bluuebunny/crossref_metadata_2025_split huggingface dataset:
Comparison of three rapid diagnostic tests for Plasmodium falciparum diagnosis in Ghana
Authors: Kayode Tolulope Adeyemi , Addo Agyapong Kofi , Addison Thomas Kwame , Tweneboah Austine , Afriyie Stephen Opoku , Abbas Dawood Ackom , Seth Ayesha , Badu-Tawiah Abraham K. , Badu Kingsley , Koepfli Cristian 
Published: August 2024

Abstract
Background
Accurate diagnosis and timely treatment are crucial in combating malaria.

Methods
A total of 449 samples were screened for Plasmodium falciparum infection by expert microscopy, qPCR, and three RDTs, namely Rapigen Biocredit Malaria Ag Pf (detecting HRP2 and pLDH on separate bands), Abbott NxTek Eliminate Malaria Ag Pf (detecting HRP2), and SD Bioline Malaria Ag Pf (detecting HRP2). hrp2/3 deletion typing was done by digital PCR.

Results
45.7% (205/449) individuals tested positive by qPCR for P. falciparum with a mean parasite density of 12.5 parasites/μL. Using qPCR as reference, the sensitivity of microscopy was 28.3% (58/205), the Biocredit RDT was 52.2% (107/205), the NxTek RDT was 49.3% (101/205), and the Bioline RDT was 39.5% (81/205). When only samples with densities > 20 parasites/μL were included (n = 89), sensitivity of 62.9% (56/89) by microscopy, 88.8% (79/89) by Biocredit, 88.8% (79/89) by NxTek, and 78.7% (70/89) by Bioline were obtained. All three RDTs demonstrated specificities > 95%. The limits of detection (95% probability that a sample tested positive) was 4393 parasites/μL (microscopy), 56 parasites/μL (Biocredit, considering either HRP2 or pLDH), 84 parasites/μL (NxTek), and 331 parasites/μL (Bioline). None of the three qPCR-confirmed P. falciparum positive samples, identified solely through the pLDH target, or eight samples negative for all RDTs but qPCR-positive at densities > 20 parasites/µL carried hrp2/3 deletions.

Conclusion
The Biocredit and NxTek RDTs demonstrated comparable diagnostic efficacies. All three RDTs performed better than microscopy.
Syringe services program staff and participant perspectives on changing drug consumption behaviors in response to xylazine adulteration
Authors: Eger William H. , Plesons Marina , Bartholomew Tyler S. , Bazzi Angela R. , Hauschild Maia H. , McElrath Corbin C. , Owens Cyrus , Forrest David W. , Tookes Hansel E. , Crable Erika L. 
Published: August 2024

Abstract
Background
Xylazine is an increasingly common adulterant in the North American unregulated drug supply that is associated with adverse health outcomes (e.g., skin infections, overdose). However, there are significant knowledge gaps regarding how xylazine was initially identified and how syringe services program (SSP) staff and clients (people who use drugs) responded to its emergence.

Methods
From June–July 2023, we conducted qualitative interviews with medical (e.g., clinicians) and frontline SSP staff (e.g., outreach workers) and adult clients with a history of injection drug use at a Miami-based SSP. Inductive memos identified emergent codes; thematic analysis involving team consensus established final themes.

Results
From interviews with SSP staff (n = 8) and clients (n = 17), xylazine emergence was identified at different times, in various ways. Initially, during summer 2022, clients identified a “tranquilizer-like substance” that worsened sedation and withdrawal and caused wounds. SSP medical staff later identified this adulterant as xylazine by treating new medical cases and through diverse information-sharing networks that included professional societies and news sources; however, frontline SSP staff and clients needed additional educational resources about xylazine and its side effects. With limited guidance on how to reduce harm from xylazine, SSP clients altered their drug consumption routes, reduced drug use, and relied on peers’ experiences with the drug supply to protect themselves. Some individuals also reported preferring xylazine-adulterated opioids and increasing their drug use, including the use of stimulants to avoid over sedation.

