bluuebunny/crossref_metadata_2025_split huggingface dataset:
Exploring knowledge, attitude, and practices of the Malawian rural communities towards antimicrobial use and resistance prevention
Authors: Ndawala Maria , Pajogo Masuzgo , Mula Chimwemwe , Musaya Janelisa 
Published: January 2024

Abstract

Background: The unnecessary use of antibiotics and concomitant rapid growth of antibiotic resistance (ABR) is a widely acknowledged threat to global health, development, and sustainability. While the underlying cause of ABR is undoubtedly the overall volume of antibiotic use in general, irrational antibiotic use, which is influenced by several interrelated factors, is a major contributory factor . There are few published articles in Africa on this topic, although the number of such articles appear to have been increasing recently. The patients may have certain knowledge and attitudes on antibiotic use but these have not been ascertained in Malawi . This study explored the knowledge, attitude and practices of Malawian rural Communities on antibiotic use and resistance prevention.
Methods: A descriptive cross-sectional study was conducted (n=350) among community members of T/A Namkumba. Simple random sampling was used to select participants and a structured questionnaire was used to interview the respondents.
Results: Female participants made up 71.4% of the total and the mean age was 25.8 (SD±13.34). From all participants, (99.1%) reported having ever heard of the antibiotics, and the most common antibiotics were Cotrimoxazole (82%), Amoxicillin (79.8%), and Metronidazole (50.9%). Cough and flue were the most prominent indication for taking antibiotics representing 41.5% and 21.6% respectively. The results also showed that the majority of the participants had a positive attitude towards appropriate antibiotic use, with 82.9% remembering to take and complete prescribed antibiotics. However, about 18% did not finish the last course of the antibiotic which were prescribed. We used Ordered Logistic Regression to determine the association between knowledge, attitude and practices of the study participants. A statistically significant association was declared at a p-value < 0.05.
Conclusion: There is massive and in appropriate use of first-line antibiotics as people were taking antibiotics for conditions which were self- limiting like flue. However, people trust the hospital for their antibiotics and all the information related to their use. Despite this, a good number of participants got their medicines from a pharmacy without physician consultation and some did not finish their last course as prescribed hence putting the bacteria at risk of developing resistance.
Revolutionizing access to cardiovascular care for 1.4 billion people - How mobile health apps and services evolved from 2016-2020 in China and its implications
Authors: Gao Hai 
Published: January 2024

Abstract

Background
Cardiovascular diseases (CVDs) create a large disease burden in China. The country’s large population and land mass make access to CVD care difficult. The virtual model of care provided through mobile health (mHealth) can improve access to care and management of chronic CVDs on a population level. The article aims to examine the evolution of mHealth coverage, patient usage, and service development and delivery for CVD on a national level and describe its potential to impact access to cardiovascular care in developing countries.
Methods
We collected data on mHealth platforms for telemedicine of CVDs in the Chinese market in 2016, 2017, 2019 and 2020 from platforms available to the general public. Factors affecting access to CVD care were analyzed including 1) longitudinal changes of mHealth services provided per region; 2) medical facility coverage rate per province by mHealth apps; 3) distribution of specific cardiovascular conditions being sought on mHealth apps; and 4) the flow of patients across geographies to receive telemedicine. Descriptive statistics were used.
Findings
45.8% of tertiary hospitals were accessible by mHealth apps in 2016, this grew at an average annual growth rate of 10.7% between 2016 to 2020. Regions with a higher economic level, population, percentage of elderly, and internet penetration, rather than CVD burden, had better mHealth coverage. 34% and 67% of patients consulted doctors outside of their own provinces in 2016 and 2020, respectively. Wealthiest areas of Beijing, Shanghai and Guangdong were the preferred destinations (57.1% in 2016, 38.4% in 2020) for patients seeking interprovincial care. The top 3 disease types were the common chronic CVDs of hypertension, coronary artery disease and arrhythmia.
Interpretation
The uniform functionality available across provinces and apps suggest a mature technological and health service infrastructure across Mainland China, where the widespread adoption of service delivery and offerings (such as payment, tracking, telemedicine, etc.) via mHealth apps show a step toward democratizing access to care across the country. The inter-provincial flow of patients to HCPs suggests poorer and resource-scarce areas are poised to benefit more while the burden on major cities can be ameliorated; We found regions that are traditionally underdeveloped and lacking in access to care had the most increase in services available. However, adequate technological infrastructure needs to be available and mobile technology widely adopted by patients and medical facilities.
Funding
None of the authors were paid by a company or other agency for the writing of this manuscript. This study was supported by the National High Level Hospital Clinical Research Funding grant awarded by the Chinese Academy of Medical Sciences to Wei Chen (grant nos.: 2022-PUMCH-B-0252 and 2022-PUMCH-C-069) for data analysis and interpretation.
Application analysis of 5G in the diagnosis of patients with congenital heart disease in Tibet, China
Authors: Jiang Honglei , Liang Li , Liu Biao 
Published: January 2024

