bluuebunny/crossref_metadata_2025_split huggingface dataset:
Compliance with research ethics in epidemiological studies targeted to conflict-affected areas in Western Ethiopia: validity of informed consent (VIC) by information comprehension and voluntariness (ICV)
Authors: Tiruneh Gemechu , Yilma Mekdes , Wakuma Bizuneh , Abdisa Eba , Bayisa Lami , Nichols Michelle , Bedeker Anja , Tiffin Nicki 
Published: January 2024

AbstractBackgroundThe conduct of research is critical to advancing human health. However, there are issues of ethical concern specific to the design and conduct of research in conflict settings. Conflict-affected countries often lack strong platform to support technical guidance and monitoring of research ethics, which may lead to the use of divergent ethical standards some of which are poorly elaborated and loosely enforced. Despite the growing concern about ethical issues in research, there is a dearth of information about ethical compliance in conflict areas. Valid and ethically informed decision-making is a premier pact with research participants in settling possible ethical issues before commencing the research, which is ensured by gaining informed consent from prospective participants of the research.AimsThis research aimed to explore compliance with research ethics and consent validity in community-based epidemiological research conducted previously.MethodsResearch participants were recruited in the western part of Ethiopia in three districts subjected to conflicts. A community-based cross-sectional study design was utilized, and 338 residents were enrolled as study participants. All participants had previously been enrolled as research participants in epidemiological studies. Data was collected using a questionnaire that was pilot-tested before the commencement of the main data collection. The questionnaire focused on participants’ experiences of the informed consent process followed when they were recruited for an epidemiological study and covered themes such as essential information provided, level of comprehension, and voluntarism of consent.ResultsOver half of the study participants, 176 (52%), were not provided with essential information before consenting. And 135 (40%) of them did not comprehend the information provided to them. One hundred and ninety (56%) participants freely and voluntarily agreed to partake in one of these epidemiological studies, with over a quarter (97; 28.7%) of them reporting they were subjected to undue influence. Written consent was obtained from only 32 (9.4%) of the participants.
Nursing students experienced academic emotions during education - a longitudinal descriptive study from a nursing bachelor’s program in Sweden
Authors: Lundell Rudberg Susanne , Sormunen Taina , Scheja Max , Lachmann Hanna , Westerbotn Margareta 
Published: January 2024

Abstract
Aim
To explore nursing students’ academic emotions during ongoing learning activities focusing on perceived challenge and competence.

Background
Emotions plays an important part in learning. Positive emotions can be beneficial while negative emotions can be detrimental to educational outcomes. Optimal experiences are situations when learners simultaneously experience sufficient challenge and competence. Since various learning activities are performed in different learning environments during the nursing program, it is of interest to investigate students’ ongoing emotions in the occurring contexts.

Design
A longitudinal descriptive study.

Methods
By using the Contextual Activity Sampling System, data was collected every third week on a three-year nursing program. From August 2015 to January 2020, a total of 2, 947 questionnaires were answered by 158 students. Experiences of positive and negative academic emotions were calculated for the entire program. Optimal experience was calculated for courses where high discrepancy between positive and negative experiences were identified.

Results
Students self-reported academic emotions varied over time and in relation to learning activities. High ratings of negative emotions were reported during clinical practice in all semesters except the final. Students’ positive academic emotions and optimal experience in clinical practice increased after having deepened their academic knowledge.

Conclusion
Nursing students had an increased positive experience when they themselves practice a learning activity and it appeared that they benefit from academic preparation prior to entering internship. Nursing students need an academic competence to develop their skills during training in the clinical reality. Increased collaboration between academia and clinic would be beneficial for students’ clinical development.
Drivers for low-acuity pediatric emergency department visits in two tertiary hospitals in Switzerland: a cross-sectional, questionnaire-based study
Authors: Jaboyedoff Manon , Starvaggi Carl , Suris Joan-Carles , Kuehni Claudia E. , Gehri Mario , Keitel Kristina 
Published: January 2024

Abstract
Purpose
Low-acuity pediatric emergency department (PED) visits are frequent in high-income countries and have a negative impact on patient care at the individual and health system levels. Knowing what drives low-acuity PED visits is crucial to inform adaptations in health care delivery. We aimed to identify factors associated with low-acuity PED visits in Switzerland, including socioeconomic status, demographic features, and medical resources of families.

