bluuebunny/crossref_metadata_2025_split huggingface dataset:
Association between relative income and mental health in adults during the COVID-19 pandemic in Korea: Insights from a community health survey
Authors: Moon Min Hui , Choi Min Hyeok 
Published: July 2023

AbstractPeople of lower socioeconomic status are much more likely to be vulnerable to COVID-19. This study aimed to compare the associations between mental health according to relative national and community income levels during the COVID-19 pandemic. Mental health inequalities according to income level during the COVID-19 pandemic were assessed using the Korea Community Health Survey before (2019) and after the COVID-19 pandemic (2021). Univariate analyses were used to calculate the perceived stress and depression rates according to the risk factor categories. A multivariate logistic regression analysis was performed to identify the association between two types of income levels (Korean or community) and perceived stress and depression. In addition, we investigated the effect of relative income levels by subgroup (gender and region) on perceived stress and the experience of depression. During COVID-19, although depression crude rates increased (from 6.24% to 7.2%), perceived stress crude rates remained similar. In addition, as for mental health inequality according to community income level, even after adjusting for each independent variable, perceived stress [Odds Ratio (OR): 1.31, 95% Confidence Interval (CI):1.31–1.32] and experience of depression (OR: 1.63, 95% CI: 1.62–1.63) increased as the income level decreased. The effect of relative income level on perceived stress rate was found to be more pronounced in urban areas than in rural areas in terms of community income levels. Contrarily, the effect of relative income level on the depression rate was found to be weaker. Our findings demonstrated that mental health inequalities based on income level were more likely to occur during the COVID-19 pandemic and that disparities in community income levels may better reflect mental health inequalities.
CLINICAL TRIAL FOR LEVOFLOXACIN VERSUS AMOXYCILLIN/CLAVULANIC ACID COMBINED WITH AZITHROMYCIN IN TREATMENT OF COMMUNITY ACQUIRED PNEUMONIA
Authors: Musungu Vincent , Onguru Daniel , Onyango Patrick 
Published: July 2023

ABSTRACTBackgroundCommunity acquired pneumonia (CAP) is an important cause of mortality and morbidity worldwide. Early initiation of antibiotics is highly recommended. In most CAP cases, multiple drug options are increasingly becoming available, but there is often a lack of evidence that allows for direct comparison of the efficacy of one drug versus another. The purpose of this study was to investigate the effectiveness of antibiotics so as to rationalize outpatient treatment of community acquired pneumonia among patients with previous antibiotic exposure.AimThe main objective was to compare treatment outcomes using oral levofloxacin alone and combined azithromycin and amoxicillin/Clavulanic acid in outpatient treatment of Community acquired pneumonia.MethodsThis study was a prospective longitudinal design. Patients diagnosed to have CAP were put into first and second treatment groups. Community acquired pneumonia was diagnosed according to America Thoracic Society criteria. Sample size of 76 was arrived at by Cochran’s formular. Variation in white blood cell counts at baseline and after treatment in the two treatment groups was analysed using ANOVA whereas differences in treatment outcome was analysed using the independent t-test.ResultsThe findings of this study suggest that combination of azithromycin and amoxycillin/clavulanic acid was associated with statistically significant faster resolution of chest pains and cough (mean 1.7 and 3.14 days respectively) compared to levofloxacin group (mean 2.21 and 3.71 days respectively) in patients who had community acquired pneumonia (p=0.009). However, in the two treatment groups, there was no difference in the meantime to fever resolution, time to crackles subsidence, resolution of difficulty in breathing and change in white blood cell count.ConclusionsBased on the quantitative analysis and methodology used by the current study, it can be concluded that although both treatment groups demonstrated similar effectiveness, combination of amoxicillin/clavulanic acid and azithromycin showed a modest superiority in relation to rate of symptom resolution and change in white blood cell count.
Telemedicine adoption in Ecuador: an assessment of physician perceptions and knowledge towards its benefits and limitation
Authors: Cherrez-Ojeda Ivan , Vanegas Emanuel , Felix Miguel , Bajaña María José Farfán , Alvarado-Villa Geovanny , Mautong Hans , Espinoza Fernando , Sarfraz Zouina , Sarfraz Azza , Robles-Velasco Karla , Michel Jack , Lahmar Abdelilah , Zimmermann Luc J. I. , Gavilanes Antonio WD 
Published: July 2023

