bluuebunny/crossref_metadata_2025_split huggingface dataset:
Cost-effectiveness of single-visit cervical cancer screening in KwaZulu-Natal, South Africa: a model-based analysis accounting for the HIV epidemic
Authors: Tran Jacinda , Hathaway Christine Lee , Broshkevitch Cara Jill , Palanee-Phillips Thesla , Barnabas Ruanne Vanessa , Rao Darcy White , Sharma Monisha 
Published: April 2024

IntroductionWomen living with human immunodeficiency virus (WLHIV) face elevated risks of human papillomavirus (HPV) acquisition and cervical cancer (CC). Coverage of CC screening and treatment remains low in low-and-middle-income settings, reflecting resource challenges and loss to follow-up with current strategies. We estimated the health and economic impact of alternative scalable CC screening strategies in KwaZulu-Natal, South Africa, a region with high burden of CC and HIV.MethodsWe parameterized a dynamic compartmental model of HPV and HIV transmission and CC natural history to KwaZulu-Natal. Over 100 years, we simulated the status quo of a multi-visit screening and treatment strategy with cytology and colposcopy triage (South African standard of care) and six single-visit comparator scenarios with varying: 1) screening strategy (HPV DNA testing alone, with genotyping, or with automated visual evaluation triage, a new high-performance technology), 2) screening frequency (once-per-lifetime for all women, or repeated every 5 years for WLHIV and twice for women without HIV), and 3) loss to follow-up for treatment. Using the Ministry of Health perspective, we estimated costs associated with HPV vaccination, screening, and pre-cancer, CC, and HIV treatment. We quantified CC cases, deaths, and disability-adjusted life-years (DALYs) averted for each scenario. We discounted costs (2022 US dollars) and outcomes at 3% annually and calculated incremental cost-effectiveness ratios (ICERs).ResultsWe projected 69,294 new CC cases and 43,950 CC-related deaths in the status quo scenario. HPV DNA testing achieved the greatest improvement in health outcomes, averting 9.4% of cases and 9.0% of deaths with one-time screening and 37.1% and 35.1%, respectively, with repeat screening. Compared to the cost of the status quo ($12.79 billion), repeat screening using HPV DNA genotyping had the greatest increase in costs. Repeat screening with HPV DNA testing was the most effective strategy below the willingness to pay threshold (ICER: $3,194/DALY averted). One-time screening with HPV DNA testing was also an efficient strategy (ICER: $1,398/DALY averted).ConclusionsRepeat single-visit screening with HPV DNA testing was the optimal strategy simulated. Single-visit strategies with increased frequency for WLHIV may be cost-effective in KwaZulu-Natal and similar settings with high HIV and HPV prevalence.
Assessment of antimicrobial prescribing patterns, guidelines compliance, and appropriateness of antimicrobial prescribing in surgical-practice units: point prevalence survey in Malaysian teaching hospitals
Authors: Jamaluddin Nurul Adilla Hayat , Periyasamy Petrick , Lau Chee Lan , Ponnampalavanar Sasheela , Lai Pauline Siew Mei , Loong Ly Sia , Tg Abu Bakar Sidik Tg Mohd Ikhwan , Ramli Ramliza , Tan Toh Leong , Kori Najma , Yin Mei Kuen , Azman Nur Jannah , James Rodney , Thursky Karin , Naina Mohamed Isa 
Published: April 2024

