bluuebunny/crossref_metadata_2025_split huggingface dataset:
Impact of annual community-directed treatment with ivermectin on the incidence of epilepsy in Mvolo, a two-year prospective study
Authors: Amaral Luís-Jorge , Jada Stephen Raimon , Ndjanfa Aimee Kemayou , Carter Jane Y. , Abd-Elfarag Gasim , Okaro Samuel , Logora Makoy Yibi , Bol Yak Yak , Lakwo Thomson , Fodjo Joseph N Siewe , Colebunders Robert 
Published: March 2024

Objectives
The potential impact of cumulative community-directed treatment with ivermectin (CDTI) on epilepsy epidemiology in Mvolo County, South Sudan, an onchocerciasis-endemic area with high epilepsy prevalence, was investigated. Annual CDTI was introduced in 2002 in Mvolo, with interruptions in 2016 and 2020.

Methods
Comprehensive house-to-house surveys in Mvolo (June 2020 and 2022) identified cases of epilepsy, including probable nodding syndrome (pNS). Community workers screened households in selected sites for suspected epilepsy, and medical doctors confirmed the diagnosis and determined the year of seizure onset. The incidence of epilepsy, including pNS, was analysed using 95% confidence intervals (CIs). Data on ivermectin intake and onchocerciasis-associated manifestations (itching and blindness) were collected.

Results
The surveys covered 15,755 (2020) and 15,092 (2022) individuals, identifying 809 (5.2%, 95% CI: 4.8–5.5%) and 672 (4.5%, 95% CI: 4.1–4.8%) epilepsy cases, respectively. Each survey reported that a third of the surveyed population experienced skin itching, and 3% were blind. Epilepsy incidence per 100,000 person-years gradually declined, from 326.5 (95% CI: 266.8–399.1) in 2013–2015 to 96.6 (95% CI: 65.5–141.7) in 2019–2021. Similarly, pNS incidence per 100,000 person-years decreased from 151.7 (95% CI: 112.7–203.4) to 27.0 (95% CI: 12.5–55.5). Coverage of CDTI was suboptimal, reaching only 64.0% of participants in 2019 and falling to 24.1% in 2021 following an interruption in 2020 due to COVID-19 restrictions. Additionally, while 99.4% of cases had active epilepsy in 2022, less than a quarter of these had access to antiseizure medication.

Conclusions
The observed decrease in epilepsy incidence despite suboptimal CDTI coverage highlights the potential impact of onchocerciasis control efforts and underscores the need to strengthen these efforts in Mvolo County and across South Sudan. As a proactive measure, Mvolo and neighbouring counties are transitioning to biannual CDTI. Furthermore, the substantial epilepsy treatment gap in Mvolo should be addressed.
Comparative effectiveness of dexamethasone in treatment of hospitalized COVID-19 patients in the United States during the first year of the pandemic: Findings from the National COVID Cohort Collaborative (N3C) data repository
Authors: Zhou Richard , Johnson Kaitlyn E. , Rousseau Justin F. , Rathouz Paul J. ,   on behalf of the N3C Consortium
Published: March 2024

Background
Dexamethasone was approved for use in hospitalized COVID-19 patients early in the pandemic based on the RECOVERY trial, but evidence is still needed to support its real-world effectiveness in heterogeneous populations of patients with a wide range of comorbidities.

Methods
COVID-19 inpatients represented within the National COVID Cohort Collaborative (N3C) Data Enclave, prior to vaccine availability, were studied. Primary outcome was in-hospital death; secondary outcome was combined in-hospital death and severe outcome defined by use of ECMO or mechanical ventilation. Missing data were imputed with single imputation. Dexamethasone-treated patients were propensity score (PS) matched to non-dexamethasone-treated controls, stratified by remdesivir treatment and based on demographics, baseline laboratory values, comorbidities, and amount of missing data before imputation. Treatment benefit was quantified using logistic regression. Further sensitivity analyses were performed using clinical adjusters in matched groups and in strata defined by quartiles of PS.