AbstractTelemedicine is a growing field with the potential to improve healthcare delivery, however it is important for a proper implementation to understand how physicians perceive the benefits and limitations related to their use. With this study our aim is to assess the perceptions and knowledge of telemedicine among a sample of Ecuadorian healthcare providers. We conducted a cross-sectional online survey-based study where participants answered a 12-item survey assessing their knowledge and perceptions towards telemedicine. Demographic variables were analyzed applying descriptive statistics, and a chi-square goodness of fit test was used to assess the observed frequencies of each of the survey’s queries. In total, 382 participants completed the survey with an average age of 51.3 years (SD, 11.4). Around half of participants expressed to be lowly to very lowly familiarized with telemedicine technology (χ2(4) = 88.497, p = .000). Most of them considered to a high extent that telemedicine is effective in reducing costs of patient care in hospitals (32.5%; n=124; χ2(4) = 78.812, p = .000). Finally, 8 out 10 participants expressed that a framework should be created to prevent breaches of data confidentiality when using telemedicine (χ2(4) = 250.749, p = .000). In this study we found a considerable proportion of physicians reporting low familiarization with telemedicine despite being aware of the benefits it can bring to patient care. Breaches of data confidentially and the potential for malpractice were cited as main concerns in need of a framework to prevent them. Future studies are needed to address the perceived barriers of technology to ensure a safe and efficient use of telemedicine in the healthcare setting.
COVID-19 vaccine information, misinformation, and vaccine uptake in Malawi
Authors: Songo John , Whitehead Hannah S. , Phiri Khumbo , Kalande Pericles , Lungu Eric , Phiri Sam , van Oosterhout Joep J. , Moses Agnes , Hoffman Risa M. , Moucheraud Corrina 
Published: July 2023

AbstractBackgroundCOVID-19 vaccine information – including source, content, and tone – may be an important determinant of vaccination, but this dynamic is not well-understood in low-income countries where COVID-19 vaccine uptake remains low. We assessed the COVID-19 vaccine information environment in Malawi, and its correlation with vaccine uptake.MethodsA survey was administered among 895 adult (≥18 years) clients at 32 Malawian health facilities in mid-2022. Respondents reported their COVID-19 vaccination history, exposure to information about the COVID-19 vaccine from different sources and its tone (positive, negative, or neutral/factual), and whether they had heard of and believed in ten COVID-19 and COVID-19 vaccine conspiracy theories. We described the COVID-19 vaccine information environment in Malawi and used logistic regression analyses to assess the association of exposure to information sources and conspiracy theories with uptake of the COVID-19 vaccine.ResultsRespondents had received information about the COVID-19 vaccine most commonly from friends and neighbors, healthcare workers, and radio (each reported by >90%). Men, urban residents, and respondents with a higher education level were exposed to more COVID-19 vaccine information sources. COVID-19 vaccine uptake was positively associated with exposure to a greater number of COVID-19 vaccine information sources (aOR 1.09, 95% CI 1.03-1.15), and more positive information (aOR 4.33, 95% CI 2.17-8.64) – and was negatively associated with believing COVID-19 vaccine conspiracy theories to be true (OR 0.76, 95% CI 0.68-0.87).ConclusionsMalawian adults were exposed to a variety of COVID-19 vaccine information sources, with less access to information among women, rural residents, and people with lower educational attainment. Exposure to misinformation was common, though infrequently believed. Vaccination was associated with exposure to high number of COVID-19 vaccine information sources, exposure to positive vaccine information and endorsing fewer conspiracy theories. Vaccination programs should disseminate communication with positive messaging, through multiple information sources, prioritizing the less exposed groups we identified.
Accuracy of clinical risk factor-based models as a screening test for detecting gestational diabetes mellitus in a low-resource setting
Authors: Senbanjo Olayinka Comfort , Akinlusi Fatimat Motunrayo , Rabiu Kabiru Afolarin 
Published: July 2023

