bluuebunny/crossref_metadata_2025_split huggingface dataset:
How Does Treatment Coverage and Proportion Never Treated Influence the Success of Schistosoma mansoni Elimination as a Public Health Problem by 2030?
Authors: Kura Klodeta , Mutono Nyamai , Basáñez Maria-Gloria , Collyer Benjamin S , Coffeng Luc E , Thumbi S M , Anderson Roy M 
Published: April 2024

Abstract

Background
The 2030 target for schistosomiasis is elimination as a public health problem (EPHP), achieved when the prevalence of heavy-intensity infection among school-aged children (SAC) reduces to &lt;1%. To achieve this, the new World Health Organization guidelines recommend a broader target of population to include pre-SAC and adults. However, the probability of achieving EPHP should be expected to depend on patterns in repeated uptake of mass drug administration by individuals.

Methods
We employed 2 individual-based stochastic models to evaluate the impact of school-based and community-wide treatment and calculated the number of rounds required to achieve EPHP for Schistosoma mansoni by considering various levels of the population never treated (NT). We also considered 2 age-intensity profiles, corresponding to a low and high burden of infection in adults.

Results
The number of rounds needed to achieve this target depends on the baseline prevalence and the coverage used. For low- and moderate-transmission areas, EPHP can be achieved within 7 years if NT ≤10% and NT &lt;5%, respectively. In high-transmission areas, community-wide treatment with NT &lt;1% is required to achieve EPHP.

Conclusions
The higher the intensity of transmission, and the lower the treatment coverage, the lower the acceptable value of NT becomes. Using more efficacious treatment regimens would permit NT values to be marginally higher. A balance between target treatment coverage and NT values may be an adequate treatment strategy depending on the epidemiological setting, but striving to increase coverage and/or minimize NT can shorten program duration.
Safety and efficacy of EsoFLIP dilation in patients with esophageal dysmotility: a systematic review
Authors: Iqbal Umair , Yodice Michael , Ahmed Zohaib , Anwar Hafsa , Arif Syeda Faiza , Lee-Smith Wade M , Diehl David L 
Published: April 2024

Abstract
Esophageal manometry is utilized for the evaluation and classification of esophageal motility disorders. EndoFlip has been introduced as an adjunctive test to evaluate esophagogastric junction (EGJ) distensibility. Treatment options for achalasia and EGJ outflow obstruction (EGJOO) include pneumatic dilation, myotomy, and botulinum toxin. Recently, a therapeutic 30 mm hydrostatic balloon dilator (EsoFLIP, Medtronic, Minneapolis, MN, USA) has been introduced, which uses impedance planimetry technology like EndoFlip. We performed a systematic review to evaluate the safety and efficacy of EsoFLIP in the management of esophageal motility disorders. A systematic literature search was performed with Medline, Embase, Web of science, and Cochrane library databases from inception to November 2022 to identify studies utilizing EsoFLIP for management of esophageal motility disorders. Our primary outcome was clinical success, and secondary outcomes were adverse events. Eight observational studies including 222 patients met inclusion criteria. Diagnoses included achalasia (158), EGJOO (48), post-reflux surgery dysphagia (8), and achalasia-like disorder (8). All studies used 30 mm maximum balloon dilation except one which used 25 mm. The clinical success rate was 68.7%. Follow-up duration ranged from 1 week to a mean of 5.7 months. Perforation or tear occurred in four patients. EsoFLIP is a new therapeutic option for the management of achalasia and EGJOO and appears to be effective and safe. Future comparative studies with other therapeutic modalities are needed to understand its role in the management of esophageal motility disorders.
Aortic aneurysms in a general population cohort: prevalence and risk factors in men and women
Authors: Pham Michael Huy Cuong , Sigvardsen Per Ejlstrup , Fuchs Andreas , Kühl Jørgen Tobias , Sillesen Henrik , Afzal Shoaib , Nordestgaard Børge Grønne , Køber Lars Valeur , Kofoed Klaus Fuglsang 
Published: April 2024

Abstract

Aims
The prevalence and difference in risk factors for having thoracic aortic aneurysm (TAA) and abdominal aortic aneurysm (AAA) in men compared with women in the general population is not well described. This study aimed to test the hypotheses that (i) cardiovascular risk factors for TAA and AAA differ and (ii) the prevalence of TAA and AAA is sex specific.