Methods
We conducted a prospective, questionnaire-based study in the PEDs of two Swiss tertiary care hospitals, Bern and Lausanne. We invited all consecutive children and their caregiver attending the PED during data collection times representative of the overall PED consultation structure (e.g. day/night, weekdays/weekends) to complete a questionnaire on demographic features, socioeconomic status, and medical resources. We collected medical and administrative data about the visit and defined low-acuity visits as those meeting all of the following criteria: (1) triage category 4 or 5 on the Australasian Triage Scale, (2) no imaging or laboratory test performed, and (3) discharge home. We used a binary multiple logistic regression model to identify factors associated with low-acuity visits.

Results
We analysed 778 PED visits (September 2019 to July 2020). Most children visiting our PEDs had a designated primary care provider (92%), with only 6% not having seen them during the last year. Fifty-five per cent of caregivers had asked for medical advice before coming to the PED. The proportion of low-acuity visits was 58%. Low-acuity visits were associated with caregiver's difficulties paying bills (aOR 2.6, 95% CI 1.6 – 4.4), having already visited a PED in the last 6 months (aOR 1.7, 95% CI 1.1 – 2.5) but not with parental education status, nor parental country of birth, parental employment status or absence of family network.

Conclusion
Economic precariousness is an important driver for low-acuity PED visits in Switzerland, a high-income country with compulsory health coverage where most children have a designated primary care provider and a regular pediatric follow-up. Primary care providers and PEDs should screen families for economic precariousness and offer anticipatory guidance and connect those in financial need to social support.
Nurses’ perspectives on user-friendly self-sampling interventions for diagnosis of sexually transmitted infections among young women in eThekwini district municipality: a nominal group technique
Authors: Jaya Ziningi N. , Mapanga Witness , Moetlhoa Boitumelo , Mashamba-Thompson Tivani P. 
Published: January 2024

Abstract
Background
Syndromic management in the main non-laboratory-based management approach for sexually transmitted infections (STI) in most low- and middle-income countries (LMICs) but it has limitations. Self-sampling has been proven as a suitable alternative approach to help improve management STIs by improving access to diagnosis among vulnerable populations. We sought to determine health workers’ perspectives on user-friendly self-sampling interventions for STIs among young women in eThekwini District Municipality.

Methods
Healthcare workers providing STI healthcare services in the study location participated in a nominal group technique (NGT) workshop. The NGT workshop was aimed enabling collaboration with key health providers in identifying user-friendly self-sampling interventions for diagnosis of STIs among young women. Data collection was conducted in two phases: phase 1 determined barrier that hinder young women from accessing current STI healthcare services and phase 2 focused on determining the key strategies for self-sampling interventions to diagnose STIs in young women. Thematic analysis and percentage form analysis were used to examine qualitative and quantitative data respectively.

Results
The following barriers were identified: negligence; myths about STIs; fear of judgement; denial; operating hours; lack of knowledge of STI symptoms and safe sex practices; and stigma associated with STIs. The following strategies were suggested: hand out self-sampling kits at popular restaurants; collect self-sampling kits from security guard at primary healthcare clinics (PHCs); receive STI diagnostic results via SMS or email or the clinic for treatment; improve youth friendly services at PHCs; educate the public on proper use of the kits. Education about STIs and handing out self-sampling kits at clinics, universities, schools, pharmacies or via outreach teams were ranked high priority strategies.

