bluuebunny/crossref_metadata_2025_split huggingface dataset:
Mediating role of food insecurity in the relationship between perceived MSM related stigma and depressive symptoms among men who have sex with men in Nepal
Authors: Paudel Kiran , Bhandari Prashamsa , Gautam Kamal , Wickersham Jeffrey A. , Ha Toan , Banik Swagata , Shrestha Roman 
Published: January 2024

Background
Previous studies have indicated the association between stigma and depressive symptoms among frequently stigmatized groups, such as men who have sex with men (MSM). While this association has been suggested in the literature, there is a dearth of evidence that examines whether food insecurity statistically mediates the relationship between stigma and depressive symptoms.

Methods
This cross-sectional study conducted between October and December 2022 among a sample of 250 MSM in Kathmandu, Nepal, recruited through respondent-driven sampling. An unadjusted model including the exposure (stigma), mediator (food insecurity), and outcome variables (depressive symptoms) and an adjusted model that controlled for sociodemographic, behavioral, and health-related confounders were used. Bootstrapping was utilized to estimate the coefficients of these effects and the corresponding 95% confidence intervals. Via bootstrap approach, we find out the mediating role of food insecurity in the association between stigma and depressive symptoms.

Results
Depressive symptoms, stigma, and food insecurity were 19.6%, 24.4%, and 29.2%, respectively, among MSM. Food insecurity was associated with higher age (b = 0.094; 95% CI = 0.039, 0.150) and monthly income (b = -1.806; 95% CI = -2.622, -0.985). Depressive symptoms were associated with condom-less sex in past six months (b = -1.638; 95% CI = -3.041, -0.092). Stigma was associated with higher age (b = 0.196; 95% CI = 0.084, 0.323) and PrEP uptake (b = 2.905; 95% CI = 0.659. 5.248). Food insecurity statistically mediated 20.6% of the indirect effect of stigma in depressive symptoms.

Conclusion
Our findings show that food insecurity affects the relationship between stigma and depressive symptoms in this population. Reducing food insecurity and addressing the stigma surrounding sexual orientation should be a priority when addressing mental health concerns among MSM in Nepal and other resource-limited countries with similar socio-cultural settings.
Isoniazid preventive therapy completion between July-September 2019: A comparison across HIV differentiated service delivery models in Uganda
Authors: Mugenyi Levicatus , Namuwenge Proscovia Mukonzo , Ouma Simple , Bakashaba Baker , Nanfuka Mastula , Zech Jennifer , Agaba Collins , Mijumbi Ojok Andrew , Kaliba Fedress , Bossa Kato John , Opito Ronald , Miya Yunus , Katureebe Cordelia , Hirsch-Moverman Yael 
Published: January 2024

Background
Tuberculosis (TB) remains the leading cause of death among people living with HIV (PLHIV). To prevent TB among PLHIV, the Ugandan national guidelines recommend Isoniazid Preventive Therapy (IPT) across differentiated service delivery (DSD) models, an effective way of delivering ART. DSD models include Community Drug Distribution Point (CDDP), Community Client-led ART Delivery (CCLAD), Facility-Based Individual Management (FBIM), Facility-Based Group (FBG), and Fast Track Drug Refill (FTDR). Little is known about the impact of delivering IPT through DSD.

Methods
We reviewed medical records of PLHIV who initiated IPT between June-September 2019 at TASO Soroti (TS), Katakwi Hospital (KH) and Soroti Regional Referral Hospital (SRRH). We defined IPT completion as completing a course of isoniazid within 6–9 months. We utilized a modified Poisson regression to compare IPT completion across DSD models and determine factors associated with IPT completion in each DSD model.

Results
Data from 2968 PLHIV were reviewed (SRRH: 50.2%, TS: 25.8%, KH: 24.0%); females: 60.7%; first-line ART: 91.7%; and Integrase Strand Transfer Inhibitor (INSTI)-based regimen: 61.9%. At IPT initiation, the median age and duration on ART were 41.5 (interquartile range [IQR]; 32.3–50.2) and 6.0 (IQR: 3.7–8.6) years, respectively. IPT completion overall was 92.8% (95%CI: 91.8–93.7%); highest in CDDP (98.1%, 95%CI: 95.0–99.3%) and lowest in FBG (85.8%, 95%CI: 79.0–90.7%). Compared to FBIM, IPT completion was significantly higher in CDDP (adjusted rate ratio [aRR] = 1.15, 95%CI: 1.09–1.22) and CCLAD (aRR = 1.09, 95% CI 1.02–1.16). In facility-based models, IPT completion differed between sites (p<0.001). IPT completion increased with age for FBIM and CCLAD and was lower among female participants in the CCLAD (aRR = 0.82, 95%CI 0.67–0.97).