Abstract
Objective
To explore the value of 5G in remote diagnosis of congenital heart disease in patients in Nagqu area of Tibet.
Methods
A retrospective analysis was performed for 51 patients with congenital heart disease who underwent 5G remote diagnosis in Nagqu area of Tibet, and the results of expert consultation, other imaging examinations (CT, MRI, etc.) and follow-up results were used as reference diagnostic criteria to evaluate the accuracy of 5G remote ultrasound diagnosis, and the images of physicians' operating experience on the examination duration were analyzed, and the differences in application experience between doctors and patients were evaluated.
Results
The duration of remote ultrasound examination in each patient was 10-27 min, with an average of (19.21±4.76) min, according to the reference standard, among the 51 cases, 46 cases were positive, 5 cases were negative, 41 cases were positive and 10 cases were negative in 5G, 46 cases were correctly diagnosed, and 5 cases were missed, including 1 case of ventricular septal defect subtrunk type, 2 cases of patent ductus arteriosus and 1 case of others, and the accuracy of the diagnosis of congenital heart disease was 90.19%, the sensitivity was 89.13%, and the specificity was 100% The missed diagnosis rate was 10.86%. All 51 cases were examined by the same physician when they had primary, intermediate and advanced experience, 20, 14 and 17 cases were examined, 3 cases, 1 case and 1 case were missed, and the examination duration was (20.71±3.32) min, (17.30±2.56) min and (14.11±3.01) min, respectively, and the overall comparison and the difference between the two comparisons were statistically significant (P<0.05）。Compared with traditional bedside ultrasound, the tension score of patients in 5G remote ultrasound examination was lower (P<0.05), but the latter's probe compression comfort and privacy protection satisfaction scores were higher (all P<0.05).
Conclusions
5G remote ultrasound examination can be used to quickly and real-time diagnose congenital heart disease in areas with scarce medical resources such as Nagqu, and the performance is better.
Needs assessment for enhancing the preparation of general practitioners enrolling in the Peruvian mandatory rural service: a cross-sectional study.
Authors: Flores-Cohaila Javier Alejandro , Copaja-Corzo Cesar , Miranda-Chavez Brayan , Rivarola-Hidalgo Marco 
Published: January 2024

Abstract
Background
Peru’s Rural and Marginal Urban Health Service (SERUMS) aims to improve healthcare in rural and marginal areas. Despite its objectives, a gap exists between training General Practitioners (GPs) and the competencies required for SERUMS. This study assesses GPs' self-perceived competencies and training needs for SERUMS.
Methods
A cross-sectional analytical study was conducted involving GPs who enrolled in SERUMS between 2020 and 2022. A questionnaire was developed based on the Ministry of Health's competency framework, assessing 21 minimal achievement conditions. The survey was distributed via Google Forms and included sections on sociodemographic information, SERUMS characteristics, self-perceived competencies, and training needs.
Results
Out of 190 GPs who participated, most were female, over 27 years old, and graduates from private universities with mixed-setting internships. The highest self-perceived competencies were in low-complexity problem management, communication, and professionalism. However, competencies in research, leadership, and health system management were rated lowest. The primary resource for training was self-study, with a preference for active learning methods for future training. Perceived training needs were in therapeutic competencies, the Peruvian health system, diagnostic competencies, administrative tasks, and interprofessional competencies.
Conclusions
This study reveals significant gaps in the training and competencies of Peruvian GPs for SERUMS. It emphasizes the need for a tailored curriculum incorporating active learning and focusing on clinical reasoning, leadership, and interprofessional competencies. This approach would better prepare GPs for SERUMS and enhance their self-efficacy and effectiveness in primary care. Leading to a better quality of care for these neglected populations.
WITHDRAWN: A non-small cell lung cancer patient experiencing venous thromboembolism during Osimertinib treatment, with disease recurrence and progression after therapy: a case report and literature review
Authors: zhou shuang , Liu Meihong , Wang Mingyu 
Published: January 2024

