bluuebunny/crossref_metadata_2025_split huggingface dataset:
Persistence of geographic barriers to maternal care services following a health system strengthening initiative in rural Madagascar
Authors: Ihantamalala Felana A. , Randriamihaja Mauricianot , Miller Ann C. , Rakotonanahary Rado J.L. , Raza-Fanomezanjanahary Mbolatiana , Kotchofa Jacques Aubin , Randriamanambintsoa Marius , Ramarson Haja , Razafinjato Benedicte , Rasoanandrasana Vololoniaina , Bonds Matthew , Finnegan Karen E. , Garchitorena Andres 
Published: October 2023

AbstractBackgroundGeographic access to healthcare continues to pose a significant challenge for pregnant women in rural areas of sub-Saharan Africa, resulting in consistently high rates of maternal mortality. Geographic barriers can persist even in settings where financial barriers have been reduced and health system strengthening (HSS) efforts are in place. The aim of this study is to combine analyses of a population-representative cohort and geolocated maternal consultation data at the village level to gain a precise understanding of spatiotemporal changes in the utilization of maternal care services in a rural district of Madagascar benefiting from HSS support.MethodsWe collected monthly information on antenatal care visits, deliveries and postnatal visits from the registries of 18 primary care health centers in Ifanadiana District, from 2016 to 2018. Similar data were collected from a district-representative cohort via surveys on over 1500 households done in 2016 and 2018. We estimated precise travel time from each village to the nearest health center to understand spatio-temporal variations in maternal care access, and to assess the impact of geographic barriers via statistical analyses.ResultsWomen who lived within a one-hour walk from a health facility in the HSS catchment area had rates of per capita utilization of most maternal health services were roughly twice that those who lived 1-2 hours away and three times higher than those who lived over 2 hours away. The exception was the first antenatal care visit (ANC1), for which travel time had more modest effect. Improvements to primary care services due to HSS in this setting were only observed among women living within two hours from health centers. Statistical models revealed that women’s travel time from a health facility was the strongest determinant of maternal care service utilization.ConclusionThis study shows how a combination of geo-located health system information and population-representative data can help assess the impact of geographical barriers to maternal care in rural areas of sub-Saharan Africa. It highlights that women who live more than 2 hours from a health facility had virtually no access to maternal health services despite efforts in place to reduce financial barriers to care and strengthen the health system.
Understanding the genetic epidemiology of hereditary breast cancer in India using whole genome data from 1029 healthy individuals
Authors: Vatsyayan Aastha , Mathur Prerika , Bhoyar Rahul C , Imran Mohamed , Senthivel Vigneshwar , Divakar Mohit Kumar , Mishra Anushree , Jolly Bani , Sivasubbu Sridhar , Scaria Vinod 
Published: October 2023

AbstractAimBreast cancer is the most highly reported cancer in India as well as globally (Globocan 2020). Genetic testing could help tackle the increasing cancer burden by enabling carriers of pathogenic variants obtain an early diagnosis through increased surveillance, and help guide treatment, and in some cases enable prevention. However, accurate interpretation of variant pathogenicity must be established in a population-specific manner to ensure effective use of genetic testing. Further, sinceBRCA1andBRCA2are importance breast cancer genes, even rare variants must be studied for their potential effect on the disease.Materials and MethodsWe query the IndiGen data obtained from whole genome sequencing of 1029 Indian individuals, and perform variant classification of all reported BRCA variants according to the gold-standard ACMG/AMP guidelines to establish disease epidemiology. We further implement machine learning approaches to classify all reported non-benign variants, and create a ready-reference of variants classified in a manner close to ACMG guidelines at scale.ResultsWe determined the genetic prevalence to be the following: 1 in nearly 341 individuals forBRCA1, and 1 in nearly 170 individuals forBRCA2are likely to be carriers of pathogenic mutations. Overall, 1 in nearly 114 individuals are likely to be carriers of pathogenic BRCA mutations. Further, using the brca-NOVUS tool, we classified 1,54,045 genetic variants across 18 population sets and 4 large variant repositories as either pathogenic or benign.ConclusionThe high population prevalence indicates a greater need of studying genetic variants linked with breast cancer in an Indian population specific manner. To the best of our knowledge, this is the first and most comprehensive population-scale genetic epidemiological study of BRCA-linked breast cancer variants reported from India.
The spread of a validated molecular marker of artemisinin partial resistancepfkelch13R622I and association withpfhrp2/3deletions in Eritrea
Authors: Mihreteab Selam , Anderson Karen , Molina - de la Fuente Irene , Sutherland Colin J. , Smith David , Cunningham Jane , Beshir Khalid B , Cheng Qin 
Published: October 2023