Conclusion
IPT completion was high overall but highest in community-based models. Our findings provide evidence that supports integration of IPT within DSD models for ART delivery in Uganda and similar settings.
Factors related to quality of life in community-dwelling adults in Sleman Regency, Special Region of Yogyakarta, Indonesia: Results from a cross-sectional study
Authors: Kusumaningrum Fitrina Mahardani , Dewi Fatwa Sari Tetra , Santosa Ailiana , Pangastuti Heny Suseani , Yeung Polly 
Published: January 2024

Background
Quality of life studies in low- and middle-income countries have demonstrated the influence of socioeconomic factors on the quality of life (QoL). However, further studies are required to confirm this association in developing countries with rapidly ageing populations. Using Ferrans et al.’s QoL model, this study aimed to identify the factors associated with the QoL of community-dwelling adults in Indonesia.

Methods
A cross-sectional study among 546 community-dwelling adults aged 50+ years was conducted in Yogyakarta, Indonesia, in 2018. QoL was measured using the Short Form 12 questionnaire, which consists of a summary of physical and mental health. We performed stepwise logistic regression analyses to determine odds ratios (ORs) with 95% confidence intervals (CIs) and examined the association between the QoL (physical and mental health) and demographic characteristics, socioeconomic status, financial management behaviour, multimorbidity status, nutritional status, cognitive impairment status, depression status, and independence. Statistical significance was set at p<0.05.

Results
Among the respondents, 15% reported poor physical health, and 9.2% reported poor mental health. Good physical health was significantly associated with the absence of chronic disease (OR 2.39; 95% CI: 1.07–5.33), independence in activities of daily living (OR 3.90; 95% CI 1.57–9.67) and instrumental activities of daily living (OR 4.34; 95% CI 2.28–8.26). Absence of depression was significantly associated with good mental health (OR 2.80; 95% CI 1.3–5.96).

Conclusion
The QoL of community-dwelling adults in Indonesia is associated with activities of daily living and instrumental activities of daily living, as well as the absence of chronic disease and depression. Efforts should be made to prevent chronic disease and delay functional decline through healthy lifestyles and routine physical and mental health screenings.
Effects of physical exercise on executive functions of individuals with schizophrenia spectrum disorders: Protocol for a systematic review and meta-analysis
Authors: Pérez-Romero Nuria , Campos-Jara Christian , Pesce Caterina , Araya Sierralta Sergio , Cerda-Vega Enrique , Ramirez-Campillo Rodrigo , Campos-Jara Rodrigo , Martínez-Salazar Cristian , Arellano-Roco Cristián , Contreras-Osorio Falonn 
Published: January 2024

Introduction
Executive functions are commonly impaired in individuals with schizophrenia spectrum disorders. Physical exercise has the potential for improving executive functions and can be easily implemented as a therapeutic method. However, there are only few systematic reviews of exercise effects in schizophrenia including cognitive outcomes, and no meta-analytical syntheses of effects on “cool” and “hot” executive functions. The purpose of this systematic review and meta-analysis will be to determine the effects of physical exercise on “cool” and “hot” executive functions of adults with schizophrenia spectrum disorders.

Methods and analysis
This protocol was guided by PRISMA-P guidelines. Studies will be searched using combinations of keywords and medical terms in the Web of Science, PubMed, Scopus, and EBSCO databases. Inclusion criteria will be determined as per PICOS approach. The risk of bias will be assessed using the Cochrane RoB2 tool. The certainty of evidence (per outcome) will be assessed using the GRADE method. The meta-analyses will be performed using the DerSimonian and Laird random effects model. Effect sizes (Hedges’ g) with 95% confidence intervals will be calculated for each main outcome.

Conclusions
The results of this review may be useful for mental health professionals to design treatment plans for adults with schizophrenia spectrum disorders, offering potential benefits related to the quality of life and cognitive abilities of this population.

PROSPERO registration number
CRD42023392295.
Factors influencing the uptake of a mono-PrEP implant for the prevention of HIV: Males’ perspectives from three South African provinces
Authors: Mthimkhulu Nqaba , Chidumwa Glory , Kutywayo Alison , Mataboge Paballo , Martin Catherine E. , Kwatsha Khanyiswa , Makalela Nthabiseng , Mazibuko Mbali , Butler Vusile , Mullick Saiqa 
Published: January 2024

Introduction
Oral pre-exposure prophylaxis (PrEP) is an effective HIV prevention method; however, males over 15 years face challenges with its effective use. Long-acting prevention products could address barriers to effective PrEP use. This study aimed to estimate the potential uptake of a mono-PrEP implant and the factors influencing uptake among males in South Africa. The study also examined messaging and demand creation tactics that males perceive will improve HIV prevention uptake.