Results
Dexamethasone treatment was associated with reduced risk of in-hospital mortality for n = 1,263 treated, matched 1:3 to untreated, patients not receiving remdesivir (OR = 0.77, 95% CI: 0.62 to 0.95, p = 0.017), and for n = 804 treated, matched 1:1 to untreated, patients receiving remdesivir (OR = 0.74, 95% CI: 0.53 to 1.02, p = 0.054). Treatment showed secondary outcome benefit. In sensitivity analyses, treatment effect generally remained similar with some heterogeneity of benefit across quartiles of PS, possibly reflecting concentration of benefit among the more severely affected.

Conclusions
We add evidence that dexamethasone provides benefit with respect to mortality and severe outcomes in a diverse, national hospitalized sample, prior to vaccine availability.
Acute kidney injury in hospitalized children with proteinuria: A multicenter retrospective analysis
Authors: Baggett Katelyn H. , Manghi Tomas , Walter Vonn , Thomas Neal J. , Freeman Michael A. , Krawiec Conrad 
Published: March 2024

Background and objective
Acute kidney injury (AKI) is a common complication in hospitalized pediatric patients. Previous studies focused on adults found that proteinuria detected during an admission urinalysis is fit to serve as an indicator for AKI and associated clinical outcomes. The objective of this study is to evaluate if proteinuria on the first day of hospital services in hospitalized children is associated with AKI, need for renal replacement therapy, shock and/or antibiotic use, critical care services, and all-cause mortality at 30 days, hypothesizing that it is associated with these outcomes.

Methods
This is a retrospective cohort study using TriNetX electronic health record data of patients 2 to 18 years of age who underwent urinalysis laboratory testing on hospital admission, had three subsequent days of hospital or critical care services billing codes and creatinine laboratory values, and no pre-existing renal-related complex chronic condition. This study evaluated for the frequency, odds, and severity of AKI as defined by Kidney Disease: Improving Global Outcomes modified criteria and assessed for associated clinical outcomes.

Results
This study included 971 pediatric subjects [435 (44.7%) with proteinuria]. Proteinuria on the first day of hospital services was associated with an increased odds for higher severity AKI on any day of hospitalization (odds ratio [OR] 2.41, CI 1.8–3.23, p<0.001), need for renal replacement therapy (OR 4.58, CI 1.69–12.4, p = 0.001), shock and/or antibiotic use (OR 1.34, CI 1.03–1.75, p = 0.033), and all-cause mortality at 30 days post-admission (OR 10.0, CI 1.25–80.5, p = 0.013).

Conclusion
Children with proteinuria on the first day of hospital care services may have an increased odds of higher severity AKI, need for renal replacement therapy, shock and/or antibiotic use, and all-cause mortality at 30 days post-admission, with no significant association found for critical care services, mechanical intubation, or inotrope or vasopressor use.
Implementation of evidence-based clinical practice and its associated factors among health care workers at public hospitals in Sidama regional state, southern Ethiopia
Authors: Yeheyis Tomas , Hoyiso Dawit , Borie Yacob Abraham , Tagesse Negash 
Published: March 2024

Background
Health disparities, inconsistent outcomes, and underwhelming health services continue to be problems for all nurses and doctors. Studies from a variety of nations have found that doctors and nurses have little familiarity with evidence-based practice. There is a knowledge vacuum about the degree of evidence-based nursing practice and its contributing factors in Ethiopia as well as the current study region.

Objective
The study’s objective was to evaluate how healthcare professionals working in government hospitals in the Sidama regional state of 2022 are implementing evidence-based clinical practice and to identify associated factors.

Methods
From October 1 to December 30/2022, a cross-sectional institution-based study with a mix of quantitative and qualitative methods was carried out. A total of 422 healthcare workers were randomly selected to participate in the current study from 6 randomly selected public hospitals in the region. This study included 25 key informant interviews. The Friedman test and Funk’s BARRIER scale were adapted into a semi-structured questionnaire quantitative. Multivariable logistic regression was used to assess the significance of the association between the dependent and independent variables. A pretest was conducted on 22 healthcare workers from Shashmane Hospital.

Result
This study found that more than half, 51.7%, of the participants had a total implementation of evidence-based practice score below the mean score (40.4). only Access to the internet [having smart phone] (Adjusted Odds Ratio (AOR) = 3.03: 95% Confidence Interval (CI): (1.75–5.26))., favorable Attitude toward EBP of participants. (Adjusted Odds Ratio (AOR) = 1.84Confidence Interval (1.12–2.70)), inadequate Self-efficacy of Evidence-based practice skills (Adjusted Odds Ratio (AOR) = 0.29 Confidence interval = 0.19–0.46), and Knowledge of evidence-based practice (Adjusted Odds Ratio (AOR) = 0.45 Confidence interval = 0.30–0.77)were factors significantly associated with EBP implementation.

