bluuebunny/crossref_metadata_2025_split huggingface dataset:
Loss to follow-up and its predictors among children living with HIV on antiretroviral therapy, southern Oromia, Ethiopia: a 5-year retrospective cohort study
Authors: Bankere Assefa Washo , Daba Sintayehu Gabisa , Ami Bonso , Gedefa Lalisa Kebebe , Lencha Bikila 
Published: August 2024

BackgroundLoss to follow-up (LTFU) among paediatric patients living with HIV presents a significant challenge to the global scale-up of life-saving antiretroviral therapy (ART).ObjectivesThis study aims to estimate LTFU incidence and its determinants among children with HIV on ART in Shashemene town public health institutions, Oromia, Ethiopia.DesignA retrospective cohort study from 1 January 2015 to 30 December 2020.SettingThis study was conducted in Shashemene town, Oromia, Ethiopia.ParticipantsMedical records of 269 children receiving ART at health facilities in Shashemene town were included.MethodsData from patients’ medical records were collected using a standardised checklist. EpiData V.3.1 was employed for data entry, while Statistical Package for the Social Sciences (SPSS) V.25 facilitated analysis. The Kaplan-Meier survival curve was used for estimation of survival time. To measure association, adjusted HRs (AHRs) with 95% CIs were calculated. Both bivariable and multivariable Cox proportional hazards regression models were employed to identify predictors of LTFU.ResultsOf the 269 children living with HIV included in the final analysis, 43 (16%) were lost to follow-up. The overall incidence rate of LTFU was 3.3 (95% CI 2.4 to 4.4) per 100 child-years of observation. Age less than 5 years (AHR 0.03, 95% CI 0.00 to 0.36), non-orphan status of the child (AHR 0.13, 95% CI 0.05 to 0.34), < 30 min distance to health facility (AHR 0.24, 95% CI 0.08 to 0.73), disclosed HIV status (AHR 0. 32, 95% CI 0.13 to 0.80), history of opportunistic infection (AHR 3.54, 95% CI 1.15 to 10.87) and low CD4 count (AHR 5.17, 95% CI 2.08 to 12.85) were significant predictors of LTFU.ConclusionThe incidence rate of LTFU was lower compared with other studies in Ethiopia. This result indicated that age less than 5 years, non-orphans, low CD4, disclosed HIV status and distance from health facility were predictors of LTFU.
Assessing economic investment required to scale up bariatric surgery capacity in England: a health economic modelling analysis
Authors: Baker-Knight James , Pournaras Dimitri J , Mahawar Kamal , Welbourn Richard , Li Yuxin , Sharma Yuvraj , Guerra Ines , Tahrani Abd 
Published: August 2024

ObjectivesTo quantify the economic investment required to increase bariatric surgery (BaS) capacity in National Health Service (NHS) England considering the growing obesity prevalence and low provision of BaS in England despite its high clinical effectiveness.DesignData were included for the patients with obesity who were eligible for BaS. We used a decision-tree approach including four distinct steps of the patient pathway to capture all associated resource use. We estimated total costs according to the current capacity (current scenario) and three BaS scaling up strategies over a time horizon of 20 years (projected scenario): maximising NHS capacity (strategy 1), maximising NHS and private sector capacity (strategy 2) and adding infrastructure to NHS capacity to cover the entire prevalent and incident obesity populations (strategy 3).SettingBaS centres based in NHS and private sector hospitals in England.Main outcome measuresNumber of BaS procedures (including revision surgery), cost (GBP) and resource utilisation over 20 years.ResultsAt current capacity, the number of BaS procedures and the total cost over 20 years were estimated to be 140 220 and £1.4 billion, respectively. For strategy 1, these values were projected to increase to 157 760 and £1.7 billion, respectively. For strategy 2, the values were projected to increase to 232 760 and £2.5 billion, respectively. Strategy 3 showed the highest increase to 564 784 and £6.4 billion, respectively, with an additional 4081 personnel and 49 facilities required over 20 years.ConclusionsThe expansion of BaS capacity in England beyond a small proportion of the eligible population will likely be challenging given the significant upfront economic investment and additional requirement of personnel and infrastructure.
Assessing the cataract surgical rate and gender equity in cataract services in south-east Nigeria
Authors: Onyia Onyinye , Aghaji Ada Ejealor , Ubaka Christiana , Achigbu Eberechukwu Ogbeanu , Ejiakor Ifeoma Lilian , Mbatuegwu Adaku I , Okeke Chiamaka J P , Okoli Barbara C , Ogborogu Emmanuel U , Dike Kenneth C , Nkwogu Florence U , Gilbert Clare 
Published: August 2024