Abstract

Background:In advanced non-small cell lung cancer(NSCLC) with epidermal growth factor receptor (EGFR) gene mutations, the epidermal growth factor receptor-tyrosine kinase inhibitors (EGFR-TKIs) have significantly improved patient prognosis. The third-generation EGFR-TKI, Osimertinib, has become the standard first-line treatment. In recent years, some studies have suggested that Osimertinib may carry a higher risk of developing venous thromboembolism (VTE) in the real world. There have been some related cases of Osimertinib inducing thrombus formation, although the underlying mechanisms remain unclear.As one of the most critical complications of cancer, the occurrence mechanisms and treatment strategies for venous thromboembolism (VTE) have been widely paid attention. Tumor promotes thrombus formation through various pathways, while the body's hypercoagulable state facilitates the growth, metastasis, and invasion of tumor cells, impacting the treatment process for cancer patients, prolonging hospitalization, and potentially leading to the death of patients.
Case Description:We report a case of a NSCLC patient with exon 19 deletion mutation of EGFR gene who developed acute venous thromboembolism (VTE) during treatment with Osimertinib. After combined anticoagulant therapy, the patient showed improvement in the condition and resolution of the thrombus. However, upon discontinuation of anticoagulation and continued use of Osimertinib, there was recurrence of venous thromboembolism, increase in the size of the cancerous lesion, and eventual death. The patient had a progression-free survival(PFS) of 8 months after the onset of VTE and an overall survival(OS) of 10 months.To our knowledge, this is the first reported case of VTE recurrence in a patient continuing Osimertinib after receiving Osimertinib combined anticoagulant therapy.
Conclusions:In this case, after taking osimertinib for half a month, the NSCLC patient developed acute venous thromboembolism, and then experienced resolution of the thrombus and reduction in cancer size with Osimertinib combined with anticoagulant therapy. Considering relevant literature, Osimertinib might contribute to and accelerate the occurrence of VTE in cancer patients. Combined anticoagulant therapy may assist in controlling both the cancerous lesion and thrombotic conditions, extending the progression-free survival. However, the recurrence and progression of the condition upon discontinuation of anticoagulation and continued Osimertinib use suggest an interrelation between tumor cell growth, metastasis, and thrombus formation, impacting the therapeutic outcomes for cancer patients and even leading to patient mortality.
Study on the effect of mechanically ground ferrous extraction tailing of nickel slag on the properties of cement-based materials
Authors: Feng Qiong , Wei Chao , Qiao Hongxia , Song Yanning 
Published: January 2024

Abstract
In order to realize the full resource utilization of ferronickel slag (FNS) in cement-based materials, this paper studied the influence of mechanical grinding activation on the physical and chemical properties and reactivity of ferrous extraction tailing of nickel slag (FETNS). Four grinding processes of 5min, 10min, 20min and 30min were set up to evaluate the influence of grinding process on the physical and chemical properties of FETNS with the aid of BET, XRD, Rietveld analysis and particle size distribution. The cement-FETNS composite cementitious material was prepared by replacing cement with 0%, 10%, 15%, 20%, 25% and 30% FETNS. The influence of FETNS fineness and content on the properties of composite cementitious system were characterized by mechanical properties, reaction products, early hydration process and pore structure characteristics. The results show that the grinding process can effectively improve the pozzolanic activity of FETNS. The compressive strength of FETNS-M30 paste is higher than that of FETNS-M5 paste in the early and late stages, and the later strength is higher than that of the baseline group when the content of FETNS-M30 is 10%-25%. The pozzolanic activity of FNS-M30 powder was significantly improved and higher than that of FNS-M5 powder.Under the same content, the Ca/Si ratio of C-S-H gel in FETNS-M30 paste is small, and the degree of silicate polymerization is higher. When the FETNS-M30 content is 10%, the proportions of favorable pores d < 50nm ( harmless pores and less-harmful pores ) of FNS-M5 paste and FNS-M30 paste is 95.3% and 95.4%, respectively, indicating a denser pore structure of the FETNS-M30 paste.
Traditional Chinese Exercise for Rehabilitation from Coronary Heart Disease: A Systematic Review and Meta-Analysis
Authors: Xu NingYang , Zhang Shi , Zhang Fan , Liu Yue , Li Hang , Zhou ZiQi , Zhang Bin , Jin SiAn , Kong DeZhao , Han XiaoMeng , Zhao Yu , Li ZiWei , Wang JianHua , Liang LiZhe , Li GuoXin 
Published: January 2024

