bluuebunny/crossref_metadata_2025_split huggingface dataset:
The role ofAnopheles arabiensisandAnopheles funestusin malaria transmission within houses with different characteristics in South-eastern Tanzania
Authors: Limwagu Alex J. , Msugupakulya Betwel J. , Ngowo Halfan S. , Mwelugelo Yohana A. , Kilalangongono Masoud S. , Okumu Fredros O. , Ngasala Bill E. , Lyimo Issa N. 
Published: December 2023

AbstractBackgroundMalaria vectors persist predominantly in houses lacking screened windows, doors, and eave space, leading to ongoing transmission. Some other vectors adapt their feeding behavior to sustain reproduction. This study evaluates the role of primary malaria vectors on malaria transmission in relation to house characteristics in Kilombero Valley.MethodsMosquito data collection was done using three methods: a CDC light trap, a miniaturized double net trap (DN-Mini trap), and a Prokopack aspirator through 222 households that were randomly selected in the three villages, namely Ebuyu, Chirombora, and Mzelezi. The houses are characterized during mosquito collections, and the Geographical Position System (GPS) was used to geolocate the sampled houses. Morphological identification was done on the collected sample (i.e., fed, part-fed, gravid, and unfed), and a sub-sample was sent to the laboratory to assess the sibling species, blood meal, and sporozoite.ResultsA total of 1542 Anopheline mosquitoes were collected, of which 79.1% (n= 1219) wereAn. funestusand 20.3% (n= 313) wereAn. arabiensisas primary malaria vectors, while the secondary malaria vector was 0.6% (n = 10). Out of 487 anopheline mosquitoes assayed forplasmodium falciparumsporozoite, 92.8% (n = 13) ofAn. funestuswas reported to be dominant whileAn. arabiensiswas dominant by 7.2% (n = 1). WhileAn. funestuswas the only species that had a blood meal and was found to feed on humans (88.16%, n = 134), dogs (11.18% n = 17), and a mixture of both human and chicken blood meal. In addition to that, the house with screened eave space had fewerAn. funestuscompared to the house with open eave space (RR = 0.978, p =0.864), while the house with a brick wall had a higherAn. funestuscompared with the house with a mud wall (RR = 0.690, p =0.107).ConclusionAnopheles funestusremained the dominant malaria vector responsible for all transmissions in the villages. The human population is at risk due to their preference forAn. funestus, which contributes about 92.8% of infections in the village. Additionally, the house design appears to play a significant role in facilitating malaria vectors to continue transmitting malaria.
The economic effects of kidney failure treatment on the household welfare of patients on Dialysis in Buea and Bamenda–Cameroon
Authors: Dingana Therence Nwana , Ngasa Stewart Ndutard , Ngasa Neh Chang , Fozeu Leo Fosso , Kum Fuein V. , Aloysius Njong M. 
Published: December 2023

AbstractBackgroundNoncommunicable diseases, such as kidney failure, diabetes, and cancer, are among the leading causes of death worldwide. There is a sharp increase in the incidence and prevalence of patients with kidney failure requiring replacement therapy. This has led to a very high cost, especially in resource-limited settings like Cameroon. The aim of this study is to determine the effects of direct and indirect costs of kidney failure treatment on their household income.MethodsA descriptive cross-sectional study design was used. Primary data was collected using a self-administered pre-tested questionnaire for the economic impact of chronic disease. For bivariate analysis, we used the Cochran-Mantel-Haenszel test to obtain crude Odd Ratios (OR) of factors associated with household welfare. Multivariate logistic regression, the OLS model was used to identify independent associations between kidney failure treatment and household welfare. This was presented as adjusted odd ratios along with their p-values. A p-value of <0.05 was used as a cut-off for statistical significance.ResultsThe mean age of participants was 44.6±15.5 years; most patients (83(62.4%)) were married. Seventy-nine (59.4%) were unemployed, and eighty-one (60.9%) had no financial support. Their annual household expenditure ranged from 300,000FCFA to 3,360,000FCFA, with a mean and standard deviation of 1,547,729FCFA and 781,882FCFA, respectively. The yearly total cost of kidney failure treatment ranged from 520,000FCFA to 10,000,000FCFA with a mean and standard deviation of 2,137,556FCFA and 1,541,163FCFA, respectively. The cost of consultation and laboratory tests had negative regression coefficients (P=0.001 and <0.001 respectively).Conclusionkidney failure has a significant negative effect on the household welfare of patients on dialysis. Kidney disease screening and prevention programs are necessary to reduce the number of persons in need of hemodialysis. Health insurance schemes and universal health coverage should target patients on hemodialysis.
HIV prevention and missed opportunities among people with recently acquired HIV infection: Α protocol for a systematic review
Authors: Karakosta Argyro , Ruiz-Burga Elisa , Tariq Shema , Touloumi Giota , Nicholls Emily Jay , Pantazis Nikos , Jarrin Inma , Van der Valk Marc , Sabin Caroline , Mussini Christina , Meyer Laurence , Anne Alain Volny , Carlander Christina , Grabar Sophie , Wittkop Linda , Spire Bruno , Gill Jonh , Porter Kholoud , Burns Fiona ,   CASCADE Collaboration
Published: December 2023