Conclusions
The findings highlight the need to address stigma and fear of judgment and provide comprehensive education to improve healthcare-seeking behaviour in young women. Additionally, the study also indicates that using eHealth solutions could significantly enhance the accessibility and efficiency of STI healthcare services in LMICs.
Triple artemisinin-based combination therapy (TACT): advancing malaria control and eradication efforts
Authors: Kokori Emmanuel , Olatunji Gbolahan , Akinboade Adeola , Akinoso Aminat , Egbunu Emmanuel , Aremu Sikiru Ademola , Okafor Chuka Emmanuel , Oluwole Olamide , Aderinto Nicholas 
Published: January 2024

AbstractThis paper examines the far-reaching implications of Triple Artemisinin-Based Combination Therapy (TACT) in the global battle against malaria. Artemisinin-Based Combination Therapy (ACT) is recognized for its cost-effectiveness, lower likelihood of adverse events, and widespread acceptance by patients and healthcare providers. However, TACT introduces novel dimensions to the fight against malaria that make them a superior choice in several aspects. TACT has been demonstrated to address resistance, offer a broader spectrum of action, reduce the risk of treatment failure, and can be tailored to meet regional needs, strengthening the global effort to combat malaria. However, maximizing these benefits of TACT depends on accessibility, particularly in resource-limited regions where malaria is most prevalent. Collaborative efforts among stakeholders, sustainable pricing strategies, efficient supply chains, and public–private partnerships are essential to ensure that TACT reaches needy populations. Moreover, dispelling prevalent malaria myths through health education campaigns is critical in this endeavour. The paper underscores the significance of collaborative initiatives and partnerships among governments, international organizations, research institutions, acadaemia, pharmaceutical companies, and local communities. Together, these efforts can pave the way for the acceptance, adoption, and success of TACT, ultimately advancing the global goal of a malaria-free world.
Genomic insights into Plasmodium vivax population structure and diversity in central Africa
Authors: Gartner Valerie , Redelings Benjamin D. , Gaither Claudia , Parr Jonathan B. , Kalonji Albert , Phanzu Fernandine , Brazeau Nicholas F. , Juliano Jonathan J. , Wray Gregory A. 
Published: January 2024

Abstract
Background
Though Plasmodium vivax is the second most common malaria species to infect humans, it has not traditionally been considered a major human health concern in central Africa given the high prevalence of the human Duffy-negative phenotype that is believed to prevent infection. Increasing reports of asymptomatic and symptomatic infections in Duffy-negative individuals throughout Africa raise the possibility that P. vivax is evolving to evade host resistance, but there are few parasite samples with genomic data available from this part of the world.

Methods
Whole genome sequencing of one new P. vivax isolate from the Democratic Republic of the Congo (DRC) was performed and used in population genomics analyses to assess how this central African isolate fits into the global context of this species.

Results
Plasmodium vivax from DRC is similar to other African populations and is not closely related to the non-human primate parasite P. vivax-like. Evidence is found for a duplication of the gene PvDBP and a single copy of PvDBP2.

Conclusion
These results suggest an endemic P. vivax population is present in central Africa. Intentional sampling of P. vivax across Africa would further contextualize this sample within African P. vivax diversity and shed light on the mechanisms of infection in Duffy negative individuals. These results are limited by the uncertainty of how representative this single sample is of the larger population of P. vivax in central Africa.
Testing the test strips: laboratory performance of fentanyl test strips
Authors: Halifax John C. , Lim Lilly , Ciccarone Daniel , Lynch Kara L. 
Published: January 2024

Abstract
Background
The overdose crisis driven by synthetic opioids continues to escalate in the USA. We evaluated the efficacy of multiple manufacturing lots of a fentanyl test strip (FTS) to detect fentanyl and fentanyl analogs and assessed cross-reactivity with possible interferences.

Methods
Drug standards were dissolved in water in a laboratory setting and serially diluted. Drug dilutions were tested using five different manufacturing lots of BTNX Rapid Response (20 ng/mL cutoff) lateral flow chromatographic immunoassay strips to assess lot-to-lot variability for FTS sensitivity and cross-reactivity for the analytes of interest.

Results
All five manufacturing lots cross-reacted with fentanyl and eleven fentanyl analogs. Diphenhydramine, lidocaine, MDMA, and methamphetamine were found to cause false positives with the strips. There was notable lot-to-lot variability in the sensitivity of the strips for fentanyl, fentanyl analogs, and known interferences.