ABSTRACTEritrea is the first African country to switch away from exclusive use of HRP2-based RDTs for the detection ofP. falciparumdue to high prevalence ofpfhrp2/3-deletedP. falciparumparasites causing false-negative RDT results. While heavy reliance on malaria RDTs played a significant role in the rapid expansion ofpfhrp2/3-deleted parasites in Eritrea, we hypothesize that the use of antimalarial (artesunate-amodiaquine) may have also contributed to their spread. We conducted a retrospective investigation of mutations in the propeller domain of theP. falciparum kelch13gene in samples collected in 2016 (n=50) from the Northern Red Sea Zone before the RDT switch away from HRP2-RDTs and in samples collected in 2018-2020 (n=587) from the Gash Barka, Anseba and Debub Zones after the RDT switch. No mutations were identified in the 2016 samples. However, in 2018-2019 samples, we detected five different single non-synonymous mutations. The most prevalent mutation waspfk13R622I, which was detected in samples collected from all health centres, with an overall prevalence of 11.9% (ranging from 5.9% to 28%). Parasites carrying the R622I mutation have diverse microsatellite marker haplotypes, indicating that they had evolved multiple times from different genetic backgrounds. The prevalencepfk13R622I was significantly higher in singlepfhrp3-deleted parasites (18.0%) compared to parasites withoutpfhrp2/3deletions (6.2%) and dualpfhrp2/3-deleted parasites (9.0%), suggesting association between thepfk13R622I mutation and thepfhrp2/3deletions in Eritrea. Continuous monitoring the trends inpfhrp2/3andpfk13mutants is needed to inform effective malaria management strategies in Eritrea.
Different perspectives on Quality in clinical education of physical therapy students – protocol of a scoping review
Authors: Walter Matthias M , Rogan Slavko , Schurz Alexander P , Zinzen Evert 
Published: October 2023

AbstractBackgroundClinical education (CE) plays a crucial role in physical therapy education, yet there is a notable absence of established quality characteristics for its implementation.ObjectivesThis scoping review aims to elucidate how various stakeholders define and describe the quality of CE in higher education for physical therapy students. Additionally, it seeks to identify commonalities and distinctions in the application of the term “quality” in the context of CE.MethodsPeer-reviewed studies encompassing physical therapy students, clinical instructors, lecturers in physical therapy education, physical therapy educational sites, and supervising physical therapists in internships across all clinical fields will be included in the review. A comprehensive search strategy will be employed, utilizing multiple electronic databases, including MEDLINE, EMBASE, the Cochrane Library, ERIC, Education Research Complete, Education Database, and CINAHL. Eligibility screening will be independently conducted by two reviewers. Data extraction will be presented in a tabular or graphical format, aligning with the review’s objectives.DiscussionInsights gleaned from this study hold the potential to inform targeted interventions and improvements in CE, ultimately enhancing the learning outcomes and satisfaction of physical therapy students. This endeavor seeks to bridge the existing gap in defining and achieving quality in clinical education within the realm of physical therapy higher education.
Investigating the impact of physical activity on mitochondrial function in Parkinson’s disease (PARKEX): Study protocol for a randomised controlled clinical trial
Authors: Magaña Juan Carlos , Deus Cláudia M. , Baldellou Laura , Avellanet M , Gea-Rodríguez E , Calzada Silvia Enriquez , Laguna Ariadna , Martínez-Vicente Marta , Hernández-Vara Jorge , Giné-Garriga Maria , Pereira Susana P. , Montané Joel 
Published: October 2023