Conclusion
More than half of the participants,51.7%, do not implement evidence-based practice in the care of their clients, which is unacceptable. The use of EBP has been significantly associated with access to the internet (having a smartphone), participants’ positive attitudes toward it, their level of skill efficacy in finding and accessing it, and their knowledge of it. Therefore, stakeholders ought to think about addressing these obstacles to the adoption of EBP.
Exploring the association between social determinants and aphasia impairment: A retrospective data integration approach
Authors: Jacobs Molly , Evans Elizabeth , Ellis Charles 
Published: March 2024

Introduction
Traditionally, the study of aphasia focused on brain trauma, clinical biomarkers, and cognitive processes, rarely considering the social determinants of health. This study evaluates the relationship between aphasia impairment and demographic, socioeconomic, and contextual determinants among people with aphasia (PWA).

Methods
PWA indexed within AphasiaBank—a database populated by multiple clinical aphasiology centers with standardized protocols characterizing language, neuropsychological functioning, and demographic information—were matched with respondents in the Medical Expenditure Panel Survey based on response year, age, sex, race, ethnicity, time post stroke, and mental health status. Generalized log-linear regression models with bootstrapped standard errors evaluated the association between scores on the Western Aphasia Battery-Revised Aphasia Quotient (WAB-R AQ) and demographic, economic, and contextual characteristics accounting for clustering of respondents and the stratification of data collection. Region, age, and income specific models tested the sensitivity of results.

Results
PWA over age 60 had 2.4% (SE = 0.020) lower WAB-R AQ scores compared with younger PWA. Compared to White PWA, Black and Hispanic PWA had 4.7% (SE = 0.03) and 0.81% (SE = 0.06) lower WAB-R AQ scores, respectively, as did those and living in the Southern US (-2.2%, SE = 0.03) even after controlling for age, family size, and aphasia type. Those living in larger families (β = 0.005, SE = 0.008), with income over $30,000 (β = 0.017, SE = 0.022), and a college degree (β = 0.030, SE = 0.035) had higher WAB-R AQ relative to their counterparts. Region-specific models showed that racial differences were only significant in the South and Midwest, while ethnic differences are only significant in the West. Sex differences only appeared in age-specific models. Racial and ethnic differences were not significant in the high-income group regression.

Conclusion
These findings support evidence that circumstances in which individuals live, work, and age are significantly associated with their health outcomes including aphasia impairment.
Mortality in patients with normal left ventricular function requiring emergency VA-ECMO for postcardiotomy cardiogenic shock due to coronary malperfusion
Authors: Kang Jagdip , Marin-Cuartas Mateo , Flo Forner Anna , Menon Priya R. , Ginther André , Saaed Diyar , de Waha Suzanne , Meineri Massimiliano , Ender Jörg , Borger Michael A. 
Published: March 2024

Objectives
To analyze outcomes in patients with normal preoperative left ventricular ejection fraction (LVEF) undergoing venoarterial extracorporeal membrane oxygenation (VA-ECMO) therapy due to postcardiotomy cardiogenic shock (PCCS) related to coronary malperfusion.

Methods
Retrospective single-center analysis in patients with normal preoperative LVEF treated with VA-ECMO for coronary malperfusion-related PCCS between May 1998 and May 2018. The primary outcome was 30-day mortality, which was compared using the Kaplan-Meier method and the log-rank test. Multivariable logistic regression was performed to identify predictors of mortality.

Results
During the study period, a total of 62,125 patients underwent cardiac surgery at our institution. Amongst them, 59 patients (0.1%) with normal preoperative LVEF required VA-ECMO support due to coronary malperfusion-related PCCS. The mean duration of VA-ECMO support was 6 days (interquartile range 4–7 days). The 30-day mortality was 50.8%. Under VA-ECMO therapy, a complication composite outcome of bleeding, re-exploration for bleeding, acute renal failure, acute liver failure, and sepsis occurred in 51 (86.4%) patients. Independent predictors of 30-day mortality were lactate levels > 9.9 mmol/l before VA-ECMO implantation (odds ratio [OR]: 3.3; 95% confidence interval [CI] 1.5–7.0; p = 0.002), delay until revascularization > 278 minutes (OR: 2.9; 95% CI 1.3–6.4; p = 0.008) and peripheral arterial artery disease (OR: 3.3; 95% 1.6–7.5; p = 0.001).