Methods
We conducted a mixed methods study comprising participatory workshops and a self-administered survey among 142 PrEP-eligible males (18–40 years) in three provinces (Gauteng, Eastern Cape, and Kwa-Zulu Natal) in South Africa from July to November 2022. Logistic regression was used to assess the relationship between the potential uptake of a hypothetical, non-biodegradable mono-PrEP implant and socioeconomic and behavioural factors. Workshop data were analysed using content analysis.

Results
The top three HIV prevention products that males would consider using were the monthly pill (74.6%), the mono-PrEP implant (62.7%), and event-driven oral PrEP (59.2%). If one prevention option was available, 31.7% of participants stated that they would use the monthly oral pill, 28.2% would use the six-monthly injection, and 19.7% the mono-PrEP implant. Four key themes were noted as influential to potential mono-PrEP uptake: “Health Over Everything”, “Mono-PrEP Implant Concerns”, “Potential Disclosure of Mono-PrEP Use”, and “Information Distribution Channels”. Participants preferred social and mainstream media as information distribution channels to receive information on HIV prevention services, including the mono-PrEP implant.

Conclusion
In this study among predominantly heterosexual men in South Africa, there was interest in long-acting HIV prevention methods but concerns about the mono-PrEP implant. A comprehensive and participatory introduction will be needed for the implant, to improve acceptability and address potential concerns. Demand-creation strategies utilising social media and health campaigns should be considered to engage and reach males.
Serum level of full-length connective tissue growth factor reflects liver fibrosis stage in patients with Fontan-associated liver disease
Authors: Kogiso Tomomi , Takayanagi Kayo , Ishizuka Tsutomu , Otsuka Motoyuki , Inai Kei , Ogasawara Yuri , Horiuchi Kentaro , Taniai Makiko , Tokushige Katsutoshi 
Published: January 2024

Background
Chronic liver disease leads to liver fibrosis, and an accurate diagnosis of the fibrosis stage is crucial for medical management. Connective tissue growth factor (CTGF) is produced by endothelial cells and platelets and plays a central role in inducing fibrosis in various organs. In the present study, we tested the validity of measuring the serum levels of two types of CTGF to estimate the biopsy-confirmed liver fibrosis stage.

Methods
We used two detection antibodies targeting the N- and C-terminal of CTGF to measure the serum levels of two forms of CTGF consisting of its full length and its N-terminal fragment. We analyzed the level of CTGF (via enzyme-linked immunosorbent assay) and the liver fibrosis stage in 38 patients with Fontan-associated liver disease (FALD) (26 cases of which were diagnosed pathologically). Correlations were determined by multivariate analysis and the area under the receiver operating characteristic curve. The 65 patients with nonalcoholic fatty liver disease (NAFLD) were included as a disease control group for examination.

Results
Full-length CTGF was significantly inversely correlated with liver fibrosis in patients with FALD. Although the platelet count was also associated with the liver fibrosis stage, full-length CTGF was more closely correlated with the fibrosis stage. Furthermore, the level of full-length CTGF was inversely associated with high central venous pressure. Conversely, the serum level of CTGF was not correlated with the fibrosis stage in NAFLD.

Conclusion
The serum level of full-length CTGF may be useful for estimating the liver fibrosis stage in patients with FALD.
Predicting invasive mechanical ventilation in COVID 19 patients: A validation study
Authors: Statlender Liran , Shvartser Leonid , Teppler Shmuel , Bendavid Itai , Kushinir Shiri , Azullay Roy , Singer Pierre 
Published: January 2024

Introduction
The decision to intubate and ventilate a patient is mainly clinical. Both delaying intubation (when needed) and unnecessarily invasively ventilating (when it can be avoided) are harmful. We recently developed an algorithm predicting respiratory failure and invasive mechanical ventilation in COVID-19 patients. This is an internal validation study of this model, which also suggests a categorized “time-weighted” model.

Methods
We used a dataset of COVID-19 patients who were admitted to Rabin Medical Center after the algorithm was developed. We evaluated model performance in predicting ventilation, regarding the actual endpoint of each patient. We further categorized each patient into one of four categories, based on the strength of the prediction of ventilation over time. We evaluated this categorized model performance regarding the actual endpoint of each patient.