BackgroundIn 2020, almost 100 million people were blind or visually impaired from cataract. Cataract surgery is a cost-effective treatment for cataracts. In Nigeria, twice as many women are cataract blind as men. Cataract surgical rate (CSR, the number of cataract operations per million population per year in a defined geographical location) is an output indicator of cataract surgical services. The recommended target CSR for sub-Saharan Africa is 1000/year. The aim of this study was to assess the CSR in men and women in Imo state, Nigeria.MethodsA retrospective review of cataract surgery undertaken in all eye health facilities in Imo State in 2019. Data collected included the type and location of facilities, patient demographics and the number and type of cataract operations performed in each facility. The CSR was calculated overall, in men and women, and in younger and older women.ResultsThe CSR overall was 330/million and was slightly higher in women (347/million) than in men (315/million) (p<0.001). More elderly women (≥65 years) accessed cataract surgery through outreach than men and younger women (OR 1.5 (95% CI 1.03 to 2.22, p=0.03) and 1.6 (95% CI 1.07 to 2.44, p=0.02)), respectively.ConclusionThe overall CSR in Imo state was approximately one-third of that recommended for sub-Saharan Africa. Although the CSR was higher in women than in men, considerably higher CSRs are needed in women to address their higher burden of cataract blindness. Operational and intervention science research are needed, to identify and evaluate interventions which address demand and supply barriers to accessing cataract surgery, particularly for elderly women.
Mixed methods evaluation of a specialty-specific system to promote physician engagement in safety and quality reporting in a large academic health system
Authors: Lessios Anna Sophia , Vilendrer Stacie , Peterson Ashley , Brown-Johnson Cati , Kling Samantha M.R. , Veruttipong Darlene , Arteaga Michelle , Gessner Daniel , Gostic William John 
Published: August 2024

BackgroundIncident reporting systems (IRS) can improve care quality and patient safety, yet their impact is limited by clinician engagement. Our objective was to assess barriers to reporting in a hospital-wide IRS and use data to inform ongoing improvement of a specialty-specific IRS embedded in the electronic health record targeting anaesthesiologists.MethodsThis quality improvement (QI) evaluation used mixed methods, including qualitative interviews, faculty surveys and user data from the specialty-specific IRS. We conducted 24 semi-structured interviews from January to May 2023 in a large academic health system in Northern California. Participants included adult and paediatric anaesthesiologists, operating room nurses, surgeons and QI operators, recruited through convenience and snowball sampling. We identified key themes and factors influencing engagement, which were classified using the Systems Engineering Initiative for Patient Safety framework. We surveyed hospital anaesthesiologists in January and May 2023, and characterised the quantity and type of reports submitted to the new system.ResultsParticipants shared organisation and technology-related barriers to engagement in traditional system-wide IRSs, many of which the specialty-specific IRS addressed-specifically those related to technological access to the system. Barriers related to building psychological safety for those who report remain. Survey results showed that most barriers to reporting improved following the specialty-specific IRS launch, but limited time remained an ongoing barrier (25 respondents out of 44, 56.8%). A total of 964 reports with quality/safety concerns were submitted over the first 8 months of implementation; 47–76 unique anaesthesiologists engaged per month. The top safety quality categories of concern were equipment and technology (25.9%), clinical complications (25.3%) and communication and scheduling (19.9%).ConclusionsThese findings suggest that a specialty-specific IRS can facilitate increased physician engagement in quality and safety reporting and complement existing system-wide IRSs.
Prevalence and progression of chronic kidney disease among adults undergoing creatinine testing in South African public healthcare facilities: a study leveraging data from South Africa’s National Health Laboratory Service (NHLS)
Authors: Brennan Alana T , Kileel Emma M , Khoza Siyabonga , Crowther Nigel J , Bor Jacob , Fox Matthew P , Rosen Sydney , Hibberd Patricia , Raal Frederick , Chetty Kamy , Mlisana Koleka , George Jaya A 
Published: August 2024