Methods and results
Aortic examination using computed tomography angiography was performed in 11 294 individuals (56% women), with a mean age of 62 (range 40–95) years participating in the Copenhagen General Population Study. TAAs were defined as an ascending aortic diameter ≥45 mm and a descending aortic diameter ≥35 mm, while AAAs were defined as an abdominal aortic diameter ≥30 mm. Demographic data were obtained from questionnaires. Overall prevalence of aortic aneurysms (AAs) in the study population included: total population 2.1%, men 4.0% and women 0.7% (P-value men vs. women P &lt; 0.001). AAs were independently associated with male sex, increasing age, and body surface area (BSA). While TAAs were associated with hypertension, odds ratio (OR) = 2.0 [95% confidence interval (CI): 1.5–2.8], AAAs were associated with hypercholesterolaemia and smoking, OR = 2.4 (95% CI: 1.6–3.6) and 3.2 (95% CI: 1.9–5.4).

Conclusion
Subclinical AAs are four times more prevalent in men than in women. In both sexes, increasing age and BSA are risk factors for AAs of any anatomical location. Whereas arterial hypertension is a risk factor for TAAs, hypercholesterolaemia and smoking are risk factors for AAAs.
Simple models vs. deep learning in detecting low ejection fraction from the electrocardiogram
Authors: Hughes John Weston , Somani Sulaiman , Elias Pierre , Tooley James , Rogers Albert J , Poterucha Timothy , Haggerty Christopher M , Salerno Michael , Ouyang David , Ashley Euan , Zou James , Perez Marco V 
Published: April 2024

Abstract

Aims
Deep learning methods have recently gained success in detecting left ventricular systolic dysfunction (LVSD) from electrocardiogram (ECG) waveforms. Despite their high level of accuracy, they are difficult to interpret and deploy broadly in the clinical setting. In this study, we set out to determine whether simpler models based on standard ECG measurements could detect LVSD with similar accuracy to that of deep learning models.

Methods and results
Using an observational data set of 40 994 matched 12-lead ECGs and transthoracic echocardiograms, we trained a range of models with increasing complexity to detect LVSD based on ECG waveforms and derived measurements. The training data were acquired from the Stanford University Medical Center. External validation data were acquired from the Columbia Medical Center and the UK Biobank. The Stanford data set consisted of 40 994 matched ECGs and echocardiograms, of which 9.72% had LVSD. A random forest model using 555 discrete, automated measurements achieved an area under the receiver operator characteristic curve (AUC) of 0.92 (0.91–0.93), similar to a deep learning waveform model with an AUC of 0.94 (0.93–0.94). A logistic regression model based on five measurements achieved high performance [AUC of 0.86 (0.85–0.87)], close to a deep learning model and better than N-terminal prohormone brain natriuretic peptide (NT-proBNP). Finally, we found that simpler models were more portable across sites, with experiments at two independent, external sites.

Conclusion
Our study demonstrates the value of simple electrocardiographic models that perform nearly as well as deep learning models, while being much easier to implement and interpret.
Digest: Sexual selection may shape species’ range limits
Authors: Sinclair Olivia R , Taberer Tabitha R 
Published: April 2024

Abstract
In a recent study, Tschol et al. (2024) present a model that investigates how 2 different forms of sexual selection, selection for traits that increase mate encounters and selection for traits that enhance one’s ability to compete for mates, affect geographical range limits. The model demonstrates that range limits expand in response to selection on mate-encountering traits and contract when selection acts on reproductive competitiveness. When traits coevolve, range limits depend on the mating system. This study demonstrates the importance of accounting for sexual selection and intraspecific interactions when investigating eco-evolutionary dynamics of geographic range limits.
Multi-omics analysis reveals improvement of tomato quality by grafting on goji rootstock
Authors: Wang Ruiting , Yang Yang , Xu Kexin , Wang Tingjin , A. Elsadek Mohamed , Yuan Lu , Hu Zhongyuan , Lv Yongping , Yuan Xin , Chen Xiangfu , Wang Yiting , Chen Liping 
Published: April 2024

Abstract

Background
Tomato quality is a complex trait influenced by multiple genes involved in various complicated metabolic pathways.