Conclusions
Xylazine’s emergence characterizes the current era of unprecedented shifts in the unregulated drug supply. We found that xylazine spurred important behavioral changes among people who use drugs (e.g., transitioning from injecting to smoking). Incorporating these experiences into early drug warning surveillance systems and scaling up drug-checking services and safer smoking supply distribution could help mitigate significant health harms caused by xylazine and other emergent adulterants.
Pilot study of using transcranial temporal interfering theta-burst stimulation for modulating motor excitability in rat
Authors: Wu Chun-Wei , Lin Bor-Shing , Zhang Zhao , Hsieh Tsung-Hsun , Liou Jian-Chiun , Lo Wei-Lun , Li Yu-Ting , Chiu Shao-Chu , Peng Chih-Wei 
Published: August 2024

AbstractTranscranial temporal interference stimulation (tTIS) is a promising brain stimulation method that can target deep brain regions by delivering an interfering current from surface electrodes. Most instances of tTIS stimulate the brain with a single-frequency sinusoidal waveform generated by wave interference. Theta burst stimulation is an effective stimulation scheme that can modulate neuroplasticity by generating long-term potentiation- or depression-like effects. To broaden tTIS application, we developed a theta burst protocol using tTIS technique to modulate neuroplasticity in rats. Two cannula electrodes were unilaterally implanted into the intact skull over the primary motor cortex. Electrical field of temporal interference envelopes generated by tTIS through cannula electrodes were recorded from primary motor cortex. Theta burst schemes were characterized, and motor activation induced by the stimulation was also evaluated simultaneously by observing electromyographic signals from the corresponding brachioradialis muscle. After validating the stimulation scheme, we further tested the modulatory effects of theta burst stimulation delivered by tTIS and by conventional transcranial electrical stimulation on primary motor cortex excitability. Changes in the amplitude of motor evoked potentials, elicited when the primary motor cortex was activated by electrical pulses, were measured before and after theta burst stimulation by both techniques. Significant potentiation and suppression were found at 15 to 30 min after the intermittent and continuous theta burst stimulation delivered using tTIS, respectively. However, comparing to theta burst stimulations delivered using conventional form of transcranial electrical stimulation, using tTIS expressed no significant difference in modulating motor evoked potential amplitudes. Sham treatment from both methods had no effect on changing the motor evoked potential amplitude. The present study demonstrated the feasibility of using tTIS to achieve a theta burst stimulation scheme for motor cortical neuromodulation. These findings also indicated the future potential of using tTIS to carry out theta burst stimulation protocols in deep-brain networks for modulating neuroplasticity.
Direct aortic TAVI via anterior right mini-thoracotomy using 32 mm myval for pure aortic regurgitation
Authors: Aljanadi Firas , McNeilly Graham , Manoharan Ganesh , McNiece Andrew , Jeganathan Reuben 
Published: August 2024

Abstract
Background
Aortic regurgitation with dilated annulus presents a technical challenge for conventional transcatheter aortic valve implantation (TAVI) procedures.

Case presentation
We report a case of an 84-year-old frail patient with a history of breathlessness found to have severe aortic regurgitation and moderately impaired left ventricular systolic function. The patient underwent a successful TAVI procedure using the XL-Myval 32 mm transcatheter heart valve (THV) via an anterior right mini-thoracotomy with a direct aortic approach. The patient recovered well post-operatively with good hemodynamic resolution.

Conclusions
This first in human case highlights the efficacy and potential of applying innovative approaches, such as the new sizes of Myval THV and direct aortic access via anterior right mini thoracotomy, in addressing challenging anatomical variations in TAVI procedures with good outcome.
Human errors in emergency medical services: a qualitative analysis of contributing factors
Authors: Poranen Anna , Kouvonen Anne , Nordquist Hilla 
Published: August 2024

Abstract
Background
The dynamic and challenging work environment of the prehospital emergency care settings creates many challenges for paramedics. Previous studies have examined adverse events and patient safety activities, but studies focusing on paramedics’ perspectives of factors contributing to human error are lacking. In this study, we investigated paramedics’ opinions of the factors contributing to human errors.

Method
Data was collected through semi-structured individual interviews (n = 15) with paramedics and emergency medical field supervisors in Finland. The data was analyzed using inductive content analysis. Consolidated criteria for reporting qualitative research were used.

