bluuebunny/crossref_metadata_2025_split huggingface dataset:
Utility of Point-of-Care Ultrasound in A Resource-Limited Health Care Setting in Southeast Ghana: A Needs Assessment
Authors: Mohamed Elfadil Mahmoud , Baraniecki-Zwil Gwen , Fowose Mobolaji H. , Schiff Julia , Munawar Maham , Panebianco Nova , Kramer Jeffrey A. 
Published: July 2023

ABSTRACTBackgroundMany proven benefits of point-of-care ultrasound (POCUS) are increasingly recognized, including being non-invasive, cost-effective, and of significant diagnostic value. Evidence for these benefits has been replicated in variable settings. However, litle is known about the utilization of POCUS in the developing world and in an out-of-hospital, resource-limited setting. This needs assessment study describes utilization of POCUS in rural Ghana.MethodsWe performed retrospective analysis of data from medical missions to Southeast Ghana, evaluating the utilization of POCUS in a rural resource-limited health setting. The first mission trip took place in the Oti region between January 25th, 2023, and February 1st, 2023. The second was in the Volta region between February 19th, 2023, and February 24th, 2023. These missions established out-of-hospital remote clinics for walk in patients who are informed about the clinic by the word of mouth by their community leaders and neighbors. We included all POCUS scans performed as part of those missions.FindingsA total of 128 POCUS studies were performed and included in this analysis. Studies were performed for 111 patients (median age 23 years; 49.9% male). Twelve distinct types of sonographic studies were performed. Notably, 48.4% revealed significant findings that helped to confirm a working diagnosis and subsequently formulate or optimize plan of management. A therapeutic intervention was made based on US findings in 16.4% of encounters, while a referral to higher level of care was recommended in 27.3% of cases. Reassurance with ruling out a main differential diagnosis was the case in 7% of encounters.ConclusionPOCUS is effective and can be utilized for a wide range of types of scans effectively in out-of-hospital resource-limited settings in rural Ghana with significant impact on clinical decision-making process.
Estimating the gap between clinical cholera and true community infections: findings from an integrated surveillance study in an endemic region of Bangladesh
Authors: Hegde Sonia , Khan Ashraf Islam , Perez-Saez Javier , Khan Ishtiakul Islam , Hulse Juan Dent , Islam Md Taufiqul , Khan Zahid Hasan , Ahmed Shakeel , Bertuna Taner , Rashid Mamunur , Rashid Rumuna , Hossain Md Zakir , Shirin Tahmina , Wiens Kirsten , Gurley Emily S. , Bhuiyan Taufiqur Rahman , Qadri Firdausi , Azman Andrew S. 
Published: July 2023

AbstractOur understanding of cholera transmission and burden largely rely on clinic-based surveillance, which can obscure trends, bias burden estimates and limit the impact of targeted cholera-prevention measures. Serologic surveillance provides a complementary approach to monitoring infections, though the link between serologically-derived infections and medically-attended disease – shaped by immunological, behavioral, and clinical factors – remains poorly understood. We unravel this cascade in a cholera-endemic Bangladeshi community by integrating clinic-based surveillance, healthcare seeking, and longitudinal serological data through statistical modeling. We found >50% of the study population had aV. choleraeO1 infection annually, and infection timing was not consistently correlated with reported cases. Four in 2,340 infections resulted in symptoms, only one of which was reported through the surveillance system. These results provide new insights into cholera transmission dynamics and burden in the epicenter of the 7thcholera pandemic and provide a framework to synthesize serological and clinical surveillance data.
Impact of four years of annually repeated indoor residual spraying (IRS) with Actellic 300CS on routinely reported malaria cases in an agricultural setting in Malawi
Authors: Hoek Spaans Remy , Mkumbwa Albert , Nasoni Peter , Jones Christopher M. , Stanton Michelle C. 
Published: July 2023