Results
881 patients were included in the study; 96 of them were ventilated. AUC of the original algorithm is 0.87–0.94. The AUC of the categorized model is 0.95.

Conclusions
A minor degradation in the algorithm accuracy was noted in the internal validation, however, its accuracy remained high. The categorized model allows accurate prediction over time, with very high negative predictive value.
Alpha-1 antitrypsin deficiency and pregnancy complications and birth outcomes: A population-based cohort study in Denmark
Authors: Orimoloye Helen T. , He Di , Li Tong , Janzen Carla , Barjaktarevic Igor , Wang Xuexia , Hansen Johnni , Heck Julia E. 
Published: January 2024

Background
Alpha-1 antitrypsin deficiency (AATD) is related to developing lung and liver disease, but no large-scale studies examine its association with birth outcomes.

Objective
We investigated the risk of pregnancy complications and adverse birth outcomes in mothers and children with AATD.

Methods
Using a large cohort data of Danish mothers and children with AATD from 1973 to 2013 (n = 2,027,229), with 559 cases (305 mothers and 254 children). We conducted Poisson regression to examine associations between alpha-1 antitrypsin deficiency, adverse birth outcomes, and pregnancy complications in mothers and children.

Results
AATD was related to term low birth weight [<2500g; Risk Ratio(RR) = 2.04, 95% confidence interval (CI): 1.50–2.79], lowest quartile of abdominal circumference at birth in children of non-smoking mothers (RR = 1.55, 95% CI: 1.14–2.11), delivery via Cesarean-section (RR = 1.59, 95% CI: 1.05–2.40), preterm birth (RR = 1.54, 95% CI: 1.19–2.00) and preeclampsia (RR = 2.64, 95% CI: 1.76–3.94).

Conclusions
This emphasizes the need for mothers with AATD to be monitored closely during pregnancy to reduce the risk of adverse birth outcomes. Routine screening for alpha-1 antitrypsin in pregnancy may be considered among mothers with a pulmonary and liver disease history.
Efficacy of preoperative lymphoscintigraphy in predicting surgical outcomes of lymphaticovenous anastomosis in lower extremity lymphedema: Clinical correlations in gynecological cancer-related lymphedema
Authors: Yoo Min Young , Woo Kyong-Je , Kang Seo Young , Moon Byung Seok , Kim Bom Sahn , Yoon Hai-Jeon 
Published: January 2024

Background
Lymphaticovenous anastomosis (LVA) is a promising microsurgical treatment for lower extremity lymphedema (LEL). Lymphoscintigraphy effectively assesses lower limb lymphatic systems before LVA, but its role in predicting the therapeutic outcomes of LVA is indeterminate. In this study we investigate the efficacy of preoperative lymphoscintigraphy using clinical findings to predict outcomes in gynecological cancer-related LEL patients who underwent LVA.

Methods
A retrospective review was conducted on consecutive gynecological cancer patients with LEL who had undergone LVA between June 2018 and June 2021. The therapeutic efficacy was assessed by measuring the change rate of the lower extremity lymphedema index (LELi) six months after surgery. Clinical data and lymphoscintigraphic findings were analyzed to assess therapeutic efficacy of LVA.

Results
Out of the 60 evaluated legs, 83.3% of the legs showed improved results after LVA. Univariable linear regression analysis revealed that higher preoperative LELi, and ovarian cancer were associated with superior LELi change rate (LC rate). Absence of dermal backflow (DBF) on lymphoscintigraphy was associated with inferior LC rate. Multivariable linear regression analysis identified ovarian cancer and higher preoperative LELi were independently correlated with favorable outcomes, while the absence of DBF was independently correlated with inferior outcomes.

Conclusion
The results of this study emphasizes the effectiveness of preoperative lymphoscintigraphy, preoperative LELi, and primary malignancy as predictors of LVA outcomes in gynecological cancer-related LEL patients.
Analysis of serum vitamin C and nitric oxide in children with septic shock
Authors: Yunarto Yuliana , Ratih Dewi , Wistiani Wistiani 
Published: January 2024