Results
Contributing factors to human errors were divided into three main categories. The first main category, Changing work environment, consisted of two generic categories: The nature of the work and Factors linked to missions. The second main category, Organization of work, was divided into three generic categories: Inadequate care guidelines, Interaction challenges and Challenges related to technological systems. The third main category, Paramedics themselves, consisted of four generic categories: Issues that complicate cognitive processing, Individual strains and needs, Attitude problems and Impact of work experience.

Conclusion
Various factors contributing to human errors in emergency medical services (EMS) settings were identified. Although many of them were related to individual factors or to the paramedics themselves, system-level factors were also found to affect paramedics’ work and may therefore negatively impact patient safety. The findings provide insights for organizations to use this knowledge proactively to develop their procedures and to improve patient safety.
The influence of environmental factors related to Juvenile Dermatomyositis (JDM), its course and refractoriness to treatment
Authors: Valões Clarissa C.M. , Arabi Tamima M. , Braga Alfésio L.F. , Campos Lúcia M.A. , Aikawa Nádia E. , Kozu Kátia T. , Silva Clovis A. , Farhat Sylvia C.L. , Elias Adriana M. 
Published: August 2024

Abstract
Objective
To evaluate the influence of environmental factors and prematurity relating to juvenile dermatomyositis (JDM), its course and refractoriness to treatment.

Methods
A case-control study with 35 patients followed up at a tertiary hospital and 124 healthy controls, all residents of São Paulo. Patients were classified according to monocyclic, polycyclic or chronic disease courses and refractoriness to treatment. The daily concentrations of pollutants (inhalable particulate matter-PM10, sulfur dioxide-SO2, nitrogen dioxide-NO2, ozone-O3 and carbon monoxide-CO) were provided by the Environmental Company of São Paulo. Data from the population were obtained through a questionnaire.

Results
Fifteen patients had monocyclic courses, and 19 polycyclic/chronic courses. Eighteen patients were refractory to treatment. Maternal occupational exposure to inhalable agents (OR = 17.88; IC 95% 2.15–148.16, p = 0.01) and exposure to O3 in the fifth year of life (third tertile > 86.28µg/m3; OR = 6.53, IC95% 1.60–26.77, p = 0.01) were risk factors for JDM in the multivariate logistic regression model. The presence of a factory/quarry at a distance farther than 200 meters from daycare/school (OR = 0.22; IC 95% 0.06–0.77; p = 0.02) was a protective factor in the same analysis. Prematurity, exposure to air pollutants/cigarette smoke/sources of inhalable pollutants in the mother’s places of residence and work during the gestational period were not associated with JDM. Prematurity, maternal exposure to occupational pollutants during pregnancy as well as patient’s exposure to ground-level pollutants up to the fifth year of life were not associated with disease course and treatment refractoriness.

Conclusion
Risk factors for JDM were maternal occupational exposure and exposure to O3 in the fifth year of life.
Determining the accuracy of the leukocyte esterase reagent strip test in the rapid diagnosis of adult septic arthritis
Authors: Mirghaderi Peyman , Pahlevan-Fallahy Mohammad-Taha , Mahmoudi Jamil , Mortazavi S.M. Javad 
Published: August 2024

Abstract
Backgrounds
Septic arthritis is a dangerous disease that occurs when microorganisms enter synovial fluid. It needs fast and accurate management; otherwise, it can harm the patient’s life. Currently, the tests measure WBC and PMN in SF, so we hypothesized to use a proxy that is easier and faster to measure. Leukocyte esterase is an enzyme secreted by neutrophils that can be found in the synovial fluid of SA patients. In this study, we tried to investigate the sensitivity and specificity of leukocyte esterase in diagnosing septic arthritis.

Methods
We obtained synovial fluid samples from forty-six patients suspected of having septic arthritis and fifty-eight healthy individuals and measured the WBCs, ESR, CRP, PMN, glucose, and protein of SF in 2021. We also used the leukocyte esterase dipstick test to investigate the level of LE in synovial fluid for one minute.

