bluuebunny/crossref_metadata_2025_split huggingface dataset:
Diabetes mellitus and associated factors among HIV-positive patients at primary health care facilities in Harare, Zimbabwe: a descriptive cross-sectional study
Authors: Chireshe Rumbidzai , Manyangadze Tawanda , Naidoo Keshena 
Published: January 2024

Abstract
Background
Highly active antiretroviral therapy (HAART) has improved the life expectancy of people living with HIV (PLWH) and has increased the risk of chronic non-communicable diseases. Comorbid HIV and diabetes mellitus (DM) significantly increase cardiovascular disease and mortality risk. This study aimed to determine the prevalence of type 2 diabetes mellitus among HIV-positive patients receiving HAART in Zimbabwe and its associated risk factors.

Methods
This cross-sectional study was conducted at eight primary healthcare facilities in Harare, Zimbabwe, between January 2022 and March 2023. Non-probability convenience sampling was used to recruit adult HIV-positive patients undergoing HAART attending the facilities. Data were captured on clinical history and socio-demographic and behavioral characteristics, and analyzed using descriptive statistics to determine DM prevalence rates. Additionally, bivariate and multivariate logistic regression models were employed to examine factors associated with HIV and DM comorbidities.

Results
A total of 450 participants were included in this study, of which 57.6% (n = 259) were female. The majority were married (73.8%) and older than 35 years (80.2%). Most participants had completed high school (87.6%) and 68.9% were employed either formally or self-employed. The prevalence of diabetes mellitus (DM) was 14.9%. HIV/DM comorbidity was more prevalent in patients who were female, self-employed, and smoked (p < 0.05). Multivariate logistic regression analysis revealed that the factors associated with DM-HIV comorbidity were gender, age, education, marital status, employment status, smoking, physical activities, duration of HAART, and diet. Age, level of education, marital status, and occupation were not associated with HIV-DM comorbidity. Obesity (body mass index > 30 kg/m2), smoking, and alcohol consumption were associated with an increased risk of DM. Regular physical activity is associated with a reduced risk of DM.

Conclusion
A substantial burden of DM was found in PLWH. The intersectoral integration approach is advocated, and active screening for DM is recommended. Gender-specific interventions are necessary to target diseases and health behaviors that differ between men and women. These interventions should be customized to the specific diseases and behaviors of each group.
A volunteer-supported walking programme to improve physical function in older people with restricted mobility (the POWER Study): a randomised controlled trial
Authors: Grede Nina , Trampisch Ulrike , Weissbach Sabine , Heinzel-Gutenbrunner Monika , Freiberger Ellen , Sönnichsen Andreas , Donner-Banzhoff Norbert 
Published: January 2024

Abstract
Background
Regular physical activity has multiple health benefits, especially in older people. Therefore, the World Health Organization recommends at least 2.5 h of moderate physical activity per week. The aim of the POWER Study was to investigate whether volunteer-assisted walking improves the physical performance and health of older people.

Methods
We approached people aged 65 years and older with restricted mobility due to physical limitations and asked them to participate in this multicentre randomised controlled trial. The recruitment took place in nursing homes and the community setting. Participants randomly assigned to the intervention group were accompanied by volunteer companions for a 30–50 min walk up to three times a week for 6 months. Participants in the control group received two lectures that included health-related topics. The primary endpoint was physical function as measured with the Short Physical Performance Battery (SPPB) at baseline and 6 and 12 months. The secondary and safety endpoints were quality of life (EQ-5D-5L), fear of falling (Falls Efficacy Scale), cognitive executive function (the Clock Drawing Test), falls, hospitalisations and death.

Results
The sample comprised 224 participants (79% female). We failed to show superiority of the intervention with regard to physical function (SPPB) or other health outcomes in the intention-to-treat analyses. However, additional exploratory analyses suggest benefits in those who undertook regular walks. The intervention appears to be safe regarding falls.

Conclusions
Regular physical activity is essential to preserve function and to improve health and quality of life. Against the background of a smaller-than-planned sample size, resulting in low power, and the interference of the COVID-19 pandemic, we suggest that community based low-threshold interventions deserve further exploration.