BackgroundChronic kidney disease (CKD) has emerged as a substantial global health challenge, with a marked rise in associated mortality. However, it often goes undetected until advanced stages, particularly in low-income and middle-income countries such as South Africa. We investigated the prevalence and progression of CKD in South Africa, utilising a subset of data from the National Health Laboratory Services Multi-morbidity Cohort.MethodsThis study was a retrospective analysis of adults aged 18–85 years who underwent initial creatinine laboratory testing at government hospitals and clinics from January 2012 to January 2016. CKD was assessed using the Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) equation, excluding the race factor, with a cut-off of CKD-EPI<60 mL/min/1.73 m2. Lab-diagnosed CKD was defined as two estimated glomerular filtration rate measurements <60 mL/min/1.73 m2at least 90 days apart. Cox regression and survival curves were used to estimate HRs and rates of progression.ResultsAmong 6 106 521 adults tested between 2012 and 2016, 1.5% (95% CI 1.4% to 1.5%) were diagnosed with CKD, with the majority in stage 3. Over follow-up (median: 2 years, IQR: 0.8–3.6 years), 28.2% (95% CI 27.7% to 28.6%) of patients diagnosed as stage 3a progressed to a more severe disease state. Among patients who were in stage 3b at diagnosis, 29.6% (95% CI 29.0% to 30.1%) progressed and 33.3% (95% CI 32.5% to 34.1%) of stage 4 patients progressed. We estimated a 48% higher adjusted hazard of CKD progression for individuals with diabetes (adjusted HR 1.48, 95% CI 1.41 to 1.57) compared with those without. Advancing age also increased the risk, particularly for those aged >50 years.ConclusionsThis study underscores the urgency for early detection and management of CKD in South Africa, particularly for high-risk individuals. Strengthening primary healthcare systems and raising CKD awareness are vital for improved patient outcomes and to alleviate the burden on healthcare resources. Early intervention can delay CKD progression, thus reducing the need for costly treatments like dialysis and transplantation.
Health data management practice and associated factors among health professionals working in public health facilities in Oromia Special Zone, Amhara, Ethiopia: a cross-sectional study
Authors: Molla Abdu , Hayelom Mulugeta , Adamu Kidist , Mihiretu Mengistu Mera , Adem Yonas Fissha 
Published: August 2024

ObjectiveData and information are vital to the decision-making process surrounding health sector reform. In spite of the vast amounts of capital invested in the development of health information systems, health professionals continue to fight with a lack of basic data management skills in Ethiopia. Therefore, this study aimed to assess health data management practices and associated factors among health professionals in public facilities in the Oromia Special Zone, northeast Ethiopia.MethodA facility-based cross-sectional survey was conducted among 442 health professionals working in Oromia Special Zone from 8 March 2023 to 28 March 2023. Data were entered into Epi-Data V.4.6, and then it was exported to SPSS V.26 statistical software for processing and analysis. Bi-variable and multivariable logistic regression analyses were computed to see the association between health data management practice and selected independent variables. The bi-variable logistic regression analysis model was used to identify candidate variables for multivariable regression, with a p value <0.2 fitted into the multivariable logistic regression analysis model; a p value less than 0.05 and an adjusted OR (AOR) with a 95% CI were used to declare statistical significance associated with the dependent variable.ResultsThe prevalence of good health data management practices among health professionals was found to be 51.1%, with a 95% CI (45.9 to 55.7). In this study, received training on health data management (AOR=1.82, 95% CI (1.06 to 3.13)), used appropriate technology (AOR=1.78, 95% CI (1.09 to 2.91)) and competency (AOR=6.62, 95% CI (4.06 to 10.80)) were positively associated with health data management practice among health professionals.Conclusion and recommendationsNearly half of health professionals had poor health data management practices. The Zonal Health Department should plan capacity-building training for healthcare professionals, so as to improve their competency. All healthcare facilities should have appropriate and functional health data management technology.
A prospective study of injuries and illnesses among 910 amateur golfers during one season
Authors: Robinson Patrick Gordon , Clarsen Benjamin , Murray Andrew , Junge Astrid , Mountjoy Margo Lynn , Drobny Tomas , Gill Lance , Gazzano Francois , Voight Mike , Dvorak Jiri 
Published: August 2024

