bluuebunny/crossref_metadata_2025_split huggingface dataset:
Prevalence and diagnostic accuracy of different diagnostic tests for Chagas disease in an indigenous community of the Paraguayan Chaco
Authors: Ardiles-Ruesjas Sofia , Lesmo Vidalia , González-Romero Valeria , Cubilla Zully , Chena Lilian , Huber Claudia , Rivas María José , Saldaña Patricia , Carrascosa Adrián , Méndez Susana , Sanz Sergi , Becker Sören L. , Alonso-Padilla Julio , Losada Irene 
Published: February 2025

Introduction
Chagas disease (CD), caused by the protozoan Trypanosoma cruzi (T. cruzi), poses a major health challenge in Paraguay, especially in the resource-limited Chaco region. Rapid diagnostic tests (RDTs) are valuable tools to enhance diagnostic access. This study evaluates CD prevalence and risk factors in an indigenous community in the Paraguayan Chaco and validates the national RDT-based diagnostic algorithm for resource-limited settings against the recommended standard algorithm, which relies solely on conventional serological tests.

Methodology
A descriptive cross-sectional study was conducted in Casanillo, Presidente Hayes, Paraguay. In July 2023, a two-week field campaign was executed using a non-probability convenience sampling method targeting individuals aged over 9 months. Screening involved a single RDT, with positives confirmed via enzyme-linked immunosorbent assay (ELISA). Algorithm accuracy was validated externally at the National Reference Laboratory of Paraguay against the standard algorithm, which, in this study, included an ELISA and Hemagglutination test. Discordant cases were resolved with a second ELISA or Immunofluorescence.

Results
The study involved 999 participants, with a median age of 26 years (IQR 12-45), and 51.1% were female. The RDT-based diagnostic algorithm showed 97.1% agreement (κ = 0.94, 95%CI: 0.90–0.98) with the standard algorithm. The RDT alone had 96.0% agreement (κ = 0.91, 95%CI: 0.87–0.96), while the confirmatory ELISA had 94.3% agreement (κ = 0.88, 95%CI: 0.83–0.93). The algorithm’s sensitivity/specificity (95%CI) were 94.6% (89.2–97.8)/98.6% (96.1–99.7), with the RDT at 94.6% (89.2–97.8)/96.8% (93.6–98.7) and the ELISA at 96.9% (92.3–99.2)/92.7% (88.5–95.8). T.cruzi infection seroprevalence was 12.6% (95%CI: 9.56–16.52). Age, Sanapaná ethnicity, and awareness of CD vectors were significantly associated with infection odds. No significant associations were found with other typical CD risk factors, clinical history, or health habits.

Conclusion
The study underscores the high burden of T. cruzi infection in indigenous communities in the Paraguayan Chaco, urging immediate interventions for improved diagnosis and treatment. The combination of RDTs with conventional serology for diagnostic screening in resource-constrained settings proved useful, and its further use is encouraged.
Health-economic evaluation of the outpatient, inpatient, and public health sector in Germany: Insights from the first three COVID-19 waves
Authors: Gandjour Afschin 
Published: February 2025

Aim
The aim of this study is to quantify the effectiveness and cost-effectiveness of the outpatient and inpatient sectors (specifically intensive care units, ICUs) and local health departments in managing the first three waves of the COVID-19 pandemic in Germany.

Methods
The analysis is based on a modelling approach using secondary data. The effectiveness of each sector was measured by determining the reduction in the case fatality rate (CFR) of COVID-19 patients by May 7, 2021. A counterfactual scenario assuming the absence of each sector was used to quantify their effectiveness. Direct medical costs for each sector were calculated from a statutory health insurance perspective, utilizing reimbursement rates for both the inpatient and outpatient sectors. Incremental cost-effectiveness ratios (ICERs) were determined, representing the costs per death avoided.

Results
The ICUs achieved the greatest reduction in the CFR of COVID-19 patients during the first three waves (1.9%). The outpatient sector followed with a reduction of 1.4%, and the local health departments contributed to a 0.3% decrease in the CFR. In terms of spending, ICUs had the highest expenditures among the sectors, resulting in an ICER of €59,055 per death avoided. On the other hand, local health departments were costlier but less effective than the outpatient sector. Results remained consistent across various input assumptions.