Trial registration
The trial was registered with the German Clinical Trials Register (www.germanctr.de), with number DRKS00015188 on 31/08/2018.
First global report about the prevalence of multi-drug resistant Haemophilus influenzae: a systematic review and meta-analysis
Authors: Abavisani Mohammad , Keikha Masoud , Karbalaei Mohsen 
Published: January 2024

Abstract
Background
In recent decades, the prevalence of antibiotic resistance is increasing in Haemophilus influenzae (Haemophilus influenzae), which poses important challenges to global health. This research offers a comprehensive meta-analysis of the global epidemiology of multi-drug resistant (MDR) H. influenzae.

Methods
In this study, we conducted a meta-analysis based on PRISMA checklist. Electronic databases including PubMed, ISI Web of Science, Scopus, EMBASE, and Google Scholar were reviewed using keywords related to H. influenzae and antibiotic resistance. Eligible studies were selected based on stringent inclusion and exclusion criteria. Then, data from these studies were analyzed using the Comprehensive Meta-Analysis (CMA) software.

Results
Of 375 retrieved articles, 16 met the inclusion criteria. These studies were conducted from 2003 to 2023 and analyzed data from 19,787 clinical isolates of H. influenzae. The results showed different levels of resistance of H. influenzae to different antibiotics: ampicillin (36%), azithromycin (15.3%), ceftriaxone (1.4%), etc. The global prevalence for beta-lactamases producing H. influenzae and MDR H. influenzae was measured 34.9% and 23.1%, respectively. The prevalence rate of MDR H. influenzae was higher in Asian countries (24.6%) compared to Western regions (15.7%). MDR H. influenzae had the highest prevalence in meningitis cases (46.9%) and the lowest prevalence in acute otitis media (0.5%).

Conclusions
The prevalence of MDR H. influenzae has been increasing worldwide, especially in Asian regions. This highlights the urgent need for monitoring and implementation of effective antibiotic stewardship programs globally.
Poor nutritional status is associated with the severity of omicron infection in the older adults
Authors: Gu Xiaohan , Guo Yongchao , Shi Yongmei , Lu Yaxiong , Yang Shihan , Jiang Yongmei , Jin Qianwen , Li Qing Yun 
Published: January 2024

Abstract
Background
The Omicron wave of Coronavirus disease 2019 (COVID-19) remains the dominant strain worldwide. The studies of nutritional status in geriatric people with COVID-19 Omicron variant are limited. Thus, the aim of this study was to investigate the incidence of poor nutritional status among Omicron infected older patients, and to explore the correlation between the nutritional status and the severity of Omicron infection in older patients.

Methods
This is a retrospective cross-sectional study. According to the clinical symptoms, patients were divided into two groups: mild and moderate to severe. Mini Nutritional Assessment short-form (MNA-SF) was conducted when patients were admitted and poor nutritional status was defined as MNA-SF score of 0–11. The inflammatory markers including neutrophil lymphocyte ratio (NLR), platelet lymphocyte ratio (PLR) and systemic inflammatory index (SII) were calculated and compared between two groups.

Results
Total of 324 patients were enrolled, with median [interquartile range (IQR)] age of 73 (17) years. Overall, 241 cases were mild, 83 cases were moderate to severe at the time of diagnosis and that 54.3% of patients had poor nutritional status. Patients with poor nutritional status were found to be older (P < 0.001) and less vaccinated (P < 0.001), with a longer virus shedding duration (P = 0.022), more comorbidities (≥ 2) (P = 0.004) and higher value of NLR (P < 0.001), PLR (P < 0.001) and SII (P = 0.012). Vaccination, cycle threshold value in ORF1ab gene (OR CT value) and female, higher MNA-SF score was negatively connected with probability of moderate to severe infection. For every 1 score increase in MNA-SF, the odds ratio of moderate to severe infection decreased by 14.8% [adjusted odds ratio (aOR), 0.852; 95% confidence interval (CI): 0.734–0.988; P = 0.034].