AbstractBackgroundIndividuals who have recently acquired HIV represent a unique population because the time frame since HIV acquisition is relatively short and identification of missed HIV prevention opportunities is, therefore, closer to real time and less subject to recall bias. Identifying prevention measures used and missed opportunities for using them, can help stop further HIV transmission.ObjectivesThis systematic review aims to synthesise current global evidence on uptake of HIV prevention methods among people with recently acquired HIV from 2007, the year that the concept of ART as a prevention method was first introduced.Methods and analysisMEDLINE/PubMed, EMBASE, PsycINFO, Cochrane and Web of Science databases, will be searched for articles published January 2007 - July 2023. Eligible studies will be those that reported on HIV prevention methods among people with recently acquired HIV. Quality assessment of the studies selected will be undertaken, and reporting of the systematic review will be informed by Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines.ResultsThe results of the systematic review will be available by the end of January 2024.ConclusionsThe findings will be of key relevance to researchers, healthcare providers including third sector organisations/ community groups and policymakers, as they will offer insight into better understanding of missed or failed HIV prevention efforts and will help ensure future efforts meet the needs of those in need of them.
Exposure to valsartan products containing nitrosamine impurities in the US, Canada, and Denmark
Authors: Eworuke Efe , Shinde Mayura U. , Hou Laura , Paterson J. Michael , Jensen Peter Bjødstrup , Maro Judith C. , Rai Ashish , Pottegård Anton , Scarnecchia Daniel , Liang Yuanling , Johnson Deborah , Platt Robert W. , Lee Hana , Bradley Marie C. 
Published: December 2023

ABSTRACTBackgroundFollowing the mass recall of valsartan products with nitrosamine impurities in July 2018, the number of patients exposed to these valsartan products, the duration of exposure, and the potential for cancer remains unknown. Therefore, we assessed the extent and duration of use of valsartan products with a nitrosamine impurity in the US, Canada, and Denmark.MethodsWe conducted a retrospective cohort study using administrative healthcare data from the US FDA Sentinel System, four Canadian provinces that contribute to the Canadian Network for Observational Drug Effect Studies (CNODES), and the Danish National Prescription Registry. Patients, 18 years and older between May 2012 and December 2020 with a valsartan dispensing were identified in each database. Patients were followed from the date of valsartan dispensing until discontinuation. We defined four valsartan exposure categories based on nitrosamine impurity status; recalled generic products with confirmed NDMA/NDEA levels (recalled-tested); recalled generic products that were not tested (recalled); non-recalled generic and non-recalled branded products. In Denmark, recalled-tested category was not included due to absence of testing data. The proportion and duration of use of valsartan episodes stratified by nitrosamine-impurity status.ResultsWe identified 3.3 and 2.8 million (US) and 51.3 and 229 thousand (Canada) recalled-tested and recalled valsartan exposures. In Denmark, where valsartan exposure was generally low, there were 10,747 recalled exposures. Immediately after the recall notices were issued, there was increased rates of switching to a non-valsartan ARB. The mean duration of use of the recalled-tested products was 167(±223.1) and 146(±255.8) days in the US and Canada respectively. For the recalled products, mean cumulative duration of use was 178(±249.6), 269(±397.3) and 166(±251.0) days in the US, Canada, and Denmark, respectively.ConclusionIn this cohort study, despite widespread use of recalled generic valsartan between 2012 and 2018, the duration of use was relatively short and likely did not pose an elevated risk of nitrosamine-induced cancer. However, since products with nitrosamine impurity could have been on the market over a six-year period, patients potentially exposed to these products for longer duration could have a different risk of cancer.
The validation and clinical applicability of angiography-derived assessment of coronary microcirculatory resistance: a [15O]H2O PET study
Authors: Jukema Ruurt A. , Raijmakers Pieter G , Hoshino Masahiro , Driessen Roel S. , van Diemen Pepijn A. , Knuuti Juhani , Maaniitty Teemu , Twisk Jos , Kooistra Rolf A. , Timmer Janny , Reiber Johan H.C. , van der Harst Pim , Cramer Maarten J. , van der Hoef Tim , Knaapen Paul , Danad Ibrahim 
Published: December 2023