Abstract

Objectives: To assess the effects of Traditional Chinese exercises (TCEs) in patients undergoing rehabilitation from coronary heart disease (CHD).
Design: Systematic review and meta-analysis.
Data sources: PubMed, Embase, the Cochrane Library, Chinese National Knowledge Infrastructure, VIP Chinese Science and Technology Periodical Database, and Wan fang Database, were searched from the corresponding inception date to March 2022. Eligibility criteria for selecting studies: Randomized controlled trials involving TCEs alone or in combination with conventional therapy versus conventional therapy on CHD patients undergoing rehabilitation were included.
Data synthesis: Data analysis was performed with RevMan software version 5.2.0.
Main outcomes and measures: The primary outcomes were the Seattle Angina Questionnaire (SAQ) and self-rating depression scale (SDS), and the secondary outcomes were 36-Item Short Form Health Survey (SF-36), self-rating anxiety scale (SAS), left ventricular ejection fraction (LVEF), N-terminal pro-B type natriuretic peptide (NT-proBNP), six-min walking test (6-MWT), and peak oxygen uptake (peak VO2).
Results: 22 studies, including a total of 2100 patients, met the study criteria. When compared with conventional therapy alone: Baduanjin combined with conventional therapy improved the SAQ (physical limitation (n=360, MD=5.72 points, 95% CI (2.02, 9.41), p=0.002, I 2=94) ；angina frequency (n=360, MD=14.49 points, 95% CI (8.43, -20.55), p＜0.00001, I 2=96)), SF-36 (general health (n=425, MD = 9.77 points, 95% CI (8.21, 11.32), p＜0.00001, I 2=0); physical function (n=425, MD = 6.73 points, 95% CI (5.49, 7.97), p＜0.00001, I 2=6)), and 6-MWT (n=336, MD= 40.80 m, 95% CI (8.80, 72.80), p=0.01, I 2=99) of patients after percutaneous coronary intervention (PCI); Baduanjin combined with conventional therapy improved SAQ in patients suffering from stable angina pectoris (SAP) (physical limitation (n=110, MD = 4.13 points, 95% CI (0.38,7.88), p=0.03, I 2=0); angina frequency (n=410, MD=9.88 points, 95% CI (6.08,13.67), p<0.00001, I 2=27)). TaiChi combined with conventional therapy 2improved SF-36 in patients after PCI (general health (n=227, MD = 12.00 points, 95% CI (5.21, 18.80), p=0.0005, I 2=91%) ; physical function (n=227, MD = 12.46 points, 95% CI (7.67, 17.26), p＜0.00001, I 2=83%)).
Conclusions: Baduanjin combined with conventional therapy may improve the quality of life of patients with PCI and SAP, and the cardiopulmonary function of patients after PCI; TaiChi combined with conventional therapy may improve the quality of life of patients with PCI. However, due to the low quality of the included studies and high heterogeneity among different studies, we should take a cautious attitude towards this conclusion.
PROSPERO registration number: CRD 42022323676
Severe pneumonia increases the likelihood of neonatal necrotizing enterocolitis that necessitates surgical intervention
Authors: Lv Jilin , Zhang Yunhan , Feng Wei , Xiang Xiao , Guo Zhenhua 
Published: January 2024