Objectives: This study sought to investigate the quality of antimicrobial prescribing among adult surgical inpatients besides exploring the determinants of non-compliance and inappropriate prescribing to inform stewardship activities.Methods: A cross-sectional point prevalence study employing Hospital National Antimicrobial Prescribing Survey (Hospital NAPS) was conducted in April 2019 at two teaching hospitals in Malaysia.Results: Among 566 surgical inpatients, 44.2% were receiving at least one antimicrobial, for a total of 339 prescriptions. Antimicrobials belonging to the World Health Organization’s Watch group were observed in 57.8% of cases. Both hospitals exhibited similar types of antimicrobial treatments prescribed and administration routes. A significant difference in antimicrobial choice was observed between hospitals (p &lt; 0.001). Hospital with electronic prescribing demonstrated better documentation practice (p &lt; 0.001). Guidelines compliance, 32.8% (p = 0.952) and appropriateness, 55.2% (p = 0.561) did not significantly differ. The major contributors of inappropriateness were incorrect duration, (15%) and unnecessary broad-spectrum coverage, (15.6%). Non-compliance and inappropriate prescribing were found to be 2 to 4 times significantly higher with antimicrobial prophylaxis prescription compared to empirical therapy.Conclusion: Antimicrobial stewardship efforts to improve appropriate surgical prescribing are essential. These initiatives should prioritize surgical prophylaxis prescribing, focusing on reducing unnecessarily prolonged use and broad-spectrum antimicrobials, raising awareness among prescribers and promoting proper documentation.
Ganoderma lucidum spore extract improves sleep disturbances in a rat model of sporadic Alzheimer’s disease
Authors: Qin Yu , Zhao Yan , Hu Xiao , Chen Xi , Jiang Yan-Ping , Jin Xue-Jun , Li Gao , Li Zhen-Hao , Yang Ji-Hong , Zhang Guo-Liang , Cui Su-Ying , Zhang Yong-He 
Published: April 2024

Introduction:Ganoderma lucidum (G. lucidum, Lingzhi) has long been listed as a premium tonic that can be used to improve restlessness, insomnia, and forgetfulness. We previously reported that a rat model of sporadic Alzheimer’s disease (sAD) that was induced by an intracerebroventricular injection of streptozotocin (ICV-STZ) showed significant learning and cognitive deficits and sleep disturbances. Treatment with a G. lucidum spore extract with the sporoderm removed (RGLS) prevented learning and memory impairments in sAD model rats.Method: The present study was conducted to further elucidate the preventive action of RGLS on sleep disturbances in sAD rats by EEG analysis, immunofluorescence staining, HPLC-MS/MS and Western blot.Results: Treatment with 720 mg/kg RGLS for 14 days significantly improved the reduction of total sleep time, rapid eye movement (REM) sleep time, and non-REM sleep time in sAD rats. The novelty recognition experiment further confirmed that RGLS prevented cognitive impairments in sAD rats. We also found that RGLS inhibited the nuclear factor-κB (NF-κB)/Nod-like receptor family pyrin domain-containing 3 (NLRP3) inflammatory pathway in the medial prefrontal cortex (mPFC) in sAD rats and ameliorated the lower activity of γ-aminobutyric acid (GABA)-ergic neurons in the parabrachial nucleus (PBN).Discussion: These results suggest that inhibiting the neuroinflammatory response in the mPFC may be a mechanism by which RGLS improves cognitive impairment. Additionally, improvements in PBN-GABAergic activity and the suppression of neuroinflammation in the mPFC in sAD rats might be a critical pathway to explain the preventive effects of RGLS on sleep disturbances in sAD.
Sporoderm-removed Ganoderma lucidum spores ameliorated early depression-like behavior in a rat model of sporadic Alzheimer’s disease
Authors: Zhao Yan , Qin Yu , Hu Xiao , Chen Xi , Jiang Yan-Ping , Jin Xue-Jun , Li Gao , Li Zhen-Hao , Yang Ji-Hong , Cui Su-Ying , Zhang Yong-He 
Published: April 2024

Introduction:Ganoderma lucidum: (G. lucidum, Lingzhi) is a medicinal and edible homologous traditional Chinese medicine that is used to treat various diseases, including Alzheimer’s disease and mood disorders. We previously reported that the sporoderm-removed G. lucidum spore extract (RGLS) prevented learning and memory impairments in a rat model of sporadic Alzheimer’s disease (sAD), but the effect of RGLS on depression-like behaviors in this model and its underlying molecular mechanisms of action remain unclear.Method: The present study investigated protective effects of RGLS against intracerebroventricular streptozotocin (ICV-STZ)-induced depression in a rat model of sAD and its underlying mechanism. Effects of RGLS on depression- and anxiety-like behaviors in ICV-STZ rats were assessed in the forced swim test, sucrose preference test, novelty-suppressed feeding test, and open field test.Results: Behavioral tests demonstrated that RGLS (360 and 720 mg/kg) significantly ameliorated ICV-STZ-induced depression- and anxiety-like behaviors. Immunofluorescence, Western blot and enzyme-linked immunosorbent assay results further demonstrated that ICV-STZ rats exhibited microglia activation and neuroinflammatory response in the medial prefrontal cortex (mPFC), and RGLS treatment reversed these changes, reflected by the normalization of morphological changes in microglia and the expression of NF-κB, NLRP3, ASC, caspase-1 and proinflammatory cytokines. Golgi staining revealed that treatment with RGLS increased the density of mushroom spines in neurons. This increase was associated with elevated expression of brain-derived neurotrophic protein in the mPFC.Discussion: In a rat model of ICV-STZ-induced sAD, RGLS exhibits antidepressant-like effects, the mechanism of which may be related to suppression of the inflammatory response modulated by the NF-κB/NLRP3 pathway and enhancement of synaptic plasticity in the mPFC.
The influence of gratitude and personality traits on career resilience and career success among college students
Authors: Zhao Kai , Ji Wenna 
Published: April 2024