Results
Based on clinical and paraclinical criteria, sixteen out of the forty-six patients were diagnosed with SA. When (++) was considered positive, the sensitivity and specificity of the LE dipstick test for the diagnosis of SA were 93.7% (95% CI: 81.8–100%) and 60% (95% CI: 42.4–77.5%, P = 0.000), respectively. When both (+) and (++) were considered positive, they were 100% and 43.3% (95% CI: 25.6–61.0% P = 0.000), respectively. All the patients in the control group had negative cultures and LE test readings (specificity = 100%).

Conclusion
The LE dipstick test can be a valuable diagnostic tool in the initial diagnosis of SA since it is affordable, fast, and reliable.
Neogene shale-detached extension and contraction linked system in the Akal Fold and Thrust Belt, Southeast Mexico
Authors: Portillo Pineda Rodrigo , Cerca Mariano 
Published: August 2024

Structures related to shale mobility represent an important challenge for proper interpretation in seismic data sets. The large number of seismic sections obtained in recent times of the Akal Fold and Thrust Belt (AFTB) makes this province a natural laboratory for studying shale-related structural styles. The interpretation of two orthogonal 2D seismic sections reveals the geometry of a gravity-driven extension-contraction structural system that developed in the central portion of the AFTB during the Late Miocene to the Early Pliocene. The gravity-driven system was triggered by increasing the sedimentary load in the Miocene and developed a set of listric faults and related growth strata. The contracting structures are the in-sequence fold thrust that evolved from shale-cored detachment anticlines. An Oligocene sequence of soft, weak shale with alternating, rigid layers of sandstone and limestone and a low-resistivity signature acts as the detachment of the gravity-driven system. The progressive sequential restoration of a structural cross section provides more information about the progression of the gravity-driven system. We suggest that mobility started when the Oligocene shale reached a critical condition at >2–3 km burial depth. The coeval northeastward regional Chiapanecan shortening interferes with the last stage of the shale detachment (the Early Pliocene) in the study area and masks the previous interpretation of the gravity-driven system.
Deprivation of liberty in hospital: the MHA versus DoLS dilemma
Authors: Cave Jeremy , Ruck Keene Alex , Lowe Matthew 
Published: August 2024

SUMMARY
When admitting patients to hospital and treating them, psychiatrists and other health professionals may need to deprive them of their liberty. Where this occurs, professionals will need to work within a statutory framework to practice legally and protect their patients’ right to liberty under Article 5 of the European Convention on Human Rights. Within England and Wales, some clinical scenarios will require a choice to be made between the Mental Health Act 1983 (MHA) and the Mental Capacity Act 2005 (MCA) and its Deprivation of Liberty Safeguards (DoLS). This choice can be complex, is often overlooked and frequently misunderstood in clinical practice. Deciding between the two frameworks must be done on a case-specific basis. With the use of code of practice guidelines, case law and an unfolding clinical scenario we aim in this article to support clinicians in taking a clear-sighted approach to the dilemma and the factors to consider when deciding between the two regimes.
Understanding gait alterations: trunk flexion and its effects on walking neuromechanics
Authors: Núñez-Lisboa M. , Echeverría K. , Willems P. A. , Ivanenko Y. , Lacquaniti F. , Dewolf A. H. 
Published: August 2024

ABSTRACT
Evolutionary and functional adaptations of morphology and postural tone of the spine and trunk are intrinsically shaped by the field of gravity in which humans move. Gravity also significantly impacts the timing and levels of neuromuscular activation, particularly in foot-support interactions. During step-to-step transitions, the centre of mass velocity must be redirected from downwards to upwards. When walking upright, this redirection is initiated by the trailing leg, propelling the body forward and upward before foot contact of the leading leg, defined as an anticipated transition. In this study, we investigated the neuromechanical adjustments when walking with a bent posture. Twenty adults walked on an instrumented treadmill at 4 km h−1 under normal (upright) conditions and with varying degrees of anterior trunk flexion (10, 20, 30 and 40 deg). We recorded lower-limb kinematics, ground reaction forces under each foot, and the electromyography activity of five lower-limb muscles. Our findings indicate that with increasing trunk flexion, there is a lack of these anticipatory step-to-step transitions, and the leading limb performs the redirection after the ground collision. Surprisingly, attenuating distal extensor muscle activity at the end of stance is one of the main impacts of trunk flexion. Our observations may help us to understand the physiological mechanisms and biomechanical regulations underlying our tendency towards an upright posture, as well as possible motor control disturbances in some diseases associated with trunk orientation problems.
EVALUATION OF IMPLEMENTATION OF COMPREHENSIVE EMERGENCY NEONATAL OBSTETRICS SERVICES PROGRAM (PONEK)
Authors: Irma Irma , Gustina Erni 
Published: August 2024