AbstractCurrent World Health Organization guidelines recommend fasting 2-hour tests for all pregnant women, a strategy that is burdensome for patients as well as time and labor-intensive for health systems. There have been suggestions for the use of clinical risk factors-based models as alternatives. These have not been widely tested especially in low-resource countries. We aimed to determine the prevalence of GDM and the accuracy of clinical risk factor-based models as screening tools for detecting GDM.This was a prospective cohort study of consenting 400 pregnant women receiving antenatal care at a tertiary health facility in Lagos, Nigeria. All the study subjects were assessed for the risk of GDM using three different clinical risk-based models. They also had universal screening for GDM at 24–28 weeks gestational age using the gold standard 2-hour 75g Oral Glucose Tolerance Test (OGTT). Statistical analysis was done using the statistical package for social science version 24. The Receiver Operating Curve (ROC) was used to determine the accuracy of the risk factor-based models.The mean age of the subjects was 31.0±5.3 years. A total of 76 subjects met the IADPSG/WHO 2013 criteria giving a prevalence of 19.0%. According to the clinical risk scores by Nayloret al, Caliskanet aland Phaloprakarnet al,340 (85%), 269 (67.3%) and 375 (93.8%) participants respectively had a risk score positive for GDM. If the study participants were selectively screened based on these models, between 71.1-96.1% of the women with GDM would have been identified and 6.3-32.8% of the women would not have performed the diagnostic test. The models had areas under the ROC that ranges between 51.6-52.9%.Conclusions:The prevalence of GDM is high and the clinical risk factor-based prediction models tested in this study could be used to stratify low-risk women out of diagnostic tests.
TRENDS, IN-HOSPITAL OUTCOMES, AND INDEPENDENT PREDICTORS OF ACUTE KIDNEY INJURY IN PATIENTS ADMITTED FOR MYOCARDIAL INFARCTION WITH PERCUTANEOUS CORONARY INTERVENTION: An insight from the National Inpatient Sample Database
Authors: Antia Akanimo , Ubokudom Daniel , Adabale Olanrewaju , Okorare Ovie , Daniel Emmanuel , Evbayekha Endurance , Onuegbu Chinwendu Angel , Ong Kenneth 
Published: July 2023

ABSTRACTBackgroundAcute kidney injury (AKI) is an important risk factor associated with adverse outcomes in cardiovascular illnesses, more importantly, myocardial infarction (MI). This study describes the Trends, in-hospital outcomes, and independent predictors of Acute Kidney Injury (AKI) in patients admitted for Myocardial infarction with Percutaneous Coronary Intervention (PCI).MethodsThis retrospective study used patient records from the 2016-2020 National In-patient Database (NIS). We identified patients who were admitted for the management of an MI who had a PCI procedure and an AKI and evaluated their associated socio-demographic and comorbid factors using International Classification of Diseases-10 (ICD-10) codes. The chi-square test was used to compare baseline characteristics between our populations with and without AKI and outcomes and multivariate logistic regression to identify independent predictors of AKI.ResultsThere were 1,551,630 patients admitted for an MI and PCI, with 15% having an AKI. We observed that our population with AKI were older on admission and were more likely to be whites than blacks. A higher percentage were males. Our subpopulation was likely to have heart failure, atrial fibrillation, coronary artery disease, obesity, CKD and Charlson comorbidity index ≥ 3. A diagnosis of AKI was associated with higher in-hospital mortality rates [adjusted odds ratio (aOR): 2.84, CI: 2.7–3.02, p<0.001], longer mean length of stay (LOS) and higher hospital costs. We noted an increasing trend in the percentage of patients who had an AKI, from about 13.5% in 2016 to 16.5% in 2020.ConclusionAcute Kidney Injury is strongly associated with worse hospital outcomes in patients admitted for MI and PCI, with higher mortality rates, a longer mean length of stay, and a higher hospitalization cost. A more concise look at preventive measures is recommended to minimize these outcomes.
Comparative Assessment of Myocardial Work Performance during Spontaneous Rhythm, His Bundle Pacing, and Left Bundle Branch Area Pacing: Insights from the EMPATHY Study
Authors: Azzolini Giorgia , Bianchi Nicola , Vitali Francesco , Malagù Michele , Balla Cristina , Raffele Martina De , Bertini Matteo 
Published: July 2023