IntroductionThe study examines the interplay between gratitude and career success, with career resilience as the mediating mechanism and personality traits, i.e., conscientiousness and extraversion, as moderating factors. The overarching goal is to enhance our understanding of the complex dynamics that influence career outcomes of college students in China.MethodsData are gathered through a survey-based technique, capturing responses from a diverse sample of participants. The analysis employs Structural Equation Modeling (SEM) to explore the relationships among gratitude, career resilience, personality traits, and career success.ResultsThe results reveal that gratitude impacts students’ career success through the mediating mechanism of career resilience. In addition, conscientiousness and extraversion are found to positively intervene the direct effect between gratitude and career resilience and the indirect effect between gratitude and career success through career resilience.DiscussionThe findings offer valuable insights for individuals, organizations, and career development practitioners, emphasizing the importance of cultivating gratitude and recognizing the differential impact of personality traits on this process. As organizations seek to foster resilient and successful career paths, acknowledging these nuanced dynamics can inform targeted interventions and strategies.
Dose–response associations between physical activity and sedentary time with functional disability in older adults with or without frailty: a prospective cohort study
Authors: Seino Satoshi , Abe Takumi , Nofuji Yu , Hata Toshiki , Shinkai Shoji , Kitamura Akihiko , Fujiwara Yoshinori 
Published: April 2024

PurposeEvidence regarding the dose–response curve shapes of physical activity (PA) and sedentary time (ST) in older adults with functional disability (FD) is extremely limited. Moreover, these associations may differ depending on with/without frailty. We examined the dose–response associations between moderate-to-vigorous PA (MVPA) and ST with FD among older adults with/without frailty.MethodsWe included 7,480 initially nondisabled adults (3,795 men and 3,685 women) aged 65–84 years in Ota City, Tokyo, Japan. MVPA and ST were evaluated using the International Physical Activity Questionnaire-Short Form. FD was prospectively identified using a nationally unified database of the long-term care insurance system. Frailty was determined using Check-List 15, validated against Fried’s frailty criteria. Multivariate-adjusted hazard ratios (HRs) and 95% confidence intervals (CIs) of MVPA and ST for FD were calculated, and dose–response curves were examined using restricted cubic splines.ResultsDuring 3.6 years of follow-up, 1,001 (13.4%) participants had FD. Among all participants, compared with no MVPA, the HRs for FD reduced linearly up to approximately 2000 metabolic equivalents (METs)■min/week of MVPA, and the lowest HR (HR: 0.61, 95% CI: 0.51–0.74) was reached at around 3,000–4,000 METs■min/week. Although the shape of this association was consistent regardless of with/without frailty, the magnitude of the association tended to be stronger in frail older adults than in non-frail older adults. Compared with those for the median (300 min/day) of ST, the HRs for FD increased linearly as ST reached approximately 600 min/day or more, independent of MVPA, with a maximum HR of 1.31 (95% CI: 1.01–1.71) for 1,080 min/day among all participants. This association was more pronounced among non-frail older adults but not statistically significant among frail older adults.ConclusionHigher MVPA levels consistently reduced the incidence of FD regardless of frailty in a significant inverse nonlinear dose–response manner. A significant positive nonlinear dose–response association between ST and FD risk was identified among non-frail older adults but not among frail older adults. Increasing MVPA and reducing prolonged ST are important for preventing FD among non-frail older adults. However, reducing ST alone may be insufficient; increasing MVPA, even if by only small increments, is highly recommended for frail older adults.
“I am still human and worth a life:” a qualitative study of the impacts of a community based, peer-led, treatment support model for young adults living with HIV in Zimbabwe
Authors: Zamudio-Haas Sophia , Mahaka Imelda , Chapwanya Gwendoline , Dunbar Megan S. , Lightfoot Marguerita 
Published: April 2024