AbstractParkinson’s disease (PD) is characterized by the progressive dopaminergic neuron degeneration, resulting in striatal dopamine deficiency. Mitochondrial dysfunction and oxidative stress are associated with PD pathogenesis. Physical activity (PA) has been shown to ameliorate neurological impairments and to impede age-related neuronal loss. In addition, skin fibroblasts have been identified as surrogate indicators of pathogenic processes correlating with clinical measures. The PARKEX study aims to compare the effects of two different PA programs, analyzing the impact on mitochondrial function in patients’ skin fibroblasts as biomarkers for disease status and metabolic improvement. Early-stage PD patients (n=24, H&Y stage I to III) will be randomized into three age– and sex-matched groups. Group 1 (n=8) will undergo basic physical training (BPT) emphasizing strength and resistance. Group 2 (n=8) will undergo BPT combined with functional exercises (BPTFE), targeting the sensorimotor pathways that are most affected in PD (proprioception-balance-coordination) together with cognitive and motor training (Dual task training). Group 3 (n=8) will serve as control (sedentary group; Sed). Participants will perform three sessions per week for 12 weeks. Assessment of motor function, quality of life, sleep quality, cognitive aspects and humor will be conducted pre– and post-intervention. Patient skin fibroblasts will be collected before and after the intervention and characterized in terms of metabolic remodeling and mitochondrial bioenergetics. Ethical approval has been given to commence this study. This trial is registered at clinicaltrials.gov (NCT05963425)
Assessment of Sociodemographic Factors Associated with Time to Self-reported COVID-19 Infection Among a Large Multi-Center Prospective Cohort Population in the Southeastern United States
Authors: Beron Andrew J. , Yukich Joshua O. , Berry Andrea A. , Correa Adolfo , Keating Joseph , Bott Matthew , Wierzba Thomas F , Weintraub William S. , Friedman-Klabanoff DeAnna J. , Mongraw-Chaffin Morgana , Gibbs Michael A. , Taylor Yhenneko J. , Kissinger Patricia J. , Hayes Devin , Schieffelin John S. , Burke Brian K. , Oberhelman Richard A. 
Published: October 2023

AbstractObjectiveWe aimed to investigate sociodemographic factors associated with self-reported COVID-19 infection.MethodsThe study population is a multicenter prospective cohort of adult volunteers recruited from healthcare systems located in the mid-Atlantic and southern United States. Between April 2020 and October 2021 participants completed daily online questionnaires about symptoms, exposures, and risk behaviors related to COVID-19, including self-reports of positive SARS CoV-2 detection tests and COVID-19 vaccination. Analysis of time from study enrollment to self-reported COVID-19 infection used a time-varying mixed effects Cox-proportional hazards framework.ResultsOverall, 1,603 of 27,214 study participants (5.9%) reported a positive COVID-19 test during the study period. The adjusted hazard ratio demonstrated lower risk for women, those with a graduate level degree, and smokers. A higher risk was observed for healthcare workers, those aged 18-34, those in rural areas, those from households where a member attends school or interacts with the public, and those who visited a health provider in the last year.ConclusionsIncreased risk of self-reported COVID-19 was associated with specific demographic characteristics, which may help to inform targeted interventions for future pandemics.
Edematous Type of Malnutrition Takes Longer Recovery Time Compared to Severe Wasting (Marasmus): Findings on 6-59 months old children treated for Severe Acute Malnutrition After the War in Northern Ethiopia, 2023: Prospective Longitudinal Study
Authors: Tesfay Wagnew , Abay Mebrahtu 
Published: October 2023

AbstractBackgroundSevere acute malnutrition (SAM) is still having public health significance by attributing almost fifty percent of the estimated ten to eleven million deaths encountered in less than five-years old children, imposing nine-fold likelihood of death compared with well-nourished children of similar age group. It increases terrifyingly and become lethal during conflicts due to lack of food, compromised water supply and hygienic practices along with insufficient healthcare services.MethodsHospital-based prospective cohort study was conducted using regularly collected programme data of children admitted to the stabilization center in Suhul general hospital from January 1st, 2023 up to July 31st, 2023. To collect the data, pretested structured questionnaire was generated referring to the national SAM management protocol. Then collected data get coded and entered into Microsoft Excel spreadsheet 2016 version. All forms of analyses were done using statistical package for social sciences (SPSS) version 25.ResultsFrom the total 168 children aged 6-59 months enrolled in the study, ninety-four per cent of them were recovered and transferred to the outpatient therapeutic programme while the rest six per cent of the participants were censored. Appetite test (AHR = 1.874; 95% CI: 1.180-2.978), level of dehydration (AHR = 0.538; 95% CI: 0.361-0.800 for some/moderate dehydration and AHR = 0.250; 95% CI: 0.128-0.489 for severe dehydration or shock), diagnosis at admission (AHR = 0.452; 95% CI: 0.294-0.694), blood transfusion (AHR = 5.559; 95% CI: 2.419-12.773), type of antibiotics (AHR = 0.365; 95% CI: 0.192-0.692) and nasogastric tube feeding (AHR = 0.531; 95% CI: 0.372-0.758) were declared significant predictors of recovery time.ConclusionBottom line of the study shows the inpatient therapeutic feeding center has met the agreed indicators for nutrition interventions during humanitarian crises. We recommend the hospital leadership, the regional health bureau and other humanitarian agencies to stress on training clinical workforce directly involved in patient management and care.
Factors Influencing the Trajectory of COVID-19 Evolution: A Longitudinal Study of 12 Asian Countries
Authors: He Xiaona , Liu Hui , Zeng Fanyan , Gao Wei 
Published: October 2023