Conclusion
During the first three waves of the COVID-19 pandemic in Germany, the inpatient sector (ICUs) made the largest contribution to preventing deaths while also incurring the highest costs.
Midwifery care in The Gambia: A focus group study with clinical midwives, midwifery students, educators and leaders on how barriers and facilitators impact quality midwifery care
Authors: Suwareh Lamin , Lindgren Helena , Erlandsson Kerstin , Tunkara Bah Haddy , Holm Evelina , Meljoum Majda , Manjang Omar , Sanneh Saineh , Cham Baboucarr , Byrskog Ulrika 
Published: February 2025

Objective
The aim of this study is to explore the impact of barriers and facilitators on the quality of midwifery care in The Gambia, from the perspectives of clinical midwives, midwifery students, educators, and leaders.

Methods
A qualitative study based on focus group discussions with 29 clinical midwives, midwifery students, educators and leaders analysed with content analysis. The study was conducted in The Gambia.

Results
The analyses led to three main categories outlining barriers and facilitators for the quality of midwifery care: 1) the gap between theory and practice, 2) working in a harsh environment and 3) facilitating factors that can pave ways forward. The results are described in generic categories: 1a) national plans and facility-based guidelines, 1b) midwifery education, 1c) becoming a skilled midwife, 2a) scarcity of resources, 2b) encountering community barriers, 2c) midwives - a passionate but demotivated profession, 3a) positive assets for quality midwifery care, 3b) women in leadership as a tool for a motivated midwifery workforce and 3c) teamwork.

Conclusions
Addressing the gaps between theory and practice, and strengthening the incentives for midwives to remain in their profession are central for improved quality of midwifery care in The Gambia. Guaranteed employment after completing education, equal opportunities for men and women to become midwives and the significance of passion are assets which need to be carefully maintained within the health care system.
Risk factors for loss to follow-up in patients with gout: A Korean prospective cohort study
Authors: Do Hyunsue , Son Chang-Nam , Choi Hyo Jin , Kim Ji Hyoun , Kim Min Jung , Shin Kichul , Kim Sang-Hyon , Choi Byoongyong , Ha You-Jung , Ahn Joong Kyong , Kim Hyun-Ok , Lee Sung Won , Lee Chang Hoon , Song Ran , Son Kyeong Min , Lee Seung-Geun , Moon Ki Won 
Published: February 2025

Objectives
Gout, a common form of inflammatory arthritis, is often managed with urate-lowering therapy, but many patients only adhere to treatment during gout attacks, resulting in poor follow-up and suboptimal management. This study aimed to identify characteristics associated with loss to follow-up (LTFU) and develop strategies for better patient management.

Methods
Data were analyzed from the Urate Lowering TheRApy in gout (ULTRA) registry, a prospective cohort of Korean gout patients recruited since September 2021. Patients aged 18 or older who met the 2015 ACR/EULAR classification criteria were included. Demographic data, clinical characteristics, lifestyle habits, comorbidities, and quality of life assessments using the Korean Gout Impact Scale (K-GIS) and EuroQol 5-Dimension (EQ-5D) were collected at baseline, six months, and annually. LTFU was defined as missing a clinic visit for more than a year. Logistic regression was used to determine factors associated with LTFU.

Results
Among 269 patients, 125 (46.5%) were classified as LTFU. Patients not lost to follow-up experienced more frequent gout attacks (P = 0.020) and expressed greater concerns about future flares (P = 0.034). In contrast, LTFU patients had higher levels of anxiety (P = 0.049), depressive symptoms (P = 0.009), impaired mobility (P = 0.002), and a higher EQ-5D score (P = 0.002). Logistic regression identified frequent gout attacks, concerns about attacks, anxiety, impaired mobility, and EQ-5D scores as significant predictors of LTFU.

Conclusion
Fewer gout attacks, heightened anxiety and depression, and lower quality of life were key factors associated with LTFU. Providing emotional support and comprehensive education may enhance follow-up and improve gout management.
Modulation of extrinsic and intrinsic signaling together with neuronal activation enhances forelimb motor recovery after cervical spinal cord injury
Authors: Takatani Hirohide , Fujita Naoki , Imai Fumiyasu , Yoshida Yutaka 
Published: February 2025