Discussion
FTS remains an important overdose prevention tool, but lot-to-lot variability in performance complicates robust instructions that balance the prevention of false positives and false negatives. Continued lot-to-lot performance assessment is recommended to ensure health education for FTS remains accurate. More sophisticated drug checking technologies and services are needed in the community landscape to augment personal FTS use to facilitate informed consumption and overdose risk mitigation.
Alterations in gut and genital microbiota associated with gynecological diseases: a systematic review and meta-analysis
Authors: Zhou Ziwei , Feng Yifei , Xie Lishan , Ma Song , Cai Zhaoxia , Ma Ying 
Published: January 2024

Abstract
Background
Increasing number of studies have demonstrated certain patterns of microbial changes in gynecological diseases; however, the interaction between them remains unclear. To evaluate the consistency or specificity across multiple studies on different gynecological diseases and microbial alterations at different sites of the body (gut and genital tract), we conducted a systematic review and meta-analysis.

Methods
We searched PubMed, Embase, Web of Science, and Cochrane Library up to December 5, 2022(PROSPERO: CRD42023400205). Eligible studies focused on gynecological diseases in adult women, applied next-generation sequencing on microbiome, and reported outcomes including alpha or beta diversity or relative abundance. The random-effects model on standardized mean difference (SMD) was conducted using the inverse-variance method for alpha diversity indices.

Results
Of 3327 unique articles, 87 eligible studies were included. Significant decreases were found in gut microbiome of patients versus controls (observed species SMD=-0.35; 95%CI, -0.62 to -0.09; Shannon index SMD=-0.23; 95%CI, -0.40 to -0.06), whereas significant increases were observed in vaginal microbiome (Chao1 SMD = 1.15; 95%CI, 0.74 to 1.56; Shannon index SMD = 0.51; 95%CI, 0.16 to 0.86). Most studies of different diagnostic categories showed no significant differences in beta diversity. Disease specificity was observed, but almost all the changes were only replicated in three studies, except for the increased Aerococcus in bacterial vaginosis (BV). Patients with major gynecological diseases shared the enrichment of Prevotella and depletion of Lactobacillus, and an overlap in microbes was implied between BV, cervical intraepithelial neoplasia, and cervical cancer.

Conclusions
These findings demonstrated an association between alterations in gut and genital microbiota and gynecological diseases. The most observed results were shared alterations across diseases rather than disease-specific alterations. Therefore, further investigation is required to identify specific biomarkers for diagnosis and treatment in the future.
Cost-utility of tiotropium in patients with severe asthma
Authors: Buendía Jefferson Antonio , Patiño Diana Guerrero 
Published: January 2024

Abstract
Summary
Add-on therapy with tiotropium was cost-effective when added to usual care in patients who remain uncontrolled despite treatment with medium or high-dose ICS/LABA in a middle-income country.

Background
A significant proportion of asthma patients remain uncontrolled despite inhaled corticosteroids and long-acting beta-agonists. Some add-on therapies, such as tiotropium bromide, have been recommended for this subgroup of patients. This study aimed to assess the cost-effectiveness of tiotropium as an add-on therapy to inhaled corticosteroids and long-acting b2 agonists for patients with severe asthma.

Methods
A probabilistic Markov model was created to estimate the cost and quality-adjusted life-years (QALYs) of patients with severe asthma in Colombia. Total costs and QALYs of two interventions include standard therapy with inhaled corticosteroids and long-acting bronchodilators versus add-on therapy with tiotropium. Multiple sensitivity analyses were conducted. Cost-effectiveness was evaluated at a willingness-to-pay value of $5180.

Results
The expected incremental cost per QALY (ICER) is estimated at US$–2637.59. There is a probability of 0.77 that tiotropium + ICS + LABA is more cost-effective than ICS + LABA at a threshold of US$5180 per QALY. The strategy with the highest expected net benefit is Tiotropium, with an expected net benefit of US$800. Our base-case results were robust to parameter variations in the deterministic sensitivity analyses.