Conclusions
Mortality rates are high in patients with normal preoperative LVEF who develop PCCS due to coronary malperfusion. The early implantation of VA-ECMO before the development of profound tissue hypoxia and early coronary revascularization increases the likelihood of survival. Lactate levels are useful to define optimal timing for the VA-ECMO initiation.
Validation of the prevalence to incidence conversion method for healthcare associated infections in long-term care facilities
Authors: Vicentini Costanza , Ricchizzi Enrico , Russotto Antonino , Bazzolo Stefano , Bedosti Catia , Blengini Valentina , Ceccarelli Dario , Fabbri Elisa , Gamba Dario , Maddaleno Anna , Rolfini Edoardo , Tancredi Margherita , Zotti Carla Maria 
Published: March 2024

Introduction
Residents of long-term care facilities (LTCFs) are a population at high risk of developing severe healthcare associated infections (HAIs). In the assessment of HAIs in acute-care hospitals, selection bias can occur due to cases being over-represented: patients developing HAIs usually have longer lengths of stays compared to controls, and therefore have an increased probability of being sampled in PPS, leading to an overestimation of HAI prevalence. Our hypothesis was that in LTCFs, the opposite may occur: residents developing HAIs either may have a greater chance of being transferred to acute-care facilities or of dying, and therefore could be under-represented in PPS, leading to an underestimation of HAI prevalence. Our aim was to test this hypothesis by comparing HAI rates obtained through longitudinal and cross-sectional studies.

Methods
Results from two studies conducted simultaneously in four LTCFs in Italy were compared: a longitudinal study promoted by the European Centre for Disease Prevention and Control (ECDC, HALT4 longitudinal study, H4LS), and a PPS. Prevalence was estimated from the PPS and converted into incidence per year using an adapted version of the Rhame and Sudderth formula proposed by the ECDC. Differences between incidence rates calculated from the PPS results and obtained from H4LS were investigated using the Byar method for rate ratio (RR).

Results
On the day of the PPS, HAI prevalence was 1.47% (95% confidence interval, CI 0.38–3.97), whereas the H4LS incidence rate was 3.53 per 1000 patient-days (PDs, 95% CI 2.99–4.08). Conversion of prevalence rates obtained through the PPS into incidence using the ECDC formula resulted in a rate of 0.86 per 1000 PDs (95% CI 0–2.68). Comparing the two rates, a RR of 0.24 (95% CI 0.03–2.03, p 0.1649) was found.

Conclusions
This study did not find significant differences between HAI incidence estimates obtained from a longitudinal study and through conversion from PPS data. Results of this study support the validity of the ECDC method.
Alternative products for controlling Sclerotinia sclerotiorum in vivo AND in vitro in canola crops
Authors: Henipman Hagata Siqueira , Pria Maristella Dalla , Rinaldi Polyana Elvira Christmann , Jacques Filipe Lemos , Reis Letícia 
Published: March 2024

Products that activate plant defense mechanisms, such as white mold, may increase the disease control spectrum in canola crops as an alternative to chemical control for disease management, aiming at lower environmental impacts and selection pressure on pathogens. This study evaluated Sclerotinia sclerotiorum control and resistance induction in canola crops with alternative products. In vitro and detached leaf experiments were conducted in a laboratory, and in vivo experiments occurred in a greenhouse. High Roots®; V6®; Maxi Flor®; Wert Plus®; potassium, manganese, and copper phosphites; manganese; procymidone fungicide; and Ascophyllum nodosum, Bacillus subtilis, and Bacillus thuringiensis extracts assessed S. sclerotiorum mycelial growth in vitro in detached leaves, white mold severity in a greenhouse, and enzymatic analysis in leaf tissues. The last two experiments also received the acibenzolar-S-methyl and Trichoderma asperellum treatments. S. sclerotiorum mycelial growth showed 100% inhibition under B. subtilis and Wert Plus® at 1000 ppm and procymidone at 100 and 1000 ppm in vitro. The procymidone and B. subtilis treatments in detached leaves inhibited 100% of fungus growth. The greenhouse experiments with lower severity were procymidone, copper phosphite, B. thuringiensis, B. subtilis, manganese phosphite, potassium phosphite, High Roots®, and V6®. Higher peroxidase enzyme activity occurred in plants treated with acibenzolar-S-methyl, copper phosphite, and fungicide 48 hours after pathogen inoculation. The polyphenol oxidase enzyme did not show activity. Alternative products were responsive and may aid the chemical control of white mold in canola crops.
New reimbursement models to promote better patient outcomes and overall value in laboratory medicine and healthcare
Authors: Trenti Tommaso , Petrini Anna Maria , Plebani Mario 
Published: March 2024