BackgroundA persistent treatment gap remains between children and adults living with HIV. The Zvandiri program, developed by Africaid, is one of the few models of differentiated service delivery for children, adolescents, and youth that has been shown to improve outcomes along the HIV care continuum, employing Community Adolescent Treatment Supporters (CATS) to offer peer counseling and patient navigation. Our qualitative study provides an in-depth analysis of the feelings and experiences Zimbabwean youth had following an HIV diagnosis, and the ways that CATS facilitated linkage and retention in care.MethodsWe conducted in-depth interviews in Shona with adolescents and young adults who were recently diagnosed with HIV in Zimbabwe. Interviews were audio-recorded, transcribed, and then translated to English. Interviews were coded in Dedoose using a structured a priori codebook. We wrote semi-structured summary memos for each interview. We co-conducted thematic analysis, guided by interpretive phenomenology with a team of Zimbabwean and American experienced qualitative researchers and community partners. We co-developed memos to elaborate and understand key themes across interviews.ResultsMost of our interview participants recounted an immediate sense of loss upon testing HIV positive and a fear that “there was no hope for the future.” CATS played a pivotal role for youth, providing emotional, educational, and logistical support to facilitate treatment initiation, adherence, and persistence in care. The CATS program supported youth through multiple approaches: group sessions, individual meetings, and via text or phone. While CATS offered counseling and comfort to participants, they emphasized the long-term importance of identifying at least one other person in participants’ lives who could know their status and support them around HIV.ConclusionOur findings delineate some of the key concerns that face youth after receiving an HIV diagnosis and the ways that a community-based adherence peer navigation program supported participants to navigate both their feelings and the health care system. Results can inform practice at community-based agencies that are implementing or considering peer youth navigation programs and garner support for policy to fund interventions for youth.
Examining students’ level of understanding toward COVID-19 and its associated factors in Ethiopia: a systematic review and meta-analysis
Authors: Chereka Alex Ayenew , Demsash Addisalem Workie , Butta Fikadu Wake , Shibabaw Adamu Ambachew , Gebeyehu Chernet Desalegn , Adane Daniel , Limeneh Wubalem Dilie , Fentahun Amare Dagnew , Tadesse Mathias Nega , Kitil Gemeda Wakgari 
Published: April 2024

BackgroundThis systematic review and meta-analysis aim to investigate students’ understanding of COVID-19 in Ethiopia and identify associated factors. The primary goal is to pinpoint key contributors shaping students’ perception and comprehension of the virus. The study aims to offer valuable insights for developing targeted educational interventions, ultimately enhancing students’ overall knowledge and awareness of the pandemic in the specific context of Ethiopia.MethodsThe study adhered rigorously to PRISMA criteria, ensuring a standardized methodology. Data from reputable databases like Google Scholar and PubMed were systematically collected. Ten relevant articles were meticulously analyzed using STATA version 11, with heterogeneity assessed by the I2 test. A funnel plot and Egger’s test were used to check for publication bias. The determination of the pooled effect size utilized a random-effect model meta-analysis, offering a robust 95% confidence interval.ResultsThis meta-analysis, based on 10 articles, reveals an overall prevalence of 61.58% (95% CI: 47.26–75.89). Significant contributors to students’ comprehension include Social media users (AOR) = 2.38, urban residence AOR = 3.31, news media followers AOR = 2.51, fathers’ educational status AOR = 2.35, watching television AOR = 4.71, and health science students AOR = 4.21. These findings underscore crucial elements shaping students’ understanding of COVID-19 in Ethiopia.ConclusionOur analysis indicates that 61.58% of Ethiopian students possess a good understanding of COVID-19. Factors such as active social media engagement, geographic location, frequency of news consumption, father’s level of education, television viewing habits, and enrollment in health science programs significantly influence their comprehension. These findings underscore the importance of implementing targeted interventions to enhance health literacy and education among students, thereby facilitating a more effective response to pandemics.
Age- and height-dependent bias of underweight and overweight assessment standards for children and adolescents
Authors: Isoyama Yosuke , Nose-Ogura Sayaka , Ijitsu Mariko Jana , Kruse João Gabriel Segato , Nagai Narumi , Kayaba Momoko , Ogata Hitomi , Mangalam Madhur , Kiyono Ken 
Published: April 2024

