zhengkui 
Published: July 2024

Abstract

Background
The death of a child is a highly traumatic event for parents and often leads to posttraumatic stress disorder (PTSD) and depression. PTSD and depression are frequent comorbid. However, the patterns of comorbidity at the symptom level among bereaved parents remain unclear. This study aims to identify symptom network connectivity of PTSD comorbid with depression in bereaved parents who have lost their only child, known as Shidu parents in Chinese society.
Methods
Data were obtained from 477 bereaved individuals who had lost an only child. A Gaussian graphical model (GGM) was used to construct two comorbidity networks of PTSD and depression with and without overlapping symptoms. A directed acyclic graph (DAG) was computed to determine potential directionality among symptoms in the network without overlapping symptoms.
Results
In the GGM, symptoms from alterations in arousal and reactivity (Cluster E) and negative alterations in cognition and mood (Cluster D) tended to be key bridging nodes in both networks with and without overlapping symptoms. The DAG results indicated the important triggering role of an exaggerated startle response and several negative alterations in cognition and mood symptoms.
Conclusions
The results suggest a crucial role of the exaggerated startle response in the comorbidity network between PTSD and depression among bereaved Chinese parents. This finding may serve as a significant target for psychological interventions in this population.