Abstract
The most widespread healthcare reimbursement models, including diagnostic laboratory services, are Fee-for-Service, Reference Pricing and Diagnosis-Related Groups. Within these models healthcare providers are remunerated for each specific service or procedure they operate. Healthcare payers are increasingly exploring alternative models, such as bundled payments or value-based reimbursement to encourage value of patient care rather than the simple amount of delivered services. These alternative models are advised, as they are more efficient in promoting cost-effective, high-quality laboratory testing, thereby improving patient health outcomes. If outcomes-based evaluation is a pillar in a new vision of “Value-Based Healthcare”, an active policy of Value-Based Reimbursement in laboratory medicine will assure both an efficiency-based sustainability and a high-quality effectiveness-based diagnostic activity. This review aims to evaluate current and alternative reimbursement models, to support a wider agenda in encouraging more Value-Based Healthcare and Value-Based Reimbursement in laboratory medicine.
A comprehensive review uncovering the anticancerous potential of genkwanin (plant-derived compound) in several human carcinomas
Authors: Pandey Pratibha , Ramniwas Seema , Verma Meenakshi , Rautela Indra , Khan Fahad , Shah Mohd Asif 
Published: March 2024

Abstract
Plant-derived bioactive compounds displayed major therapeutic and chemo-preventive roles in the pathogenesis of numerous chronic malignancies such as cancer and enhanced oxidative stress and inflammation. Antioxidants found in food, such as genkwanin, may reduce oxidative stress and the release of cytokines or pathways that promote inflammation. The goal of this work is to summarize the potential for anticancer effects of genkwanin, a methoxyflavone that is present in a variety of plant species. This review examined and analyzed numerous research studies on identifying, isolating, measuring, and analyzing anticancer properties of genkwanin. The mechanisms involved cellular and molecular activities at various levels, including apoptosis induction and cancer cell growth and proliferation inhibition. Preclinical studies have demonstrated genkwanin’s effects and mechanism of action; however, further research is required to investigate its therapeutic potential thoroughly. Additional research is needed to further our understanding of the pharmacodynamic effects of genkwanin. Additional toxicological study is necessary to evaluate the clinical efficacy and safety of genkwanin, which would help scientists to elucidate a potent drug candidate for cancer management.
Economics Education, Decision-Making, and Entrepreneurial Intention: A Mediation Analysis of Financial Literacy
Authors: Pashaei Azizeh , Hassani Mohammad , Mohajeran Behnaz , Shahbazi Kiumars 
Published: March 2024

Abstract
Adequate financial decision-making necessitates a solid foundation in financial literacy and comprehension of its principles. This is particularly crucial for students, as their financial and behavioral choices can significantly impact their future financial and career prospects. Consequently, the present study aimed to explore the causal links between economics education, financial literacy, decision-making abilities, and entrepreneurial intentions. Employing a descriptive-correlational approach, the researchers utilized structural equation modeling, drawing on a sample of 375 individuals purposefully selected from a population of 11,345 students at Urmia University. Data were collected through a questionnaire, and the research variables were initially assessed using multiple correspondence analysis. Subsequently, the research model was estimated. The findings revealed a positive and substantial impact of economics education on students' financial literacy and the influence of economics education on decision-making skills and entrepreneurial intentions through the mediating factor of financial literacy. Furthermore, the results confirmed the moderating role of socioeconomic status in the relationship between economics education and financial literacy. Consequently, the study's outcomes can inform educational institutions and policymakers, supporting the implementation of policies aimed at enhancing general economic education and emphasizing the equitable and distributive nature of such initiatives.