SummaryBackgroundThe effectiveness of different strategies in addressing the COVID-19 pandemic has been assessed, but there is still not enough evidence in Asian countries. This study aims to examine the factors influencing the trajectory of COVID-19 evolution in Asia, to provide insights for optimizing public health policies.MethodsIn this longitudinal analysis, we combined COVID-19 cases and vaccination percentages from Our Word in Data with the policy stringency index from the Oxford COVID-19 Government Response Tracker for 12 Asian countries between January 1, 2021, and September 30, 2022. An agglomerative hierarchical cluster analysis (HCA) was conducted to identify countries with similar COVID-19 evolution trajectories. We also investigated the potential impact of seasonal variations on the virus’ trajectory. The relationship between the level of policy response, vaccination coverage, and COVID-19 cases was explored using Generalized Additive Models (GAMs).FindingsThere were noticeable differences in the evolution trajectory of COVID-19 among the countries. The 12 Asian countries were grouped into two clusters based on evolutionary similarities. Cluster 1 consisted of West Asian countries (Azerbaijan, Turkey, Bahrain, Israel and Lebanon); while Cluster 2 included Japan, South Korea, Singapore, Malaysia, Thailand, Cambodia and Indonesia. The analysis revealed that the stringency index and vaccination coverage were associated with a statistically significant impact (bothPvalues < 0·0001) on the evolution trajectory of COVID-19 (adjR2=0·54). The dose-response relationships demonstrated that the continuous high levels of stringency index (≥87·6) or vaccination coverage (≥ 42·0%) have led to a decrease in COVID-19 infection rates. In early 2021, theadjR2increased to 0·93 for all countries. Furthermore, theadjR2for Cluster 1 and Cluster 2 were 0·86 and 0·90 respectively. All GAMs models have significantly improved compared to null model (Pvalues <0·0001).InterpretationBy strengthening vaccination ahead of susceptible seasons and enhancing personal self-protection measures, the transmission of COVID-19 among the population can be reduced even during the highly infectious Omicron era.FundingSenior Talent Startup Fund of Nanchang University
How does treatment coverage and proportion never treated influence the success ofSchistosoma mansonielimination as a public health problem by 2030?
Authors: Kura Klodeta , Mutono Nyamai , Basáñez Maria-Gloria , Coffeng Luc E. , Thumbi S.M. , Anderson Roy M. 
Published: October 2023

AbstractBackgroundThe 2030 target for schistosomiasis is elimination as a public health problem (EPHP), achieved when the prevalence of heavy intensity infection among school-aged children (SAC) reduces to <1%. To achieve this, the new World Health Organization (WHO) guidelines recommend a broader target of population to include pre-school (pre-SAC) and adults. However, the probability of achieving EPHP should be expected to depend on patterns in repeated uptake of mass drug administration (MDA) by individuals.MethodsWe employed two individual-based stochastic models to evaluate the impact of school-based and community-wide treatment and calculated the number of rounds required to achieve EPHP forSchistosoma. mansoniby considering various levels of the population never treated (NT). We also considered two age intensity profiles, corresponding to a low and high burden of infection in adults.ResultsThe number of rounds needed to achieve this target depends on the baseline prevalence and the coverage used. For low and moderate transmission areas, EPHP can be achieved within seven years if NT ≤10% and NT <5%, respectively. In high transmission areas, community wide treatment with NT<1% is required to achieve EPHP.ConclusionsThe higher the intensity of transmission, and the lower the treatment coverage, the lower the acceptable value of NT becomes. Using more efficacious treatment regimens would permit NT values to be marginally higher. A balance between target treatment coverage and NT values may be an adequate treatment strategy depending on the epidemiological setting, but striving to increase coverage and/or minimise NT can shorten programme duration.
Dengue Viremia Kinetics and Effects on Platelet Count and Clinical Outcomes: An Analysis of 2340 Patients from Vietnam
Authors: Vuong Nguyen Lam , Ha Quyen Nguyen Than , Hanh Tien Nguyen Thi , Hue Kien Duong Thi , Le Duyen Huynh Thi , Lam Phung Khanh , Hoai Tam Dong Thi , Ngoc Tran Van , Jaenisch Thomas , Simmons Cameron P. , Yacoub Sophie , Wills Bridget A. , Geskus Ronald B. 
Published: October 2023