ObjectivesOur aims were (a) to describe the prevalence and incidence of self-reported injuries and illnesses of amateur golfers over a 5-month period and (b) to investigate potential risk factors for injury.MethodsWe recruited 910 amateur golfers (733 males [81%] and 177 females [19%]) from golf clubs in the USA and Switzerland. The median age was 60 (IQR: 47–67) and the median golfing handicap was 12 (IQR: 6–18). Participants’ health was monitored weekly for 5 months using the Oslo Sports Trauma Research Centre Questionnaire on Health Problems. Players also completed a baseline questionnaire on personal and golf-specific characteristics and their medical history.ResultsWe distributed 19 406 questionnaires and received 11 180 responses (57.6%). The prevalence of injuries was 11.3% (95% CI: 9.8 to 12.8) and of illnesses was 2% (95% CI 1.7 to 2.2). The incidence of injuries and illnesses was 3.79 (95% CI 3.54 to 4.06) and 0.94 (95% CI 0.81 to 1.07) per golfer per year, respectively. The injury regions with the highest burden of injury (time-loss days per player per year) were lumbosacral spine (5.93), shoulder (3.47) and knee (2.08). Injury risk was higher with increased age, osteoarthritis and previous injury.ConclusionThe prevalence and incidence of injury and illness in amateur golf were low compared with many other sports. To further reduce the burden of injury, future research attention should be directed towards the lumbosacral spine, knee and shoulder.
Profile of Sport and Exercise Physician trainee’s clinical practice within Australasia in 2019: a cross-sectional study
Authors: Lim Christopher , Vaughan Brett , Fitzgerald Kylie , Fitzpatrick Jane 
Published: August 2024

ObjectiveTo identify the patient population profile and the spectrum of training activities and influencing factors of Australasian College of Sport and Exercise Physician (ACSEP) trainees.DesignRetrospective cross-sectional design.SettingTraining settings for ACSEP trainees.ParticipantsTwenty ACSEP trainees undertaking full-time training in training period 2 of the 2019 training year (1 August 2019–31 January 2020). Exclusion criteria were trainees undertaking part time study and new fellows who completed their fellowship exams in 2019.Independent variablesPatient and practitioner demographicsMethodRetrospective cross-sectional design.Main outcome measurementsPatient data recorded in ACSEP trainees’ logbook. Short questionnaire capturing pertinent trainee demographics.ResultsMost ACSEP trainee patients are adults aged 18–65 years of age (78.2%), presenting with knee (18.7%), ankle (17%) and spinal complaints (13.1%) in clinical practice or sporting team environments. Youths 10–17 make up 13.1% of presentations and older adults 66 years and older make up 8%. Only Australian trainees are engaging in additional training activities, such as surgical assisting outside of the clinic or sporting team environment.ConclusionAustralasian Sport and Exercise Physician trainees appear to consult primarily musculoskeletal complaints, including providing broader care to paediatric and older populations, and work with sporting teams. There are differences between Australia and New Zealand trainee employment conditions, which appear to be affecting training experiences. These differences warrant consideration to ensure equitable training experiences and financial stability for trainees.
Efficiency and resilience: key drivers of distribution network growth
Authors: Amico Ambra , Vaccario Giacomo , Schweitzer Frank 
Published: August 2024

AbstractNetworks to distribute goods, from raw materials to food and medicines, are the backbone of a functioning economy. They are shaped by several supply relations connecting manufacturers, distributors, and final buyers worldwide. We present a network-based model to describe the mechanisms underlying the emergence and growth of distribution networks. In our model, firms consider two practices when establishing new supply relations: centralization, the tendency to choose highly connected partners, and multi-sourcing, the preference for multiple suppliers. Centralization enhances network efficiency by leveraging short distribution paths; multi-sourcing fosters resilience by providing multiple distribution paths connecting final buyers to the manufacturer. We validate the proposed model using data on drug shipments in the US. Drawing on these data, we reconstruct 22 nationwide pharmaceutical distribution networks. We demonstrate that the proposed model successfully replicates several structural features of the empirical networks, including their out-degree and path length distributions as well as their resilience and efficiency properties. These findings suggest that the proposed firm-level practices effectively capture the network growth process that leads to the observed structures.
Nanoemulsions of Bioactive Lipids Isolated from Cladophora Green Algae Declined NO and IL-6 Production in LPS-simulated RAW264.7 Murine Macrophage Cells
Authors: Foroghi Sanaz , Sarafbidabad Mohsen , Nasiri Rozita 
Published: August 2024