Conclusions
Older patients with poor nutritional status are more likely to develop moderate to severe Omicron infection.
Early to mid-pregnancy HbA1c levels and its association with adverse pregnancy outcomes in three low middle-income countries in Asia and Sub-Saharan Africa
Authors: Nisar Muhammad Imran , das Sayan , Khanam Rasheda , Khalid Javairia , Chetia Swagata , Hasan Tarik , Shahid Shahira , Marijani Msafiri Ladislaus , Ahmed Salahuddin , Khalid Farah , Ali Said Mohammed , Chowdhury Nabidul Haque , Mehmood Usma , Dutta Arup , Rahman Sayedur , Qazi Muhammad Farrukh , Deb Saikat , Mitra Dipak Kumar , Usmani Asra Abeer , Dhingra Usha , Raqib Rubhana , Manu Alexander , Yoshida Sachiyo , Minckas Nicole , Bahl Rajiv , Baqui Abdullah H. , Sazawal Sunil , Jehan Fyezah 
Published: January 2024

Abstract
Background
Hyperglycemia during pregnancy leads to adverse maternal and fetal outcomes. Thus, strict monitoring of blood glucose levels is warranted. This study aims to determine the association of early to mid-pregnancy HbA1c levels with the development of pregnancy complications in women from three countries in South Asia and Sub-Saharan Africa.

Methods
We performed a secondary analysis of the AMANHI (Alliance for Maternal and Newborn Health Improvement) cohort, which enrolled 10,001 pregnant women between May 2014 and June 2018 across Sylhet-Bangladesh, Karachi-Pakistan, and Pemba Island-Tanzania. HbA1c assays were performed at enrollment (8 to < 20 gestational weeks), and epidemiological data were collected during 2–3 monthly household visits. The women were followed-up till the postpartum period to determine the pregnancy outcomes. Multivariable logistic regression models assessed the association between elevated HbA1c levels and adverse events while controlling for potential confounders.

Results
A total of 9,510 pregnant women were included in the analysis. The mean HbA1c level at enrollment was found to be the highest in Bangladesh (5.31 ± 0.37), followed by Tanzania (5.22 ± 0.49) and then Pakistan (5.07 ± 0.58). We report 339 stillbirths and 9,039 live births. Among the live births were 892 preterm births, 892 deliveries via cesarean section, and 532 LGA babies. In the multivariate pooled analysis, maternal HbA1c levels of ≥ 6.5 were associated with increased risks of stillbirths (aRR = 6.3, 95% CI = 3.4,11.6); preterm births (aRR = 3.5, 95% CI = 1.8–6.7); and Large for Gestational Age (aRR = 5.5, 95% CI = 2.9–10.6).

Conclusion
Maternal HbA1c level is an independent risk factor for predicting adverse pregnancy outcomes such as stillbirth, preterm birth, and LGA among women in South Asia and Sub-Saharan Africa. These groups may benefit from early interventional strategies.
Maternal plasma cortisol’s effect on offspring birth weight: a Mendelian Randomisation study
Authors: Thompson WD , Reynolds RM , Beaumont RN , Warrington NM , Tyrrell J , Wood AR , Evans DM , McDonald TJ , Hattersley AH , Freathy RM , Lawlor DA , Borges MC 
Published: January 2024

Abstract
Background
Observational studies and randomized controlled trials have found evidence that higher maternal circulating cortisol levels in pregnancy are associated with lower offspring birth weight. However, it is possible that the observational associations are due to residual confounding.

Methods
We performed two-sample Mendelian Randomisation (MR) using a single genetic variant (rs9989237) associated with morning plasma cortisol (GWAS; sample 1; N = 25,314). The association between this maternal genetic variant and offspring birth weight, adjusted for fetal genotype, was obtained from the published EGG Consortium and UK Biobank meta-analysis (GWAS; sample 2; N = up to 406,063) and a Wald ratio was used to estimate the causal effect. We also performed an alternative analysis using all GWAS reported cortisol variants that takes account of linkage disequilibrium. We also tested the genetic variant’s effect on pregnancy cortisol and performed PheWas to search for potential pleiotropic effects.