Background Imbalance of oxidants and antioxidants contributes to the sepsis process. Nitric oxide (NO) is an oxidant produced abundantly during sepsis and plays key role in the pathogenesis of hypotension in septic shock. Vitamin C functions as a potent antioxidant to scavenge free radicals, reduce endothelial permeability, cellular apoptosis, and endogenous vasopressor synthesis cofactor. Vitamin C prevents excessive production of NO by suppressing inducible nitric oxide synthase (iNOS) expression.
Objective To analyze for a possible correlation between serum vitamin C and NO levels in children with septic shock.
Methods This cross-sectional study was conducted in Dr. Kariadi Hospital, Semarang, Central Java, Indonesia. A total of 40 children with septic shock aged 1 month - 18 years were consecutively recruited. Serum vitamin C and serum NO levels were measured using colorimetric assay kits.
Results Of 40 children with septic shock, 21 (52.5%) were male, 21 (52.5%) were undernourished, 25 (62.5%) were on mechanical ventilators, and 10 (25%) required more than one vasoactive agent. Blood gas analysis revealed acidosis in 31 (77.5%) children. Subjects’ median age was 20 months (2-214 months). Mean serum vitamin C level was 7.35 (SD 2.723) µg/mL and mean serum NO was 47.25 (SD 19.278) µmol/L. There was no significant correlation between serum vitamin C levels and serum NO in children with septic shock (r=0.056; P=0.732).
Conclusion Serum vitamin C levels and serum NO has no correlation in children with septic shock.
Zinc supplementation in preterm infants and growth indicators in a developing country
Authors: Kaban Risma Kerina , Azis Henri , Prawitasari Titis , Kautsar Ahmad , Lusyati Setya Dewi , Insani Nadia Dwi 
Published: January 2024

Background Zinc is one of the micronutrients that is found deficient in preterm infants. To date, no parenteral zinc supplements are available in Indonesia and there is no recommendation established for routine zinc supplementation in preterm infants.
Objective To evaluate the impact of zinc supplementation on growth indicators and morbidity in preterm infants.
Methods This double-blind, randomized controlled trial included preterm infants aged 28-32 weeks who were assigned to one of two groups: the first group received a 10 mg zinc supplementation, while the second (control) group received a placebo. At discharge or at a maximum of 40 weeks post-menstrual age (PMA, calculated from the first day of the mother's last menstrual period), the following were evaluated : growth indicators (weight, length, and head circumference), serum zinc level, zinc supplementation side effects, and morbidity rate (intraventricular hemorrhage/IVH, necrotizing enterocolitis/NEC, btonchopulmonary dysplasia/BPD). Data were analyzed with independent T-test using SPSS version 22 software.
Results Seventy-eight subjects were assigned to the zinc supplementation group and 76 subjects were assigned to the placebo group. Serum zinc level and mean body weight increment were significantly higher in the zinc group compared to the placebo group (P=0.00 and P=0.02, respectively). There were no significant differences between groups in mean body length or head circumference increment, nor in morbidity rate.
Conclusion Preterm infants who received zinc supplementation have higher serum zinc level and mean body weight increment compared to the placebo group. No side effects are observed to have been caused by zinc supplementation.
Neutrophil lymphocyte ratio and severity of acute kidney injury in septic children
Authors: Kowita Nurul Huda , Sovira Nora , Safri Mulya , Ismy Jufitriani , Haris Syafruddin , Herdata Heru Noviat , Bakhtiar Bakhtiar 
Published: January 2024

Background Acute kidney injury (AKI) in sepsis is associated with an inflammatory process in kidney microcirculation and may increase morbidity and mortality in children. The neutrophil lymphocyte ratio (NLR) is an inflammatory biomarker of the inflammatory process in sepsis.
Objective To determine the role of NLR in predicting the severity of AKI and to describe the demographic and laboratory characteristics, as they relate to outcomes of pediatric patients with AKI and sepsis.
Methods This cross-sectional study was conducted in the PICU at Dr. Zainoel Abidin General Hospital (RSUDZA), Banda Aceh, Aceh. Medical record data were obtained from critically ill children with sepsis and AKI. Chi-square test was used to compare the proportions of each variable. We also calculated odds ratios to evaluate the AKI severity, PELOD-2 score, and patient outcomes. Spearman's analysis was used to look for a possible correlation between NLR and AKI severity in septic children.
Results Seventy-one subjects with sepsis and AKI were included. Subject characteristics were as follows: 63.4% males, 63.4% < 1 year of age, 56.3% with respiratory problems as a primary disease, 38% with AKI injury stage, and 54.9% subjects with PELOD-2 score ?10. There was no significant correlation between AKI severity and mortality (OR 3.04; 95%CI 0.990 to 9.378; P=0.052). Subjects with a PELOD-2 score ?10 had a 47.6 times higher chance of mortality in septic children with AKI compared to those with PELOD-2 scores <10. There was no correlation between NLR and AKI severity (r=0.019; P=0.878).
Conclusion There is no correlation between NLR and AKI severity. Sepsis accompanied by AKI may increase the risk of mortality in children. Septic children with more severe AKI tends to be less survive.