AbstractBackgroundPhysiological pacing has gained significant interest due to its potential to achieve optimal hemodynamic response. This study aimed to assess left ventricular performance in terms of electrical parameters, specifically QRS duration, and mechanical performance, evaluated as myocardial work. We compared His Bundle Pacing (HBP) and Left Bundle Branch Area Pacing (LBBAP) to evaluate their effects.MethodsTwenty-four patients with class I or IIa indications for pacing were enrolled in the study, with 12 patients undergoing HBP implantation and another 12 patients undergoing LBBAP implantation. A comprehensive analysis of myocardial work was conducted.ResultsOur findings indicate that there were no major differences in terms of spontaneous and HBP activation in myocardial work, except for global wasted work (217 mmHg% vs. 283 mmHg%; p 0.016) and global work efficiency (87 mmHg% vs. 82 mmHg%; p 0.049). There were no significant differences observed in myocardial work between spontaneous activation and LBBAP. Similarly, no significant differences in myocardial work were found between HBP and LBBAP.ConclusionsBoth pacing modalities provide physiological ventricular activation without significant differences when compared to each other. Moreover, there were no significant differences in QRS duration between HBP and LBBAP.However, LBBAP demonstrated advantages in terms of feasibility, as it achieved better lead electrical parameters compared to HBP (threshold@0.4 ms 0.6 V vs. 1 V; p=0.045. Sensing 9.4 mV vs. 2.4 mV; p<0.001). Additionally, LBBAP required less fluoroscopy time (6 min vs. 13 min; p=0.010) and procedural time (81 min vs. 125 min; p=0.004) compared to HBP.Clinical PerspectiveWhat is KnownHis Bundle Pacing (HBP) and Left Bundle Branch Area Pacing (LBBAP) have been recognized as more physiological alternatives to traditional right ventricular pacing. LBBAP has shown greater feasibility compared to HBP, although direct comparison data between the myocardial work in HBP and LBBAP are limited.What the Study AddsOur study contributes to the existing knowledge by demonstrating that both HBP and LBBAP provide physiological ventricular activation, with no significant differences observed between the two pacing modalities in terms of myocardial work and QRS duration. However, LBBAP showcased advantages such as reduced need for fluoroscopy, shorter procedural time, and improved electrical parameters. These findings further support the potential of LBBAP as a favorable pacing option.Graphical abstract
Left common trunkus pulmonary veins have genetic background and poorer rhythm outcome after paroxysmal atrial fibrillation catheter ablation
Authors: Choi Sung Hwa , Kim Tae-Hoon , Hong Myunghee , Kwon Oh-Seok , Kim Daehoon , Park Je-Wook , Yu Hee Tae , Uhm Jae-Sun , Joung Boyoung , Lee Moon-Hyoung , Hwang Chun , Pak Hui-Nam 
Published: July 2023