AbstractIndoor residual spraying (IRS) is one of the main vector control tools used in malaria prevention. This study evaluates IRS in the context of a privately run campaign conducted across a low-lying, irrigated, sugarcane estate from Illovo Sugar, in the Chikwawa district of Malawi. The effect of Actellic 300CS annual spraying over four years (2015-2018) was assessed using a negative binomial mixed effects model, in an area where pyrethroid resistance has previously been identified. With an unadjusted incidence rate ratio (IRR) of 0.38 (95% CI: 0.32 – 0.45) and an adjusted IRR of 0.50 (95% CI: 0.42-0.59), IRS has significantly contributed to a reduction in case incidence rates at Illovo, as compared to control clinics and time points outside of the six month protective period. This study shows how the consistency of a privately run IRS campaign can improve the health of employees. More research is needed on the duration and timing of IRS programmes.
Do people with disabilities have the same level of HIV knowledge and access to testing? Evidence from 513,252 people across 37 Multiple Indicator Cluster Surveys
Authors: Rotenberg Sara , Chen Shanquan , Hanass-Hancock Jill , Davey Calum , Banks Lena Morgon , Kuper Hannah 
Published: July 2023

AbstractBackgroundDisability and HIV are intricately linked, as people with disabilities are at higher risk of contracting HIV and HIV can lead to impairments and disability. Despite this well-established relationship, there remains limited internationally comparable evidence on HIV knowledge and access to testing for people with disabilities.Methods and FindingsWe used cross-sectional data from 37 Multiple Indicator Cluster Surveys. 513,252 people were eligible for inclusion, including 24,695 (4.8%) people with disabilities. We examined risk ratios and their 95% confidence intervals for key indicators on HIV knowledge and access to testing for people with disabilities by sex and country. We also conducted a meta-analysis to get a pooled estimate for each sex and indicator. Men and women with disabilities were less likely to have comprehensive knowledge about HIV prevention (aRR: 0.74 [0.67, 0.81] and 0.75 [0.69, 0.83], respectively) and to know of a place to be tested for HIV (aRR: 0.95 [0.92, 0.99] and 0.94 [0.92, 0.97], respectively) compared to men and women without disabilities. Women with disabilities were also less likely to know how to prevent mother-to-child transmission (aRR: 0.87 [0.81, 0.93]) and ever have been tested for HIV (aRR: 0.90 [0.85, 0.94]), while men with disabilities showed some evidence of relative inequities for these indictors. There was also some evidence women with disabilities were less likely to be tested for HIV in the past year.ConclusionMen and women with disabilities face inequities in HIV knowledge and access to testing, particularly for women with disabilities. Governments must include people with disabilities in HIV programs by improving accessibility and increasing disability-inclusion in each health system building block.
Can computer simulation support strategic service planning? Modelling a large integrated mental health system on recovery from COVID-19
Authors: Pierotti Livia , Cooper Jennifer , James Charlotte , Cassels Kenah , Gara Emma , Denholm Rachel , Wood Richard 
Published: July 2023

AbstractBackgroundCOVID-19 has had a significant impact on people’s mental health and mental health services. During the first year of the pandemic, existing demand was not fully met while new demand was generated, resulting in large numbers of people requiring support. To support mental health services to recover without being overwhelmed, it was important to know where services will experience increased pressure, and what strategies could be implemented to mitigate this.MethodsWe implemented a computer simulation model of patient flow through an integrated mental health service in Southwest England covering General Practice (GP), community-based ‘talking therapies’ (IAPT), acute hospital care, and specialist care settings. The model was calibrated on data from 1 April 2019 to 1 April 2021. Model parameters included patient demand, service-level length of stay, and probabilities of transitioning to other care settings. We used the model to compare ‘do nothing’ (baseline) scenarios to ‘what if’ (mitigation) scenarios, including increasing capacity and reducing length of stay, for two future demand trajectories from 1 April 2021 onwards.ResultsThe results from the simulation model suggest that, without mitigation, the impact of COVID-19 will be an increase in pressure on GP and specialist community based services by 50% and 50-100% respectively. Simulating the impact of possible mitigation strategies, results show that increasing capacity in lower-acuity services, such as GP, results in demand being shifted to other parts of the mental health system while decreasing length of stay in higher acuity services is insufficient to mitigate the impact of increased demand.ConclusionIn capturing the interrelation of patient flow related dynamics between various mental health care settings, we demonstrate the value of computer simulation for assessing the impact of interventions on system flow.
Two-Year Evaluation ofLegionellain an Aging Residential Building: Assessment of Multiple Potable Water Remediation Approaches
Authors: Lee-Masi Monica , Coulter Caroline , Chow Steven J. , Zaitchik Benjamin , Jacangelo Joseph G. , Exum Natalie G. , Schwab Kellogg J. 
Published: July 2023