Results
The estimated effect of maternal circulating cortisol on birth weight was a 50 gram (95% CI, -109 to 10) lower birth weight per 1 SD higher log-transformed maternal circulating cortisol levels, using a single variant. The alternative analysis gave similar results (-33 grams (95% CI, -77 to 11)). The effect of the cortisol variant on pregnancy cortisol was 2-fold weaker than in the original GWAS, and evidence was found of pleiotropy.

Conclusions
Our findings provide some evidence that higher maternal morning plasma cortisol causes lower birth weight. Identification of more independent genetic instruments for morning plasma cortisol are necessary to explore the potential bias identified.
Prophylactic pectoralis major flap to compensate for increased risk of pharyngocutaneous fistula in laryngectomy patients with low skeletal muscle mass (PECTORALIS): study protocol for a randomized controlled trial
Authors: van Beers Maartje A. , Speksnijder Caroline M. , van Gils Carla H. , Frederix Geert W.J. , Dankbaar Jan Willem , de Bree Remco 
Published: January 2024

Abstract
Background
Total laryngectomy (TL) is a surgical procedure commonly performed on patients with advanced laryngeal or hypopharyngeal carcinoma. One of the most common postoperative complications following TL is the development of a pharyngocutaneous fistula (PCF), characterized by a communication between the neopharynx and the skin. PCF can lead to extended hospital stays, delayed oral feeding, and compromised quality of life. The use of a myofascial pectoralis major flap (PMMF) as an onlay technique during pharyngeal closure has shown potential in reducing PCF rates in high risk patients for development of PCF such as patients undergoing TL after chemoradiation and low skeletal muscle mass (SMM). Its impact on various functional outcomes, such as shoulder and neck function, swallowing function, and voice quality, remains less explored. This study aims to investigate the effectiveness of PMMF in reducing PCF rates in patients with low SMM and its potential consequences on patient well-being.

Methods
This multicenter study adopts a randomized clinical trial (RCT) design and is funded by the Dutch Cancer Society. Eligible patients for TL, aged ≥ 18 years, mentally competent, and proficient in Dutch, will be enrolled. One hundred and twenty eight patients with low SMM will be centrally randomized to receive TL with or without PMMF, while those without low SMM will undergo standard TL. Primary outcome measurement involves assessing PCF rates within 30 days post-TL. Secondary objectives include evaluating quality of life, shoulder and neck function, swallowing function, and voice quality using standardized questionnaires and functional tests. Data will be collected through electronic patient records.

Discussion
This study’s significance lies in its exploration of the potential benefits of using PMMF as an onlay technique during pharyngeal closure to reduce PCF rates in TL patients with low SMM. By assessing various functional outcomes, the study aims to provide a comprehensive understanding of the impact of PMMF deployment. The anticipated results will contribute valuable insights into optimizing surgical techniques to enhance patient outcomes and inform future treatment strategies for TL patients.

Trial registration
NL8605, registered on 11-05-2020; International Clinical Trials Registry Platform (ICTRP).
A phase Ib/II randomized, open-label drug repurposing trial of glutamate signaling inhibitors in combination with chemoradiotherapy in patients with newly diagnosed glioblastoma: the GLUGLIO trial protocol
Authors: Mastall Maximilian , Roth Patrick , Bink Andrea , Fischer Maranta Angela , Läubli Heinz , Hottinger Andreas Felix , Hundsberger Thomas , Migliorini Denis , Ochsenbein Adrian , Seystahl Katharina , Imbach Lukas , Hortobagyi Tibor , Held Leonhard , Weller Michael , Wirsching Hans-Georg 
Published: January 2024

Abstract
Background
Glioblastoma is the most common and most aggressive malignant primary brain tumor in adults. Glioblastoma cells synthesize and secrete large quantities of the excitatory neurotransmitter glutamate, driving epilepsy, neuronal death, tumor growth and invasion. Moreover, neuronal networks interconnect with glioblastoma cell networks through glutamatergic neuroglial synapses, activation of which induces oncogenic calcium oscillations that are propagated via gap junctions between tumor cells. The primary objective of this study is to explore the efficacy of brain-penetrating anti-glutamatergic drugs to standard chemoradiotherapy in patients with glioblastoma.