Materials and Methods
This study sought to improve tomato taste and quality by grafting on goji rootstock. We integrated physiological and biochemical indicators, as well as metabolic and transcriptomic analysis, to evaluate tomato quality.

Results
The grafted tomatoes showed significant increases in soluble solids (51.48%), vitamin C (16.86%), soluble protein (16.19%), titratable acid (11.73%), anthocyanin (11.43%), and polysaccharide (9.43%) content compared to those of the control. Metabolomics analysis identified 234 differentially accumulated metabolites and transcriptome analysis identified 4213 differentially expressed genes between grafted and control tomatoes at three ripening stages (mature green, turning, and fully red). A total of 93 phenolic compounds, including flavonoids and phenolic acids, showed differential accumulation patterns between grafted and control tomatoes at the fully red stage. These changes were attributed to the upregulation of key genes (F3ʹH, F3ʹ5ʹH, DFR, and ANS) associated with flavonoids and anthocyanin synthesis in the goji rootstock compared to those of the control. The expression of genes involved in sucrose hydrolysis and starch synthesis, including invertase (INV), sucrase synthase (SUS), and beta-amylase (BAM) genes, were suppressed by goji grafting, resulting in increased levels of sugars. In addition, the consistency between the transcriptomic and metabolomic data provided a robust validation of the observed quality changes.

Conclusions
Taken together, our results demonstrate that grafting onto goji rootstock improves tomato quality by modulating multiple genes involved in phenylpropanoid, sucrose, and starch pathways during fruit development, providing valuable insights for improving the quality and taste of tomato.
Disparities in Stress Exposure and Later-Life Disability
Authors: Sauerteig-Rolston Madison R , Ferraro Kenneth F 
Published: April 2024

Abstract

Background and Objectives
Drawing from cumulative inequality theory and the weathering hypothesis, this study examined the relationship between life-course stress exposure (measured cumulatively and by domains) and the onset of disability in later life among White, Black, U.S.-born Hispanic, and foreign-born Hispanic older adults.

Research Design and Methods
Cross-sectional and longitudinal models were estimated using nationally representative data from the Health and Retirement Study (N = 11,483). We used logistic regression models to examine associations between stress exposure and Wave 1 disability (i.e., occurrence), and Weibull-accelerated failure-time models to examine the relationship between stress exposure and age of onset of disability 12–14 years later (i.e., incidence). We tested for moderation between stress and disability by race, ethnicity, and Hispanic nativity.

Results
At Wave 1, higher odds of disability occurrence were associated with cumulative stress burden (CSB; odds ratio [OR] = 4.93, 95% confidence interval [CI]: 2.95–8.23). In a model specifying domains of stressors, disability occurrence was associated with childhood financial strain (OR = 1.22, CI: 1.01–1.46), lifetime traumatic events (OR = 1.92, CI: 1.41–2.62), neighborhood disadvantage (OR = 1.32, CI: 1.01–1.73), and major lifetime discrimination (OR = 1.64, CI: 1.12–2.41). Over time, earlier onset of disability was associated with CSB (β = −0.39), childhood traumatic events (β = −0.16), adult financial strain (β = −0.17), everyday discrimination (β = −0.15), and major lifetime discrimination (β = −0.13). The effect of childhood traumatic events on the transition to disability was stronger for U.S.-born Hispanic adults than White adults (occurring 33% earlier).

Discussion and Implications
To reduce racial, ethnic, and nativity disparities in disability, it is important to consider the historical and structural disadvantages associated with stress exposure across the life course. It is also important to acknowledge that nativity influences stratification processes associated with disparities in racial and ethnic health trajectories.
The Benefits of Technology for Engaging Aging Adults: Findings From the PRISM 2.0 Trial
Authors: Czaja Sara J , Charness Neil , Rogers Wendy A , Sharit Joseph , Moxley Jerad H , Boot Walter R 
Published: April 2024

Abstract

Background and Objectives
Technology has potential for providing support for aging adults. This study evaluated the Personal Reminder Information and Social Management 2.0 (PRISM 2.0) software, in terms of enhancing social engagement and quality of life, and decreasing loneliness among older adults.