ABSTRACTLegionellais an opportunistic waterborne pathogen that is difficult to eradicate in colonized drinking water pipes.Legionellacontrol is further challenged by aging water infrastructure and lack of evidence-based guidance for building treatment. This study assessed multiple premise water remediation approaches designed to reduceLegionella pneumophila (Lp)within a residential building located in an aging, urban drinking water system over a two-year period. Samples (n=745) were collected from hot and cold-water lines and quantified via most probable number culture. Building-level treatment approaches included three single heat shocks (HS), three single chemical shocks (CS), and continuous low-level chemical disinfection (CCD) in the potable water system. The building was highly colonized withLpwith 71%Lppositivity. Single HS had a statistically significantLpreduction one day post treatment but no significantLpreduction one, two, and four weeks post treatment. The first two CS resulted in statistically significantLpreduction at two days and four weeks post treatment, but there was a significantLpincrease at four weeks following the third CS. CCD resulted in statistically significantLpreduction ten weeks post treatment implementation. This demonstrates that in a building highly colonized withLp, sustained remediation is best achieved using CCD.SYNOPSISLong-termLegionella control is difficult to maintain within aging premise plumbing. This study supports continuous low-level building treatment as an effective long-term remediation of a building highly colonized withLegionella.For Table of Contents Only
Genetic and phenotype analyses of primary lateral sclerosis datasets from international cohorts
Authors: Kalia Munishikha , Spargo Thomas P. , Al Khleifat Ahmad , Opie-Martin Sarah , Kabiljo Renata , Dobson Richard JB , van Damme Philip , Corcia Philippe , Couratier Philippe , Hardiman Orla , McLaughlin Russell , Gotkine Marc , Drory Vivian , Silani Vincenzo , Ticozzi Nicola , Veldink Jan H. , van den Berg Leonard H. , de Carvalho Mamede , Pinto Susana , Pardina Jesus S. Mora , Povedano Monica , Andersen Peter M. , Weber Markus , Başak Nazli A. , Shaw Christopher E , Shaw Pamela J. , Morrison Karen E. , Landers John E. , Glass Jonathan D. , Vourc’h Patrick ,   Project MinE ALS Sequencing Consortium, Al-Chalabi Ammar , Iacoangeli Alfredo 
Published: July 2023

ABSTRACTPrimary lateral sclerosis (PLS) is the rarest form of motor neurone disease (MND). It is characterized by upper motor neuron degeneration, leading to progressive weakness, spasticity and functional disability. Although PLS does not typically shorten life substantially, it gradually impacts quality of life as the diseases progresses. There is no established genetic cause of PLS. One of the biggest challenges faced by people with PLS is delayed diagnosis and misdiagnosis, since the initial symptoms can be similar to amyotrophic lateral sclerosis (ALS), the most common form of MND. In the absence of a concrete genetic test that differentiates PLS from other MNDs, this delay in diagnosis is inevitable. Understanding the genetic basis of PLS might help in reducing the time from the onset of symptoms to diagnosis, and it will improve our understanding of the disease biology favouring the development of a treatment.The aim of our study is to collect a large international PLS genetic and clinical dataset to investigate its genetic and phenotypic landscapes as well as to evaluate whether genetic testing should be advised in PLS. Through Project MinE and AnswerALS, we accessed whole-genome sequencing data of 120 PLS, 7405 ALS and 2444 controls. We identified variants in several MND genes such asFIG4, FUS, SPG7, SPG11andSQSTM1genes among others and repeat expansions in theATXN1(12.2%) andNIPA1(7.3%) genes, but none in theC9orf72andATXN2genes. Overall PLS patients harboured fewer clinically actionable MND-associated variants than ALS patients (p = 0.0001), however, depending on the panel, up to 11% of people with PLS might benefit from genetic testing. By looking at the clinical characteristics of these cohorts, the age of symptom onset was not younger for people with PLS than for those with ALS in both Project MinE and AnswerALS. On such bases, we advise that the current diagnostic criteria that discourage the use of genetic testing and rely on age of onset should be reconsidered.
Molecular diagnosis of Cytomegalovirus infection: clinical performance of Transcription Mediated Amplification (TMA) towards conventional qPCR chemistry on whole blood samples
Authors: Bottino Paolo , Pastrone Lisa , Zanotto Elisa , Sidoti Francesca , Costa Cristina , Cavallo Rossana 
Published: July 2023