AbstractBackgroundThe introduction of wire-free microcirculatory resistance index from functional angiography (angio-IMR) promises swift detection of coronary microvascular dysfunction, however it has not been properly validated. We sought to validate angio-IMR against invasive IMR and PET derived microvascular resistance (MVR). Moreover, we studied if angio-IMR could aid in the detection of ischemia with non-obstructive coronary arteries (INOCA).MethodsIn this investigator-initiated study symptomatic patients underwent [15O]H2O positron emission tomography (PET) and invasive angiography with 3-vessel fractional flow reserve (FFR). Invasive IMR was measured in 40 patients. Angio-IMR and QFR were computed retrospectively. MVR was defined as the ratio of mean distal coronary pressure to PET derived coronary flow. PET and QFR/angio-IMR analyses were performed by blinded core labs. The right coronary artery was excluded.ResultsA total of 211 patients (mean age 61±9, 148 (70%) male) with 312 vessels with successful angio-IMR analyses were included. Angio-IMR correlated moderately with invasive IMR (r=0.48, p<0.01), whereas no correlation was found between angio-IMR and MVR (r=-0.07, p=0.25). Angio-IMR did not differ for vessels without obstructive coronary artery disease (CAD) (FFR-) but with reduced stress perfusion (PET+) compared to vessels without obstructive CAD (FFR-) with normal stress perfusion (PET-) (median 28.19 IQR 20.42 – 38.99 vs 31.67 IQR 23.47 – 40.63, p=0.40).ConclusionAngio-IMR correlated moderately with invasively measured IMR, whereas angio-IMR did not correlate with PET derived MVR. Moreover, angio-IMR was similar in patients without obstructive CAD, irrespective of ischaemia status, hampering the identification of INOCA.
Nomograms for Predicting the Risk of Acute Heart Failure in ICU Patients with Atrial Fibrillation: A Retrospective Cohort Study
Authors: Wu Ziyang , Qiao Yong , Yan Gaoliang , Qin Yuhan , Tang Huihong , Liu Shiqi , Wang Dong , Tang Chengchun 
Published: December 2023

AbstractAimThis study developed two nomograms to predict the incidence of acute heart failure (AHF) in patients of atrial fibrillation (AF) and evaluated the predictive value of the nomograms.Method18179 patients of AF from the Medical Information Mart for Intensive Care IV (MIMIC-IV) database were analysed. The patients were randomly divided into two groups in a seven-to-three ratio to form a training cohort (n = 12725) and a validation cohort (n = 5454). Least absolute shrinkage and selection operator (LASSO) regression analyses were used to identify associated risk variables. Two nomograms were established to predict the rate of AHF in patients of AF for use by patients and clinicians, respectively. The new models were assessed in terms of the concordance index (C-index), the area under the curve (AUC) of receiver operating characteristic (ROC) analysis, calibration curve, and decision curve analysis (DCA).ResultsLeast absolute shrinkage and selection operator (LASSO) regression analysis identified seven potential predictors of acute heart failure in nomogram 1 and three potential predictors in nomogram 2. Multivariate logistic regression analysis was used to evaluate the effects of these predictors and create final models. The concordance index values were 0.768 and 0.696, respectively. The areas under the curves for the training and validation sets in nomogram 1 were 0.768 and 0.763, respectively. The areas under the curves for the training and validation sets in nomogram 2 were 0.696 and 0.692, respectively.ConclusionThe age, respiratory rate, fluid management, mean corpuscular hemoglobin concentration (MCHC), bicarbonate, blood urea nitrogen (BUN) and chloride were identified as predictors of the development of acute heart failure in patients with atrial fibrillation in nomogram 1. The charlson score, lods score and sapsII score were identified as predictors of the development of acute heart failure in nomogram 2. Our nomograms are reliable convenient approaches for predicting acute heart failure in patients with atrial fibrillation.
Cost-Utility Analysis of PCSK9 Inhibitors and Quality of Life: A Two-Year Multicenter Non-Randomized Study
Authors: Seijas-Amigo José , Mauriz-Montero M. José , Suarez-Artime Pedro , Gayoso-Rey Mónica , Reyes-Santías Francisco , Estany-Gestal Ana , Casas-Martínez Antonia , González-Freire Lara , Rodriguez-Vazquez Ana , Pérez-Rodriguez Natalia , Villaverde-Piñeiro Laura , Castro-Rubinos Concepción , Espino-Faisán Esther , Cordova-Arevalo Octavio , Rodríguez-Mañero Moisés , Cordero Alberto , González-Juanatey José R. ,   e Investigadores MEMOGAL
Published: December 2023