Singular strategies for promoting axon regeneration and motor recovery after spinal cord injury (SCI) have been attempted with limited success. For instance, the deletion ofRhoAandPten(an extrinsic and intrinsic modulating factor, respectively) in corticospinal neurons promotes axon sprouting after thoracic SCI, however it is unable to restore motor function. Here, we examine the effects of combiningRhoA/Ptendeletion in corticospinal neurons with chemogenetic neuronal stimulation on axonal growth and motor recovery after SCI in mice. We find that this combinatorial approach promotes greater axonal growth and synaptic bouton formation in corticospinal neurons within the spinal cord compared toRhoA;Ptendeletion alone. Furthermore, chemogenetic neuronal stimulation ofRhoA;Pten-deleted corticospinal neurons improved forelimb performance in behavioral tasks after SCI compared toRhoA;Ptendeletion alone. These results demonstrate that combination therapies pairing genetic modifications with neuronal stimulation can promote greater synaptic formation and motor recovery following SCI than either strategy alone.Significance StatementIn this study, we examined whether pairing neural stimulation with genetic deletion ofRhoAandPtenin corticospinal neurons would enhance axonal growth and motor recovery after spinal cord injury (SCI). We found that this combinatorial approach, relative to singular strategies, promoted greater presynaptic bouton formation in injured corticospinal neurons in the spinal cord, resulting in improved motor recovery in those mice. These results open the possibility for even greater enhancements in healing and recovery following SCI through carefully crafted, multifaceted treatments tailored to address the specific needs of individual SCI patients.
Characterising human disparity tuning properties using population receptive field mapping
Authors: Alvarez Ivan , Mancari Alessandro , Ip I. Betina , Parker Andrew J. , Bridge Holly 
Published: February 2025

Our visual percept of small differences in depth is largely informed by binocular stereopsis, the ability to decode depth from the horizontal offset between the retinal images in each eye. While multiple cortical areas are associated with stereoscopic processing, it is unclear how tuning to specific binocular disparities is organised across human visual cortex. We used 3T functional magnetic resonance imaging to generate population receptive fields in response to modulation of binocular disparity to characterise the neural tuning to disparity. We also used psychophysics to measure stereoacuity thresholds compared to backgrounds at different depths (pedestal disparity). Ten human participants (7 female) observed correlated or anticorrelated random-dot stereograms with disparity ranging from –0.3° to 0.3°, and responses were modelled as 1-dimensional tuning curves along the depth dimension. First, we demonstrate that lateral and dorsal visual areas show the greatest proportion of vertices selective for binocular disparity. Second, with binocularly correlated stimuli, we show a polynomial relationship between preferred disparity and tuning curve width, with sharply tuned disparity responses at near-zero disparities, and broader disparity tuning profiles at near or far disparities. This relationship held across visual areas and was not present for anticorrelated stimuli. Finally, the individual thresholds for psychophysical stereoacuity at the 3 different pedestal disparities were broadly related to population receptive field tuning width in area V1, suggesting a possible limit for fine stereopsis at the earliest level of cortical processing. Together, these findings point to heterogeneity of disparity processing across human visual areas, comparable to non-human primates.Significance StatementBinocular disparity arises from the horizonal separation of the two eyes and provides information for determining depth and 3D structure. We used functional magnetic resonance imaging and population receptive field mapping to measure tuning of multiple visual areas to binocular disparity in the human visual cortex. We additionally measured psychophysical thresholds for detecting binocular disparity and correlated these with the neural measures. The width of the disparity tuning was related to the preferred disparity across all visual areas. Disparity tuning widths in V1 were also related to psychophysical thresholds. These findings in the human are broadly comparable to non-human primates.
VIP-to-SST cell circuit motif shows differential short-term plasticity across sensory areas of mouse cortex
Authors: Rachel Jenifer , Möck Martin , Daigle Tanya L. , Tasic Bosiljka , Witte Mirko , Staiger Jochen F. 
Published: February 2025

Inhibition of GABAergic interneurons has been found to critically fine-tune the excitation-inhibition balance of the cortex. Inhibition is mediated by many connectivity motifs formed by GABAergic neurons. One such motif is the inhibition of somatostatin (SST)-expressing neurons by vasoactive intestinal polypeptide (VIP)-expressing neurons. We studied the synaptic properties of layer (L) 2/3 VIP cells onto L4 SST cells in somatosensory (S1) and visual (V1) cortices of mice of either sex using paired whole-cell patch clamp recordings, followed by morphological reconstructions. We identified strong differences in the morphological features of L4 SST cells, wherein cells in S1 fell into the non-Martinotti cell (nMC) subclass, while in V1 presented with Martinotti cell (MC)-like features. Around 40-45% of tested SST cells were inhibited by VIP cells in both cortices. While unitary connectivity properties of the VIP-to-nMC and VIP-to-MC motif were comparable, we observed stark differences in short-term plasticity. During high-frequency stimulation of both motifs, some connections showed short-term facilitation while others showed a stable response, with a fraction of VIP-to-nMC connections showing short-term depression. We thus provide evidence that VIP cells target morphological subclasses of SST cells differentially, forming cell-type specific inhibitory motifs.Significance statementInhibitory circuits are involved in a wide variety of cortical computations. In particular, the inhibition of somatostatin-expressing (SST) neurons by vasoactive intestinal polypeptide- expressing (VIP) neurons has been well-documented in L2/3 of sensory cortices. It was recently identified that L4 SST neurons of S1 and V1 exhibit two different morphological subtypes, namely, non-Martinotti (nMC) cells in S1 and Martinotti (MC) cells in V1. We show that L2/3 VIP neurons inhibit both SST subtypes in L4 with similar dynamics. However, we also find that under high frequency stimulations, the VIP-to-nMC motif exhibits strong short-term depression, but this was not observed in VIP-to-MC motifs. Therefore, we identified morphologically distinct, inhibitory cell-type specific motifs in sensory cortices of mouse.
Type 2 diabetes remission through lifestyle intervention in a geriatric patient with long-standing diabetes and at thirty-three-months follow-up
Authors: Tripathi Pramod , Tiwari Diptika , Raizada Milanjeet Kaur , Kadam Nidhi 
Published: February 2025