BackgroundPrecision in evaluating underweight and overweight status among children and adolescents is paramount for averting health and developmental issues. Existing standards for these assessments have faced scrutiny regarding their validity. This study investigates the age and height dependencies within the international standards set by the International Obesity Task Force (IOTF), relying on body mass index (BMI), and contrasts them with Japanese standards utilizing the percentage of overweight (POW).MethodWe scrutinized a comprehensive database comprising 7,863,520 children aged 5–17 years, sourced from the School Health Statistics Research initiative conducted by Japan's Ministry of Education, Culture, Sports, Science, and Technology. Employing the quantile regression method, we dissected the structure of weight-for-height distributions across different ages and sexes, quantifying the potentially biased assessments of underweight and overweight status by conventional criteria.ResultsApplying IOFT criteria for underweight assessment revealed pronounced height dependence in males aged 11–13 and females aged 10–11. Notably, a discernible bias emerged, wherein children in the lower 25th percentile were classified as underweight five times more frequently than those in the upper 25th percentile. Similarly, the overweight assessment displayed robust height dependence in males aged 8–11 and females aged 7–10, with children in the lower 25th percentile for height deemed obese four or five times more frequently than their counterparts in the upper 25th percentile. Furthermore, using the Japanese POW criteria for assessment revealed significant age dependence in addition to considerably underestimating the percentage of underweight and overweight cases under the age of seven. However, the height dependence for the POW criterion was smaller than the BMI criterion, and the difference between height classes was less than 3-fold.ConclusionOur findings underscore the intricacies of age-dependent changes in body composition during the growth process in children, emphasizing the absence of gold standards for assessing underweight and overweight. Careful judgment is crucial in cases of short or tall stature at the same age, surpassing sole reliance on conventional criteria results.
Hospitalization costs in Portugal among people with obesity: results from a nationwide population-based cohort 2011 to 2021
Authors: Destri Kelli , Henriques Ana Rita , Mendonça Nuno , Alves Joana , Barcelos Anabela , Dias Sara Simões , Gregório Maria João , Canhão Helena , Rodrigues Ana Maria 
Published: April 2024

BackgroundObesity has been extensively studied over the years, primarily focusing on the physiological aspects of the disease. However, the general burden of obesity mainly the financial implications and its influence on hospitalization and length of stay have only recently garnered attention in the literature, particularly in the case of Portugal.AimThis study aimed to investigate the association between obesity and hospitalizations in the Portuguese adult population and compare the average costs of hospitalization among participants with and without obesity.MethodsAt baseline, the analytic sample consisted of 10,102 participants aged ≥18 years from the Portuguese population-based Epidemiology of Chronic Diseases Cohort (EpiDoC). Participants were then followed for up to 10 years from 2011 to 2021 in three more waves of data collection. Body mass index was derived from self-reported weight and height, and instances of hospitalization were self-reported by the participants. The associated costs for each hospitalization episode were categorized according to national legislation and valued according to the pricing for Diagnosis Related Groups.ResultsObesity was associated with more hospitalizations (for example, Obesity class I vs. normal weight: OR = 1.33 [1.14–1.55]). However, when the presence of multimorbidity was considered, this association diminished. While longer hospital length of stay was observed in individuals with higher obesity categories, this difference did not reach statistical significance. On average, the total hospitalization costs per patient with obesity amounted to €200.4 per year.ConclusionObesity is as a risk factor for hospitalizations and potentially with higher length of stay hospitalizations, with this effect being partially mediated by the concurrent presence of multimorbidity. Consequently, obesity constitutes an additional burden on healthcare systems. This underscores the imperative of implementing cost-effective prevention programs aimed at addressing and managing this significant public health concern.