Research Design and Methods
The randomized field trial conducted in diverse living contexts (rural locations, senior housing, and assisted living communities [ALC]). Two hundred and forty-five adults, aged 64 to 99 years, were randomly assigned to the PRISM 2.0 (integrated software system designed for aging through an iterative design process) or a Standard Tablet (without PRISM) Control condition, where participants received the same amount of contact and training as those in the PRISM 2.0 condition. Primary outcomes included measures of loneliness, social support, social connectedness, and quality of life. Secondary outcomes included measures of social isolation, mobile device proficiency, and technology readiness. Data were collected at baseline and 6 and 9 months postrandomization. This article focuses on the 6-month outcomes due to coronavirus disease 2019-related data challenges at 9 months.

Results
Contrary to our hypothesis, participants in rural locations and senior housing in both conditions reported less loneliness and social isolation, and greater social support and quality of life at 6 months, and an increase in mobile device proficiency. Participants in the ALCs in both conditions also evidenced an increase in mobile device proficiency. Improvements in quality of life and health-related quality of life were associated with decreases in loneliness.

Discussion and Implications
This study provides compelling evidence about the benefits of technology for older adults in terms of enhancing social outcomes and quality of life. However, the findings also underscore that for technology applications to be successful, they need to be adapted to the abilities and needs of the user group and instructional support needs to be provided.

Clinical Trials Registration #
NCT03116399
Strategies to Improve Emergency Transitions From Long-Term Care Facilities: A Scoping Review
Authors: Tate Kaitlyn , Cummings Greta , Jacobsen Frode , Halas Gayle , Van den Bergh Graziella , Devkota Rashmi , Shrestha Shovana , Doupe Malcolm 
Published: April 2024

Abstract

Background and Objectives
Older adults residing in residential aged care facilities (RACFs) often experience substandard transitions to emergency departments (EDs) through rationed and delayed ED care. We aimed to identify research describing interventions to improve transitions from RACFs to EDs.

Research Design and Methods
In our scoping review, we included English language articles that (a) examined an intervention to improve transitions from RACF to EDs; and (b) focused on older adults (≥65 years). We employed content analysis. Dy et al.’s Care Transitions Framework was used to assess the contextualization of interventions and measurement of implementation success.

Results
Interventions in 28 studies included geriatric assessment or outreach services (n = 7), standardized documentation forms (n = 6), models of care to improve transitions from RACFs to EDs (n = 6), telehealth services (n = 3), nurse-led care coordination programs (n = 2), acute-care geriatric departments (n = 2), an extended paramedicine program (n = 1), and a web-based referral system (n = 1). Many studies (n = 17) did not define what “improvement” entailed and instead assessed documentation strategies and distal outcomes (e.g., hospital admission rates, length of stay). Few authors reported how they contextualized interventions to align with care environments and/or evaluated implementation success. Few studies included clinician perspectives and no study examined resident- or family/friend caregiver-reported outcomes.

Discussion and Implications
Mixed or nonsignificant results prevent us from recommending (or discouraging) any interventions. Given the complexity of these transitions and the need to create sustainable improvement strategies, future research should describe strategies used to embed innovations in care contexts and to measure both implementation and intervention success.
Does pay-for-performance design matter? Evidence from Brazil
Authors: Russo Letícia Xander , Powell-Jackson Timothy , Borghi Josephine , Sampaio Juliana , Gurgel Junior Garibaldi Dantas , Shimizu Helena Eri , Bezerra Adriana Falangola Benjamin , E Silva Keila Silene de Brito , Barreto Jorge Otávio Maia , de Carvalho André Luis Bonifácio , Kovacs Roxanne J , Gomes Luciano Bezerra , Fardousi Nasser , da Silva Everton Nunes 
Published: April 2024