Summary
Type 2 diabetes (T2D) is a chronic metabolic disorder that affects millions of people worldwide, particularly the elderly population. Remission of T2D in elderly patients through lifestyle modifications has been well documented, especially in newly diagnosed patients with good glycemic control and without obesity. It is also common in patients with obesity undergoing bariatric surgery. In this report, we present the case of a 66-year-old male patient with a 30-year history of T2D and mild obesity who achieved remission of T2D through customized integrated intensive lifestyle modifications, including a vegan diet, exercise and psychological support. The patient showed an improvement in HbA1c (7.7 to 5.3%) and insulin resistance (HOMA-IR; 6.2 to 1.8) and a shift in BMI (25.3 to 23.7 kg/m2) through weight loss (73 to 67 kg). The patient remains in remission 33 months after the completion of the intervention. This case suggests the possibility of long-term remission with lifestyle changes in patients with advanced age, a longer duration of diabetes and mild obesity.

Learning points

Long-term sustained remission is possible in a geriatric patient with long-standing type 2 diabetes (T2D) of more than 30 years.

Customized integrated intensive lifestyle intervention can lead to a significant improvement in glycemic control and insulin resistance in elderly patients with T2D.

Integrated lifestyle interventions, including a vegan diet, exercise and psychological support, have the potential to stop the usage of oral hypoglycemic agents and insulin in an elderly patient with a prolonged history of T2D and mild obesity.
START:AV taikymas laisvės atėmimo bausmę atliekančių jaunų suaugusiųjų imtyje: psichometrinių charakteristikų ir konvergentinio validumo tikrinimas
Authors: Klimukienė Virginija , Laurinavičius Alfredas 
Published: February 2025

In the penitentiary system, criminal risk assessment aids in tailoring the resocialization process and informs decisions about detention conditions and eligibility for conditional release. Risk assessment instruments such as START:AV facilitate both the identification of the risk level and the planning of targeted interventions. The final judgment about the risk is based on the analysis of risk and protective factors, which differ by age, leading to the implementation of separate assessment instruments for adolescents and adults. The transition from adolescence to adulthood does not occur with the 18th birthday; therefore, there is an increasing emphasis on extending correctional measures applied to adolescents up to the age of 24. The aim of the study is to examine the psychometric characteristics and convergent validity of START:AV, designed for adolescents, in a sample of male offenders aged 18 to 23. The study involved 99 young individuals incarcerated in four prisons in Lithuania. Negative correlations found between START:AV strengths and vulnerabilities align with the findings of other studies and support the assumption that although they are related, yet, they remain distinct constructs. The Achenbach System of Empirically Based Assessment (ASEBA) Adult Self-Report (ASR) was used to assess the convergent validity of START:AV. The results confirmed that START:AV may be applicable for assessing the risk of adverse outcomes in incarcerated adults aged 18–23. Further studies on its predictive validity in the sample of emerging adults would be necessary to substantiate the practical utility of this instrument.
Mecanismo molecular subjacente à propriedade de cicatrização de feridas in vitro do Stryphnodendron adstringens (Mart.)
Authors: Luiza Kaspary Pellenz Neida , Henrique Mastella Moisés , Farina Azzolin Verônica , Ferreira Teixeira Cibele , Köhler Carpilovsky Paula , Muller Brunelli Lucas , Köhler Carpilovsky Cristiane , Hilda Costabeber Ijoni , Beatrice Mânica da Cruz Ivana , Maria Medeiros Frescura Duarte Marta , Barbisan Fernanda 
Published: February 2025