Methods/design
GLUGLIO is a 1:1 randomized phase Ib/II, parallel-group, open-label, multicenter trial of gabapentin, sulfasalazine, memantine and chemoradiotherapy (Arm A) versus chemoradiotherapy alone (Arm B) in patients with newly diagnosed glioblastoma. Planned accrual is 120 patients. The primary endpoint is progression-free survival at 6 months. Secondary endpoints include overall and seizure-free survival, quality of life of patients and caregivers, symptom burden and cognitive functioning. Glutamate levels will be assessed longitudinally by magnetic resonance spectroscopy. Other outcomes of interest include imaging response rate, neuronal hyperexcitability determined by longitudinal electroencephalography, Karnofsky performance status as a global measure of overall performance, anticonvulsant drug use and steroid use. Tumor tissue and blood will be collected for translational research. Subgroup survival analyses by baseline parameters include segregation by age, extent of resection, Karnofsky performance status, O6-methylguanine DNA methyltransferase (MGMT) promotor methylation status, steroid intake, presence or absence of seizures, tumor volume and glutamate levels determined by MR spectroscopy. The trial is currently recruiting in seven centers in Switzerland.

Trial registration
NCT05664464. Registered 23 December 2022.
Lnc-PSMA8-1 activated by GEFT promotes rhabdomyosarcoma progression via upregulation of mTOR expression by sponging miR-144-3p
Authors: Meng Lian , Shang Hao , Liu Qianqian , Li Zhenzhen , Wang Xiaomeng , Li Qianru , Li Feng , Zhao Zhenguo , Liu Chunxia 
Published: January 2024

Abstract
Background
GEFT is a key regulator of tumorigenesis in rhabdomyosarcoma (RMS), and overexpression of GEFT is significantly correlated with distant metastasis, lymph node metastasis, and a poor prognosis, yet the underlying molecular mechanism is still poorly understood. This study aimed to investigate and validate the molecular mechanism of GEFT-activated lncRNAs in regulating mTOR expression to promote the progression of RMS.

Methods
GEFT-regulated lncRNAs were identified through microarray analysis. The effects of GEFT-regulated lncRNAs on the proliferation, apoptosis, invasion, and migration of RMS cells were confirmed through cell functional experiments. The target miRNAs of GEFT-activated lncRNAs in the regulation of mTOR expression were predicted by bioinformatics analysis combined with quantitative real-time polymerase chain reaction (qRT–PCR) analysis. The expression of lnc-PSMA8-1, miR-144-3p, and mTOR was measured by qRT–PCR in RMS tissue samples and cell lines. The regulatory mechanisms of the lnc-PSMA8-1-miR-144-3p-mTOR signaling axis were verified by RNA-binding protein immunoprecipitation (RIP), a luciferase reporter assay, qRT–PCR analysis, Western blot analysis, and cell functional experiments.

Results
The microarray-based analysis identified 31 differentially expressed lncRNAs (fold change > 2.0, P < 0.05). Silencing the 4 upregulated lncRNAs (lnc-CEACAM19-1, lnc-VWCE-2, lnc-GPX7-1, and lnc-PSMA8-1) and overexpressing the downregulated lnc-FAM59A-1 inhibited the proliferation, invasion, and migration and induced the apoptosis of RMS cells. Among the factors analyzed, the expression of lnc-PSMA8-1, miR-144-3p, and mTOR in RMS tissue samples and cells was consistent with the correlations among their expression indicated by the lncRNA–miRNA–mRNA regulatory network based on the ceRNA hypothesis. lnc-PSMA8-1 promoted RMS progression by competitively binding to miR-144-3p to regulate mTOR expression.

Conclusion
Our research demonstrated that lnc-PSMA8-1 was activated by GEFT and that the former positively regulated mTOR expression by sponging miR-144-3p to promote the progression of RMS. Therefore, targeting this network may constitute a potential therapeutic approach for the management of RMS.