Abstract

Background
Necrotizing enterocolitis is a primary factor contributing to neonatal mortality in neonatal intensive care units. Among them, those who require surgical treatment have a higher mortality rate.
Methods
A cohort of 174 children diagnosed with NEC 2a + stage between 2012 and 2022 underwent a retrospective study. The children were divided into two groups: a surgical group (89 individuals), and a medical treatment group (85 individuals). Data extraction from patient records is used to analyze biochemical and clinical variables.
Results
In comparison to the medicine treatment group, the operation group had a lower gestational age (212 (203, 223) days, as opposed to 216(209, 229) days, P = 0.023).The prevalence of severe pneumonia in the surgical group was greater compared to the non-surgical group (87% versus 66%, P = 0.001). The operation group exhibited a lower hemoglobin level (145.86 ± 38.25 VS 159.69 ± 37.46, P = 0.017), along with a reduced platelet level (194 (128, 250) VS 229 (181, 281), P = 0.003). Severe pneumonia (OR = 3.364, 95% CI:1.420–7.966), decreased hemoglobin (OR = 0.988, 95% CI 0.978–0.997), and reduced platelet count (OR = 0.995, 95%CI: 0.991–0.999) were identified as separate risk factors for NEC. The mortality rate of children with NEC was significantly higher when surgical intervention was performed, which was found to be a separate risk factor for their mortality (OR = 7.881, 95% CI :(2.671–23.254), P < 0.001).
Conclusion
Our study suggests that infants with extremely low birth weight who have severe pneumonia have a higher likelihood of developing severe NEC that necessitates surgical intervention. This correlation could be due to the existence of intestinal ischemia and injury caused by hypoxia.
Breast cancer patients participating in the Swiss mammography screening program "donna" exhibit extended survival
Authors: Kuklinski David , Blum Marcel , Subelack Jonas , Geissler Alexander , Eichenberger Alena , Morant Rudolf 
Published: January 2024

Abstract
Study goal: We compared the survival rates of women with breast cancer (BC) within vs. outside the mammography screening program (MSP) “donna”.
Methods: We merged data from the “donna” MSP with the data from corresponding cancer registries to categorize BC cases as within MSP (screen-detected and interval carcinomas) and outside the MSP. We analyzed the tumor stage distribution, tumor characteristics and the survival of the women. We further estimated hazard ratios using Cox-regressions to account for different characteristics between groups and corrected the survival rates for lead-time bias.
Results: We identified 1,057 invasive (ICD-10: C50) and in-situ (D05) BC cases within the MSP and 1,501 outside the MSP between 2010 and 2019 in the Swiss cantons of St. Gallen and Grisons. BC within the MSP had a higher share of stage I carcinoma (46.5% vs. 33.0%, p<0.01), fewer metastases at diagnosis (2.7% vs. 11.6%, p<0.01), and a smaller (mean) tumor size (19.1mm vs. 24.9mm, p<0.01). The 10-year survival rates were 92.2% for women within and 73.9% for women outside the MSP (p<0.05). A significant survival difference persisted when the same tumor stages were compared. Lead-time corrected hazard ratios were 0.391 (p<0.01) for overall survival and 0.293 (p<0.01) for BC related survival.
Conclusion: Women participating in the “donna” MSP had a significantly higher overall and BC related survival rate than women outside the program. Detection of BC at an earlier tumor stage only partially explains the observed differences.
Cytosolic N-terminal formyl-methionine deformylation derives cancer stem cell features and tumor progression
Authors: Hwang Cheol-Sang , Kim Dasom , Lee Jongeun , Seok Ok-Hee , Lee Yoontae 
Published: January 2024

Abstract
Eukaryotic cells can synthesize formyl-methionine (fMet)-containing proteins not only in mitochondria but also in the cytosol to some extent. Our previous study revealed substantial upregulation of N-terminal (Nt)-fMet-containing proteins in the cytosol of SW480 colorectal cancer cells. However, the functional and pathophysiological implications remain unclear. Here, we demonstrated that removal of the Nt-formyl moiety of Nt-fMet-containing proteins (via expressing Escherichia coli PDF peptide deformylase) resulted in a dramatic increase in the proliferation of SW480 colorectal cancer cells. Proliferation coincides with the acquisition of cancer stem cell features, including reduced cell size, enhanced self-renewal capacity, and elevated levels of the cancer stem cell surface marker CD24 and pluripotent transcription factor SOX2. Furthermore, deformylation of Nt-fMet-containing proteins promoted the tumorigenicity of SW480 colorectal cancer cells in an in vivo xenograft mouse model. Taken together, these findings suggest that cytosolic deformylation has a tumor-enhancing effect. This highlights its therapeutic potential for cancer treatment.