Objetivo: Analisar o mecanismo do extrato hidroalcóolico de barbatimão na indução da cicatrização células dérmicas de fibroblastos (HFF-1), em um modelo in vitro.
Métodos: Foram estudadas aqui duas concentrações de barbatimão utilizadas em pomadas comerciais (B1 = 0,49 mg/mL; B2 = 0,99 mg/mL), e seus efeitos foram avaliados com os seguintes marcadores às 24 e 72 horas após a indução da ferida in vitro: (1) metabolismo oxidativo [oxidação do DNA, lipoperoxidação, carbonilação de proteínas, enzimas antioxidantes (superóxido dismutase, SOD; catalase, CAT; glutationa peroxidase, GPX)]; (2) citocinas pró-inflamatórias (TNF-α, interleucina 6); (3) marcadores apoptóticos [caspase 3 (CASP3), CASP8, e fatores de crescimento: de queratinócito (KGF) e de fibroblastos-1 (FGF-1)].
Resultados: O tratamento com ambas as concentrações mostrou diminuição nos marcadores pró-oxidantes, pró-inflamatórios e pró-apoptóticos, enquanto aumentava os níveis de antioxidantes e fatores de crescimento.
Conclusões: O barbatimão atua por meio de um mecanismo pleiotrópico em cascata que envolve a modulação antioxidante, anti-inflamatória, anti-apoptótica e de migração/proliferação de fibroblastos. Nossos dados poderiam explicar o efeito e a importância do extrato de barbatimão nos mecanismos de cicatrização de feridas.
Multimorbidity and the combination of chronic non-communicable diseases and their relationship to all-cause mortality among Costa Rican older adults
Authors: Novak Beatriz 
Published: February 2025

Objective: To estimate the prevalence of multimorbidity due to chronic non-communicable diseases, the prevalence of pairs and triads of these diseases and the respective associated mortality risks in older adults in Costa Rica. Methods: The data used belong to the study Costa Rica: Longevity and Healthy Aging Study. Gompertz models (adjusted for sociodemographic factors, health-related behaviors, and functional status) were estimated to assess the association of multimorbidity with all-cause mortality between 2005 and 2009. The study population comprised 2,565 individuals who provided data on all covariates at baseline. Results: The prevalence of multimorbidity was 42.6%. The five most frequent disease pairs combine hypertension with diabetes, coronary heart disease, respiratory conditions, arthritis, and osteoporosis (around 14%, 10%, 9%, 7%, and 6%, respectively). The most frequent disease triads were diabetes-hypertension-respiratory conditions and diabetes-hypertension-coronary heart disease (about 3% in both cases). Multimorbidity was associated with 64% increased mortality risk, not adjusting for functional limitations, and 37% when adjusting for functional limitations. The following disease pairs at baseline increased the mortality risk, compared to persons without these combinations at baseline: diabetes-hypertension (49%); cancer-respiratory disease, diabetes-coronary heart disease, and diabetes-stroke (around two times); and cancer-hypertension and cancer-diabetes (around three times). The mortality risk among those with diabetes-hypertension-coronary heart disease and diabetes-hypertension-osteoporosis was twice that of persons without these diseases at baseline. Conclusion: There is a need to develop strategies to address the burdens that multimorbidity, particularly cardiometabolic multimorbidity, impose on individuals as well as on the healthcare system.
Agon interpretacji. Rola walki i rywalizacji w hermeneutyce Hansa-Georga Gadamera wobec „Rywalizacji Homera” Friedricha Nietzschego
Authors: Sznajder Paweł 
Published: February 2025

Artykuł podejmuje problem roli walki i rywalizacji (agonu) w filozofii hermeneutycznej Hansa-Georga Gadamera, który jako jedno z istotnych źródeł swojej koncepcji wskazał grecki ideał wychowania. Filozof, poddając analizie wybrane aspekty filozofii Platona oraz relację retoryki i sofistyki, wyraźnie uznaje walor walki, pod warunkiem, że jest ona samodoskonalącą walką z samym sobą lub walką o prawdę i dobro. Funduje tym samym alternatywny względem Nietzscheańskiego, dialogiczny model hermeneutyki. Nietzsche dostrzega bowiem główny czynnik kulturotwórczy świata antycznego w rywalizacji. Ostatecznie Gadamer w swojej analizie Heglowskich kategorii panowania i niewoli odrzuca walkę jako przyczynę możliwego zakłamania interpretacji.