AbstractHuman Cytomegalovirus (HCMV) infection represents a life-threating pathogen for immunocompromised patients. Molecular quantitative testing on whole blood or plasma represents the gold standard for diagnosis of invasive HCMV infection and for monitoring antiviral treatment in individuals at risk of CMV disease. For these reasons, accurate standardization towards the 1st WHO International standard between different centres and diagnostic kits represent an effort for a better clinical management of CMV-positive patients. Herein, we evaluate for the first time the performance of a new TMA (Transcription Mediated Amplification) kit towards qPCR chemistry, used as routine method, on whole blood samples. 755 clinical whole blood specimens were collected and simultaneously tested with TMA and qPCR assays. Data showed 99.27% agreement for positive quantified samples and 89.39% agreement for those not detected between two tested methods. Evaluation of viraemia in positive samples highlighted a good correlation for TMA and qPCR chemistries in terms of International Units (ΔLog10IU/ml: − 0.29 ± 0.40). TMA assay showed a significant correlation with qPCR also in monitored patients until three months, thus allowing accurate evaluation of viraemia in transplanted patients. Moreover, preliminary data about analytical sensitivity of TMA chemistry onto DBS samples showed 86.54% correlation with whole blood specimens. Thus, TMA chemistry showed a good agreement with qPCR assay, used as current diagnostic routine, and offers important advantages: FDA and IVD approval on plasma and whole blood, automated workflow with minimal hands-on time, random access loading, thus enabling a rapid and reliable diagnostics in HCMV-infected patients.
Effects of a clinical decision support system and patient portal for preventing medication-related falls in older fallers: Protocol of a cluster randomized controlled trial with embedded process and economic evaluations (ADFICE_IT)
Authors: de Wildt Kelly K. , van de Loo Bob , Linn Annemiek J. , Medlock Stephanie K. , Groos Sara S. , Ploegmakers Kim J. , Seppala Lotta J. , Bosmans Judith E. , Abu-Hanna Ameen , van Weert Julia C.M. , van Schoor Natasja M. , van der Velde Nathalie 
Published: July 2023

ABSTRACTBackgroundFalls are the leading cause of injury-related mortality and hospitalization among adults aged ≥ 65 years. An important modifiable fall-risk factor is use of fall-risk increasing drugs (FRIDs). However, deprescribing is not always attempted or performed successfully. The ADFICE_IT trial evaluates the combined use of a clinical decision support system (CDSS) and a patient portal for optimizing the deprescribing of FRIDs in older fallers. The intervention aims to optimize and enhance shared decision making (SDM) and consequently prevent injurious falls and reduce healthcare-related costs.MethodsA multicenter, cluster-randomized controlled trial with process evaluation will be conducted among hospitals in the Netherlands. We aim to include 856 individuals aged ≥ 65 years that visit the falls clinic due to a fall. The intervention comprises the combined use of a CDSS and a patient portal. The CDSS provides guideline-based advice with regard to deprescribing and an individual fall-risk estimation, as calculated by an embedded prediction model. The patient portal provides educational information and a summary of the patient’s consultation. Hospitals in the control arm will provide care-as-usual. Fall-calendars will be used for measuring the time to first injurious fall (primary outcome) and secondary fall outcomes during one year. Other measurements will be conducted at baseline, 3, 6, and 12 months and include quality of life, cost-effectiveness, feasibility, and shared decision-making measures. Data will be analyzed according to the intention-to-treat principle. Difference in time to injurious fall between the intervention and control group will be analyzed using multilevel Cox regression.DiscussionThe findings of this study will add valuable insights about how digital health informatics tools that target physicians and older adults can optimize deprescribing and support SDM. We expect the CDSS and patient portal to aid in deprescribing of FRIDs, resulting in a reduction in falls and related injuries.Trial registrationClinicalTrials.govNCT05449470(7-7-2022)Participant recruitment7 July 2022-ongoing ** Results of this study have not yet been published or submitted to any journal.Protocol version1Trial sponsorAmsterdam UMC, Meibergdreef 9, 1105 AZ Amsterdam
Prevalence and monitoring utility of glycated albumin among diabetic patients attending clinic in tertiary hospitals in Dodoma, Tanzania: A cross-sectional study protocol
Authors: Mkumbi George Gabriel , Boaz Matobogolo 
Published: July 2023