Conclusion
Add-on therapy with tiotropium was cost-effective when added to usual care in patients who remain uncontrolled despite treatment with medium or high-dose inhaled corticosteroids and long-acting bronchodilators. Our study provides evidence that should be used by decision-makers to improve clinical practice guidelines and should be replicated to validate their results in other middle-income countries.
MTFR2-dependent mitochondrial fission promotes HCC progression
Authors: Zhang La , Zhang Xiuzhen , Liu Haichuan , Yang Changhong , Yu Jiyao , Zhao Wei , Guo Jiao , Zhou Baoyong , Jiang Ning 
Published: January 2024

AbstractBackgroundThe role of mitochondrial dynamics, encompassing fission, fusion, and mitophagy, in cancer progression has been extensively studied. However, the specific impact of mitochondrial dynamics on hepatocellular carcinoma (HCC) is still under investigation.MethodsIn this study, mitochondrial dynamic genes were obtained from the MitoCarta 3.0 database, and gene expression data were collected from The Cancer Genome Atlas (TCGA) database. Based on the expression of these dynamic genes and differentially expressed genes (DEGs), patients were stratified into two clusters. Subsequently, a prognostic model was constructed using univariate COX regression and the least absolute shrinkage and selection operator (LASSO) regression, and the prognostic signature was evaluated. We analyzed the interaction between these model genes and dynamic genes to identify hub genes and reveal mitochondrial status. Furthermore, we assessed immune infiltration, tumor mutational burden (TMB), tumor stemness indices (TSI), and the response to immune checkpoint block (ICB) therapy using the TIDE algorithm and risk scores. Additionally, transmission electron microscopy (TEM), hematoxylin-eosin (H&E) staining, immunohistochemistry (IHC), western blotting (WB), and immunofluorescence (IF) were conducted to afford detailed visualization of the morphology of the mitochondria and the expression patterns of fission-associated proteins.ResultsPatients in Cluster 2 exhibited heightened mitochondrial fission and had a worse prognosis. The up-regulated dynamic genes in Cluster 2 were identified as fission genes. GO/KEGG analyses reconfirmed the connection of Cluster 2 to augmented mitochondrial fission activities. Subsequently, a ten-gene prognostic signature based on the differentially expressed genes between the two clusters was generated, with all ten genes being up-regulated in the high-risk group. Moreover, the potential links between these ten signature genes and mitochondrial dynamics were explored, suggesting their involvement in mediating mitochondrial fission through interaction with MTFR2. Further investigation revealed that the high-risk group had an unfavorable prognosis, with a higher mutation frequency of TP53, increased immune checkpoint expression, a higher TIS score, and a lower TIDE score. The mitochondrial imbalance characterized by increased fission and upregulated MTFR2 and DNM1L expression was substantiated in both HCC specimens and cell lines.ConclusionsIn conclusion, we developed a novel MTFR2-related prognostic signature comprising ten mitochondrial dynamics genes. These genes play crucial roles in mitochondrial fission and have the potential to serve as important predictors and therapeutic targets for HCC.
Psoriatic arthritis and COVID-19: a new challenge for rheumatologists and dermatologists
Authors: Jadali Zohreh 
Published: January 2024

AbstractCOVID-19 has changed the global health system and has great impact on different types of medical specialties including, dermatology and rheumatology. This point is important because although these two specialties are distinct subfields of medicine, there is some overlap between them. The overlap can be described by a number of rheumatic diseases that have cutaneous manifestations and vice versa. A good example of this is psoriatic arthritis because, in up to 42% of people, cutaneous lesions and arthritis coexist. Interestingly, emerging reports have described the possible occurrence of psoriasis and psoriatic arthritis in COVID-19 patients. Although the exact mechanism is unclear, some common pathophysiological mechanisms may contribute to disease pathogenesis. Therefore, elucidation of shared pathological pathways that connect these diseases will be valuable for better diagnosis and the complete treatment of COVID-19 patients with cutaneous and rheumatologic diseases.