AbstractBackgroundThe genetic traits of pulmonary vein (PV) variants and rhythm outcomes after atrial fibrillation (AF) catheter ablation (AFCA) remain unclear. We explored the genetic and clinical characteristics and long-term rhythm outcomes of patients with AF and left common trunkus (LCT)-PVs or accessory PVs.MethodsWe included 2,829 patients with AF (74.0% men, age 59.1±10.7 years, 66.3% paroxysmal AF) and available genome-wide association study, cardiac computed tomography, and protocol-based regular rhythm follow-up results from the Yonsei AF ablation cohort database. We examined 1,223 single nucleotide polymorphisms in 12 genetic loci associated with AF and long-term rhythm outcomes after AFCA.ResultsWe found LCT-PVs in 91(3.2%) and accessory PVs in 189(6.7%) patients. Rs9871453 (SCN10A) and rs1979409 (NEO1) were significantly associated with LCT-PV occurrence, and polygenic risk score (PRS) differed significantly between patients with LCT-PVs (p=1.64e-05) and normal PVs, but not those with accessory PVs (p=0.939). Patients with LCT-PVs had a higher proportion of the female sex(p=0.046) and CHA2DS2VASc score (p=0.026). After follow-up for 39.7±4.7 months, patients with LCT-PVs exhibited significantly greater LCT anterior wall thicknesses (p<0.001) and higher recurrence rate than those with normal PVs, particularly patients with paroxysmal AF (log-rank, p=0.042). LCT-PVs were independently associated with AF recurrence after AFCA (hazard ratio[HR], 2.26 [1.01–4.42]; p=0.046). Patients with LCT-PVs and higher PRSs had a higher risk of recurrent AF (adjusted HR 1.78, 95% CI 1.10–2.88, p=0.019).ConclusionsPatients with LCT-PVs have a significant genetic background. Post-AFCA recurrence rate was significantly higher in patients with LCT-PVs and higher PRSs, particularly in those with paroxysmal AF.Clinical PerspectiveWhat Is New?This study identifies specific genetic variants associated with the occurrence of LCT-PVs in AF patients undergoing catheter ablation.Higher AF recurrence rates were observed in LCT-PV patients, particularly those with paroxysmal AF. High-genetic risk LCT-PV patients exhibited increased AF recurrence and a thicker anterior wall of the left pulmonary vein compared to normal PV patients.What Are the Clinical Implications?The findings enhance our understanding of the genetic basis of AF and its anatomical manifestations, enabling personalized treatment approaches.Further research is needed to identify additional genetic variants associated with LCT-PV and to understand the recurrence of AF when using methods other than catheter ablation.
Dynamicity of brain network organization and their community architecture as characterizing features for classification of common mental disorders from the whole-brain connectome
Authors: Sastry Nisha Chetana , Banerjee Arpan 
Published: July 2023

AbstractThe urgency of addressing common mental disorders (bipolar disorder, ADHD, and schizophrenia) arises from their significant societal impact. Developing strategies to support psychiatrists is crucial. Previous studies focused on the relationship between these disorders and changes in the resting-state functional connectome’s modularity, often using static functional connectivity (sFC) estimation. However, understanding the dynamic reconfiguration of resting-state brain networks with rich temporal structure is essential for comprehending neural activity and addressing mental health disorders. This study proposes an unsupervised approach combining spatial and temporal characterization of brain networks to classify common mental disorders using fMRI timeseries data from two cohorts (N=408 participants). We employ the weighted stochastic block model to uncover mesoscale community architecture differences, providing insights into neural organization. Our approach overcomes sFC limitations and biases in community detection algorithms by modelling the functional connectome’s temporal dynamics as a landscape, quantifying temporal stability at whole-brain and network levels. Findings reveal individuals with schizophrenia exhibit less assortative community structure and participate in multiple motif classes, indicating less specialized neural organization. Patients with schizophrenia and ADHD demonstrate significantly reduced temporal stability compared to healthy controls. This study offers insights into functional connectivity (FC) patterns’ spatiotemporal organization and their alterations in common mental disorders, highlighting the potential of temporal stability as a biomarker.
PEP-Patch: Electrostatics in Protein-Protein Recognition, Specificity and Antibody Developability
Authors: Waibl Franz , Pomarici Nancy D. , Hoerschinger Valentin J. , Loeffler Johannes R. , Deane Charlotte M. , Georges Guy , Kettenberger Hubert , Fernández-Quintero Monica L. , Liedl Klaus R. 
Published: July 2023

ABSTRACTThe electrostatic properties of proteins arise from the number and distribution of polar and charged residues. Due to their long-ranged nature, electrostatic interactions in proteins play a critical role in numerous processes, such as molecular recognition, protein solubility, viscosity, and antibody developability. Thus, characterizing and quantifying electrostatic properties of a protein is a pre-requisite for understanding these processes. Here, we present PEP-Patch, a tool to visualize and quantify the electrostatic potential on the protein surface and showcase its applicability to elucidate protease substrate specificity, antibody-antigen recognition and predict heparin column retention times of antibodies as an indicator of pharmacokinetics.