Background: Contributing factors to maternal and infant mortality rates are caused by delays in decision making, late referral and late handling at health facilities or referral sites. One of the efforts to reduce maternal, infant and under-five mortality rates is the provision of comprehensive emergency neonatal obstetric service facilities (PONEK= Program Pelayanan Obstetri Neonatal Emergensi Komprehensif) in hospitals. The key to the success of PONEK is the availability of appropriate healthcare personnel competence, infrastructure, facilities and reliable management.Â Objective: Evaluate the PONEK program at General Hospital PKU Muhammadiyah Yogyakarta City (RSU PKU Muhammadiyah Yogyakarta City)Â Methodology: This research used qualitative approach, case study designed at RSU PKU Muhammadiyah Yogyakarta in September 2017. The subjects were 5 employees of PONEK Team and 3 patients, and using Purposive Sampling technique. Data collection by in-depth interviews and observations. Data analysis consisted of the stages of data reduction, data presentation, drawing conclusions and source triangulation.Â Result: Input program of PONEK in RSU PKU Yogyakarta is good in terms of quantity of good availability of human resources, funds, and infrastructure facilities. The process of planning, organizing and supervision is good, while in the implementation process has not run well, because one of the activities that support the PONEK of education and training has not been 100% running. Output of PONEK that has not been achieved such as training that cannot be implemented in accordance with a predetermined schedule. The service quality of the PONEK program in terms of patients is quite good and satisfied with the services provided.Â Conclusion: The implementation of comprehensive emergency neonatal obstetric service program in PKU Muhammadiyah General Hospital as a whole has been going well even though it is not perfect, because there are some parts that are carried out optimally.
ANALYSIS EFFECT OF QUALITY SERVICE AND PATIENTâ€™S KNOWLEDGE OF PATIENTS ATTITUDE OF AWARENESS OF TREATMENT AND ITS IMPACT ON DENTAL PATIENT VISIT AT PUSKESMAS SITU UDIK BOGOR DISTRICT, WEST JAVA, INDONESIA
Authors: Cahyani Lenny Asyita , Fauziah Munaya 
Published: August 2024

Background: Dental and oral disease attacks almost everyone in the world. Nevertheless, majority of people pay less attention to look after their dental and oral health. Therefore, that case gave rise the severe level. The main cause of severity of dental disease is the disobedience of the patients to the determined medical service standards.Â Objective: The purpose of this study is to reveal the impact of the service quality and knowledge of the patients with regards to the treatment awareness behavior and to the re-visit of dental patients at community health center (Puskesmas) Situ Udik, Bogor district, west Java, Indonesia 2018.Â Method: The research design used in this research is quantitative analytics. As for the analysis test, the path analysis is used. The activities were carried out in Dental Polyclinic of Puskesmas Situ Udik in February 2018 where sampling was done by using random sampling system with 143 respondents.Â Result: The statistic test shows that the factors that influence the patient's re-visit are quality of service (p value = 0.011, contribution 22,5%) and behavior of the patients (p value = 0,045, contribution 17,4%). While the factors that influence the behavior of the patients is quality (p value = 0.000, contribution 45.6%). In addition, simultaneously the quality of services, knowledge as well as behavior affect the re-visit (p value = 0.000 and contribution of 11.6%)Â Conclusion: 1) to improve the quality of service at Puskesmas Situ Udik and; 2) to provide the patients with education or health promotion in order to improve their knowledge as well as behavior with regards to dental diseases.Â