AbstractBackgroundViremia is a critical factor in understanding the pathogenesis of dengue infection, but limited data exist on viremia kinetics. This study aimed to investigate the kinetics of viremia and its effects on subsequent platelet count, severe dengue, and plasma leakage.MethodsWe pooled data from three studies conducted in Vietnam between 2000 and 2016, involving 2340 dengue patients with daily viremia measurements and platelet counts after symptom onset. Viremia kinetics were assessed using a random effects model that accounted for left-censored data. The effects of viremia on subsequent platelet count and clinical outcomes were examined using a landmark approach with a random effects model and logistic regression model with generalized estimating equations, respectively. The rate of viremia decline was derived from the model of viremia kinetics. Its effect on the clinical outcomes was assessed by logistic regression models.ResultsViremia levels rapidly decreased following symptom onset, with variations observed depending on the infecting serotype. DENV-1 exhibited the highest mean viremia levels during the first 5-6 days, while DENV-4 demonstrated the shortest clearance time. Higher viremia levels were associated with decreased subsequent platelet counts from day 6 onwards. Elevated viremia levels on each illness day increased the risk of developing severe dengue and plasma leakage. However, the effect size decreased with later illness days. A more rapid decline in viremia is associated with a reduced risk of the clinical outcomes.ConclusionsThis study provides comprehensive insights into viremia kinetics and its effect on subsequent platelet count and clinical outcomes in dengue patients. Our findings underscore the importance of measuring viremia levels during the early febrile phase for dengue studies and support the use of viremia kinetics as outcome for phase-2 dengue therapeutic trials.
Dynamics of SARS-CoV-2 Seroprevalence in a Large US population Over a Period of 12 Months
Authors: Karkanitsa Maria , Li Yan , Valenti Shannon , Spathies Jacquelyn , Kelly Sophie , Hunsberger Sally , Yee Laura , Croker Jennifer A. , Wang Jing , Alfonso Andrea Lucia , Faust Mondreakest , Mehalko Jennifer , Drew Matthew , Denson John-Paul , Putman Zoe , Fathi Parinaz , Ngo Tran B. , Siripong Nalyn , Baus Holly Ann , Petersen Brian , Ford Eric W. , Sundaresan Vanathi , Josyula Aditya , Han Alison , Giurgea Luca T. , Rosas Luz Angela , Bean Rachel , Athota Rani , Czajkowski Lindsay , Klumpp-Thomas Carleen , Cervantes-Medina Adriana , Gouzoulis Monica , Reed Susan , Graubard Barry , Hall Matthew D. , Kalish Heather , Esposito Dominic , Kimberly Robert P. , Reis Steven , Sadtler Kaitlyn , Memoli Matthew J 
Published: October 2023

ABSTRACTDue to a combination of asymptomatic or undiagnosed infections, the proportion of the United States population infected with SARS-CoV-2 was unclear from the beginning of the pandemic. We previously established a platform to screen for SARS-CoV-2 positivity across a representative proportion of the US population, from which we reported that almost 17 million Americans were estimated to have had undocumented infections in the Spring of 2020. Since then, vaccine rollout and prevalence of different SARS-CoV-2 variants have further altered seropositivity trends within the United States population. To explore the longitudinal impacts of the pandemic and vaccine responses on seropositivity, we re-enrolled participants from our baseline study in a 6- and 12-month follow-up study to develop a longitudinal antibody profile capable of representing seropositivity within the United States during a critical period just prior to and during the initiation of vaccine rollout. Initial measurements showed that, since July 2020, seropositivity elevated within this population from 4.8% at baseline to 36.2% and 89.3% at 6 and 12 months, respectively. We also evaluated nucleocapsid seropositivity and compared to spike seropositivity to identify trends in infection versus vaccination relative to baseline. These data serve as a window into a critical timeframe within the COVID-19 pandemic response and serve as a resource that could be used in subsequent respiratory illness outbreaks.