ABSTRACTBackgroundThe use of PCSK9 inhibitors in the management of cardiovascular disease has gained increasing attention. However, there is limited evidence on their cost-utility and impact on quality of life in real-world settings. This study aimed to conduct a real-world cost-utility analysis of PCSK9 inhibitors and evaluating their effects on quality of life.MethodsA multicenter prospective study was conducted across 12 Spanish hospitals from May 2020 to April 2022, involving 158 patients. QoL was assessed using the EQ-5D questionnaire. Cost-utility analysis assessed the economic impact of PCSK9 inhibitors when used with standard care compared to standard care alone, calculating the incremental cost-effectiveness ratio (ICER).ResultsThe study encompassed 158 patients with an average age of 61, predominantly male (66.5%). For patients initiating PCSK9 inhibitors, the cost of PCSK9 inhibitor treatment was €13,633.39, while standard therapy cost €3,638.25 over two years. Qualys for PCSK9 inhibitors stood at 1.648851948 over two years, compared to 1.454807792 for standard therapy. The results revealed favorable cost-utility outcomes, with an ICER of €51,427.72. Significant improvements were observed in the domains of mobility, self-care, daily activities, pain/discomfort, and anxiety/depression (p<0.001).ConclusionsThis study represents the first real-world cost-utility analyses of PCSK9 inhibitors. The findings support the economic justification and potential benefits of incorporating PCSK9 inhibitors into clinical practice. Healthcare decision-makers can consider these results when making informed decisions and reimbursement regarding the use of PCSK9 inhibitors in clinical practice.Trial Registrationclinicaltrials.govIdentifier:NCT04319081
Effect of Renin-Angiotensin System (RAS) Inhibitors in Acute Ischemic Stroke to Improve Outcomes in In-Patient Settings: A Cross Sectional and Longitudinal Analysis
Authors: Samuel Sophie , Craver Kyndol , Miller Charles , Pelsue Brittany , Gonzalez Catherine , Allison Teresa A , Gulbis Brian , Choi H Alex , Kim Seokhun 
Published: December 2023

AbstractBackgroundAcute ischemic stroke (AIS) is a major health challenge, often resulting in long-term disability and death. This study assesses the impact of renin-angiotensin system (RAS) inhibitors (angiotensin-converting enzyme inhibitors and angiotensin receptor blockers) on AIS patient mortality compared to non-RAS antihypertensive medications.MethodsThis retrospective cohort study, conducted at Memorial Hermann–Texas Medical Center in Houston, Texas, from August 31, 2017, to August 31, 2022, examined AIS patient mortality. We used a cohort design, evaluating the effects of RAS inhibitors, either alone or in combination with beta-blockers (BBs), while exploring interactions, including those related to end-stage renal disease (ESRD) and serum creatinine levels. Eligible subjects included AIS patients aged 18 or older with specific AIS subtypes who received in-patient antihypertensive treatment. Missing data were addressed using imputation, followed by Inverse Probability of Treatment Weighting (IPTW) to achieve covariate balance. Our primary outcome was mortality rates. Statistical analyses involved cross-sectional and longitudinal approaches, including generalized linear models, G-computation, and discrete time survival analysis over a 20-day follow-up period.ResultsIn our study of 3058 AIS patients, those using RAS inhibitors had significantly lower in-hospital mortality (2.2%) compared to non-users (12.1%), resulting in a relative risk (RR) of 0.18 (95% CI 0.12-0.26). Further analysis using G-computation revealed a marked reduction in mortality risk associated with RAS inhibitors (Risk 0.0281 vs. 0.0913, Risk Difference (RD) of 6.31% or 0.0631, 95% CI 0.046-0.079). Subgroup analysis demonstrated notable benefits, with individuals having creatinine levels below and above 1.3 mg/dL exhibiting statistically significant RD (RD −0.0510 vs. −0.0895), and a significant difference in paired comparison (−0.0385 or 3.85%, CI 0.023-0.054). Additionally, longitudinal analysis confirmed a consistent daily reduction of 0.93% in mortality risk associated with the intake of RAS inhibitors.ConclusionRAS inhibitors are associated with a significant reduction in in-hospital mortality in AIS patients, suggesting potential clinical benefits in improving patient outcomes.
The Role of Early Cerebral Edema and Hematoma assessment in Aneurysmal Subarachnoid Hemorrhage (a-SAH) in predicting Structural Brain Abnormalities in Cognitive Impairments
Authors: Wang Ming-Dong , Fu Qian-Hui , Ni Andrew , Yuan Yun-Peng , Li Chun-Hui , Wang Zhan-Xiang , Wang Hong 
Published: December 2023