Inflammation is part of the host’s normal response to various harmful stimuli, including chemical exposure, tissue damage, infection, or contact with bacterial components, such as lipopolysaccharide (LPS); however, excessive inflammation leads to various acute and chronic human diseases. Macrophages contribute to the inflammatory process by secreting inflammatory mediators, such as prostaglandin E2 (PGE2) and nitric oxide (NO), as well as proinflammatory cytokines such as IL-1[Formula: see text], TNF-[Formula: see text] and IL-6 and the excess of these mediators can be harmful to tissues and organisms. The RAW 264.7 murine macrophage cell line treated with LPS is a commonly used in vitro model for assessing anti-inflammatory efficacy. The base of conventional inflammation therapy is the use of steroidal and nonsteroidal anti-inflammatory medications, both of which have significant adverse effects. Therefore, finding new sources of less hazardous treatments is imperative. The anti-inflammatory qualities of bioactive lipids from crude extracts of the green alga Cladophora were investigated using ethanol and hexane-ether as two distinct solvents. As a result, the total lipid concentration of the hexane-ether extraction was higher, so the unsaturated fatty acids (UFAs) were extracted from this sample by the methanol-solvent crystallization technique at low temperatures. The presence of various fatty acids and their percentage purity were determined by gas chromatography (GC). After the elimination of 49.11% of the saturated fatty acids, the spontaneous nanoemulsification approach was applied to improve the stability and functionalization of the fatty acids. The nanoemulsion particles’ size, distribution, and stability were evaluated using a Zetasizer system. The mean particle size and zeta potential value were 194.3 nm and −25.8 mV, respectively. Finally, the MTT (thiazolyl blue tetrazolium bromide) assay was used to determine the toxicity of the extracted bioactive lipids in the macrophage cell line RAW264.7 for 24 h, and the results showed an increase in the viability of cells treated with UFAs after encapsulation. The IC[Formula: see text] values calculated from the MTT assay results for each formulation and the anti-inflammatory effects of each formulation (at 1/3 IC[Formula: see text] value) were determined in LPS-stimulated RAW 264.7 macrophages by performing nitric oxide (NO) and cytokine enzyme-linked immunosorbent assays. Nanoemulsions of polyunsaturated fatty acids inhibited the production of NO and interleukin 6, which may be promising candidates for biological and medical applications to combat inflammation.
Mast Cell Infiltration and Subtype Promote Malignant Transformation of Oral Precancer and Progression of Oral Cancer
Authors: Cai Xin-Jia , Peng Chao-Ran , Zhang Jian-Yun , Li Xue-Fen , Wang Xu , Han Ying , Zhang He-Yu , Peng Xin , Li Tie-Jun 
Published: August 2024

Abstract

The role of mast cell (MC), a common myeloid-derived immune cell, in the development of oral squamous cell carcinoma (OSCC) is unclear. The aim of this study was to investigate MC infiltration in oral precancer and oral cancer. The evaluation of immune cell infiltration and its association with prognosis in OSCC used RNA sequencing and multiple public datasets. Multiplex immunofluorescence was used to explore the infiltration of MC in the microenvironment of OSCC and oral precancer and the interaction with CD8+ cells. The role of MC in OSCC progression was verified by in vivo experiments. The resting MC infiltration was mainly present in oral precancer, whereas activated MC infiltration was significantly higher in OSCC. Activated MC was associated with malignant transformation of oral precancer and poor prognosis of OSCC. In vivo studies showed that MC promoted the growth of OSCC. The infiltration of activated MC was negatively correlated with the infiltration of CD8+ T cells. The subtype of MC containing tryptase without chymase (MCT) was significantly higher in OSCC compared with oral precancer and was associated with poor survival. Furthermore, spatial distance analysis revealed a greater distance between MCT and CD8+ cells, which was also linked to poor prognosis in OSCC. Cox regression analysis showed that MCT could be a potential diagnostic and prognostic biomarker. This study provides new insights into the role of MC in the immune microenvironment of OSCC. It might enhance the immunotherapeutic efficacy of OSCC by developing targeted therapies against MC.

Significance:
In this study, we investigated the role of mast cells (MC) in oral precancer and oral cancer and demonstrated that MCs are involved in oral cancer progression and may serve as a potential diagnostic and prognostic marker. It might improve the immunotherapeutic efficacy through developing targeted therapies against MCs.