AbstractDiabetes mellitus is a serious public health concern, with third world nations accounting for 80% of the new cases. Tanzania has a high diabetes burden, with rising prevalence, complications, and death, as well as life-threatening impairments. Diabetic diagnosis and prognosis are currently based on two tests: plasma glucose and glycated hemoglobin (HbA1c). However, other markers of glucose homeostasis, such as fructosamine and glycated albumin (GA), may be seen as an appealing alternative, especially in patients whose HbA1c test is skewed or incorrect. GA appears to have a higher overall diagnostic efficiency than fructosamine in a variety of clinical contexts. Further research is needed to determine whether GA can complement or replace traditional glycemic control measurements like HbA1c, as GA may aid in the therapeutic management of diabetic individuals whose HbA1c levels are unreliable.MethodA hospital-based cross-sectional analytical study design will be conducted among diabetic patients attending the diabetic clinics of the Dodoma Regional Referral Hospital and Benjamin Mkapa Hospital from 1stAugust to 30thOctober, 2023.All patients with a diagnosis of diabetes mellitus for more than 6 months on medication will be screened for eligibility. Informed consent, history and clinical examination will be obtained in all the patients. All patients will be subjected to voluntary blood sample collection and blood samples obtained will be sent for RBG and HbA1c. Simultaneously the Glycated Albumin levels will be obtained from the same blood samples collected. Standard glycemic status of all patients will be defined as per HbA1c. A level greater than 7% will be considered as a poor indicator, hence poor control in patients with more than six months of treatment. A questionnaire containing both open and closed ended questions will also be used in recording the patient’s response. Analysis including both descriptive and inferential statistics will be computed with SPSS version 28.0. and a predictor variable P<0.05 will be considered as statistically significant.
Validity, reliability, and readability of single-item and short physical activity questionnaires for use in surveillance: a systematic review
Authors: Tcymbal Antonina , Messing Sven , Mait Rachel , Galindo Perez Roberto , Akter Taiyeba , Rakovac Ivo , Gelius Peter , Abu-Omar Karim 
Published: July 2023

AbstractBackgroundAccurate and fast measurement of physical activity is important for surveillance. Even though many physical activity questionnaires (PAQ) are currently used in research, it is unclear which of them is the most reliable, valid, and easy to use. This systematic review aimed to identify existing brief PAQs, describe and compare their measurement properties, and assess their level of readability.MethodsWe performed a systematic review based on the PRISMA statement. Literature searches were conducted in six scientific databases in March 2022. Articles were included if they evaluated validity and/or reliability of brief (i.e., with a maximum of three questions) physical activity or exercise questionnaires intended for healthy adults. Due to the heterogeneity of studies, data were summarized narratively. The level of readability was calculated according to the Flesch-Kincaid formula.ResultsIn total, 34 articles published in English or Spanish were included, evaluating 31 distinct brief PAQs. The studies indicated moderate to good levels of reliability for the PAQs. However, the majority of results showed weak validity when validated against objective measurements and demonstrated weak to moderate validity when validated against other PAQs. Most of the assessed PAQs met the criterion of being "short," allowing respondents to complete them in less than one minute either by themselves or with an interviewer. However, only 17 questionnaires had a readability level that indicates that the PAQ is easy to understand for the majority of the population.ConclusionsThis review identified a variety of brief PAQs, but most of them were evaluated in only a single study. The methods used to assess measurement properties varied widely across studies, limiting the comparability between different PAQs and making it challenging to identify a single tool as the most suitable. Furthermore, PAQs employed different concepts for measuring physical activity, necessitating consideration of measurement properties and assessment goals when selecting a specific tool. None of the evaluated brief PAQs allowed for the measurement of whether a person fulfills the main WHO physical activity recommendations. Future development or adaptation of PAQs should prioritize readability as an important factor to enhance their usability.