Abstract
Pay-for-performance (P4P) schemes have been shown to have mixed effects on health care outcomes. A challenge in interpreting this evidence is that P4P is often considered a homogenous intervention, when in practice schemes vary widely in their design. Our study contributes to this literature by providing a detailed depiction of incentive design across municipalities within a national P4P scheme in Brazil [Primary Care Access and Quality (PMAQ)] and exploring the association of alternative design typologies with the performance of primary health care providers. We carried out a nation-wide survey of municipal health managers to characterize the scheme design, based on the size of the bonus, the providers incentivized and the frequency of payment. Using OLS regressions and controlling for municipality characteristics, we examined whether each design feature was associated with better family health team (FHT) performance. To capture potential interactions between design features, we used cluster analysis to group municipalities into five design typologies and then examined associations with quality of care. A majority of the municipalities included in our study used some of the PMAQ funds to provide bonuses to FHT workers, while the remaining municipalities spent the funds in the traditional way using input-based budgets. Frequent bonus payments (monthly) and higher size bonus allocations (share of 20–80%) were strongly associated with better team performance, while who within a team was eligible to receive bonuses did not in isolation appear to influence performance. The cluster analysis showed what combinations of design features were associated with better performance. The PMAQ score in the ‘large bonus/many workers/high-frequency’ cluster was 8.44 points higher than the ‘no bonus’ cluster, equivalent to a difference of 21.7% in the mean PMAQ score. Evidence from our study shows how design features can potentially influence health provider performance, informing the design of more effective P4P schemes.
Quadrivalent HPV Vaccine Effectiveness Against Cervical Intraepithelial Lesion Grade 2 or Worse in Norway: A Registry-Based Study of 0.9 Million Norwegian Women
Authors: Orumaa Madleen , Lahlum Elen Johanne , Gulla Marie , Tota Joseph E , Nygård Mari , Nygård Ståle 
Published: April 2024

Abstract
In Norway, single-cohort vaccination with quadrivalent human papillomavirus (qHPV) vaccine targeting 12-year-old girls took place in 2009–2016. In 2020, the oldest vaccinated cohort was 23 years old and had approached the age where risk of being diagnosed with cervical intraepithelial neoplasia grade 2 or worse (CIN2+) increases rapidly. The aim of this cohort study was to assess direct qHPV vaccine effectiveness (VE) against CIN2+ among Norwegian women aged 16–30 years in 2007–2020. By using population-based health registries and individual-level data on vaccination status and potential subsequent CIN2+ incidence, we found 82% qHPV VE among women vaccinated before age 17 years.
From Confrontation to Cooperation: Describing Non-State Armed Group–UN Interactions in Peace Operations
Authors: Kotajoki Jenniina 
Published: April 2024

Abstract
In various conflict contexts where the state is unable to maintain security and public order, non-state armed groups (NSAGs) and the United Nations (UN) conduct their activities alongside one another. While previous research has focused on hostile relations between the UN and NSAGs, less attention has been given to collaborative interactions. This paper aims to address this research gap by formulating a novel conceptual typology of NSAG–UN interactions in the context of a peace operation. The typological framework comprises two-dimensions: firstly, the thematic field of interaction including human rights, humanitarian needs and governance, security, and political processes and, secondly, the nature of interaction ranging from confrontation to cooperation. Based on the typology, interaction activities between the UN and NSAGs in two peacekeeping operations—the UN Operation in Côte d'Ivoire (UNOCI) and the UN Multidimensional Integrated Stabilization Mission in Mali (MINUSMA)—are systematically documented and described. While both cases show confrontation in the security field, UNOCI also commonly cooperated with NSAGs on security-related issues; MINUSMA instead cooperated with NSAGs primarily regarding the political process. The analysis further proposes factors that may explain such variation, including institutional arrangements and NSAG characteristics. The conceptual framework presented in this paper is crucial in advancing knowledge about an empirical phenomenon that we know little about and that has important implications for different forms of “local” engagement in peace operations and the effectiveness of UN policies and practices.
A rare case of carcino-sarcoma of the esophagus with huge intrathoracic metastasis
Authors: Alamassi Mohammad , Arabi Esraa Yaseen , Arabi Haitham , Saleh Waleed 
Published: April 2024

Abstract
Carcinosarcoma of the esophagus constitutes only 0.5%–2.8% of all malignant esophageal cancers. It is identified by the presence of both carcinomatous and sarcomatous components. A clear regimen of treatment has not been established due to the limited understanding of the disease. We present a case of carcinosarcoma of the esophagus with rapid recurrence and invasion to the intrathoracic cavity only 6 weeks after esophagectomy. Carcinosarcoma carries a poor prognosis, as it has a late tendency of hematogenous spread with a high growth rate.