ABSTRACTBackgroundEarly assessment and management of cerebral edema and hematoma following aneurysmal subarachnoid hemorrhage (a-SAH) can significantly impact clinical cognitive outcomes. However, current clinical practices lack predictive models to identify early structural brain abnormalities affecting cognition. To address this gap, we propose the development of a predictive model termed the a-SAH Early Brain Edema/Hematoma Compression Neural (Structural Brain) Networks Score System (SEBE-HCNNSS).MethodsIn this study, 202 consecutive patients with spontaneous a-SAH underwent initial computed tomography (CT) or magnetic resonance imaging (MRI) scans within 24 hours of ictus with follow-up 2 months after discharge. Using logistic regression analysis (univariate and multivariate), we evaluated clinically relevant factors and various traditional scale ratings for cognitive impairment (CI). Risk factors with the highest area under the curve (AUC) values were included in the multivariate analysis and least absolute shrinkage and selection operator (LASSO) analysis or Cox regression analysis.ResultsA total of 177 patients were enrolled in the study, and 43 patients were classified with a high SEBE-HCNNSS grade (3 to 5). After a mean follow-up of 2 months, 121 individuals (68.36%) with a-SAH and 3 control subjects developed incident CI. The CT inter-observer reliability of the SEBE-HCNNSS scale was high, with a Kappa value of 1. Furthermore, ROC analysis identified the SEBE-HCNNSS scale (OR 3.322, 95% CI 2.312-7.237, p = 0.00025) as an independent predictor of edema, CI, and unfavorable prognosis. These results were also replicated in a validation cohort.ConclusionOverall, the SEBE-HCNNSS scale represents a simple assessment tool with promising predictive value for CI and clinical outcomes post-a-SAH. Our findings indicate its practical utility as a prognostic instrument for risk evaluation after a-SAH, potentially facilitating early intervention and treatment.
Characterization of CSF inflammatory markers after hemorrhagic stroke and their relationship to disease severity
Authors: Magid-Bernstein Jessica , Yan Jennifer , Herman Alison L. , He Zili , Johnson Conor W. , Beatty Hannah , Choi Rachel , Velazquez Sofia , Neeman Eitan , Falcone Guido , Kim Jennifer , Petersen Nils , Gilmore Emily J. , Matouk Charles , Sheth Kevin , Sansing Lauren 
Published: December 2023

ABSTRACTBackgroundThe inflammatory response within the central nervous system is a key driver of secondary brain injury after hemorrhagic stroke, both in patients with intracerebral hemorrhage (ICH) and aneurysmal subarachnoid hemorrhage (aSAH). In this study, we aimed to characterize inflammatory molecules in the blood and cerebrospinal fluid (CSF) of patients within 72 hours of hemorrhage to understand how such molecules vary across disease types and disease severity.MethodsBiological samples were collected from patients admitted to a single-center Neurosciences Intensive Care Unit with a diagnosis of ICH or aSAH between 2014 and 2022. Control CSF samples were collected from patients undergoing CSF diversion for normal pressure hydrocephalus. A panel of immune molecules in the plasma and CSF samples was analyzed using Cytometric Bead Array assays. Clinical variables, including demographics, disease severity, and intensive care unit length of stay were collected.ResultsPlasma and/or CSF samples were collected from 260 patients (188 ICH patients, 54 aSAH patients, 18 controls). C-C motif chemokine ligand-2 (CCL2), interleukin-6 (IL-6), granulocyte-colony stimulating factor (G-CSF), interleukin-8 (IL-8), and vascular endothelial growth factor (VEGF), were detectable in the CSF within the first 3 days after hemorrhage, and all were elevated compared to plasma. Compared with controls, CCL2, IL-6, IL-8, G-CSF, and VEGF were elevated in the CSF of both ICH and aSAH patients (p<0.01 for all comparisons). VEGF was increased in ICH patients compared to aSAH patients (p<0.01). CCL2, G-CSF, and VEGF in the CSF were associated with more severe disease in aSAH patients only.ConclusionsWithin 3 days of hemorrhagic stroke, proinflammatory molecules can be detected in the CSF at higher concentrations than in the plasma. Early concentrations of some pro-inflammatory molecules may be associated with markers of disease severity.