bluuebunny/crossref_metadata_2025_split huggingface dataset:
Usefulness of disease surveillance data in enhanced early warning of the cholera outbreak in Southwest Cameroon, 2018
Authors: Kadia Reine Suzanne Mengue , Kadia Benjamin Momo , Dimala Christian Akem , Collins Andrew E. 
Published: February 2023

Abstract
Introduction
This study assessed the timeliness and completeness of disease surveillance data for early warning of the cholera outbreak during the socio-political crisis of Southwest Cameroon in 2018. It determined how routine integrated disease surveillance and response (IDSR) data was used for preventative actions and the challenges faced by key health staff in IDSR based decision-making.

Methods
This was a mixed-methods study conducted from June 1st to September 30th 2021. District Health Information System 2 (DHIS2) data from January 2018 to December 2020 for the Southwest region of Cameroon were analysed using simple linear regression on EPI Info 7.2 to determine a potential association of the sociopolitical crisis with timeliness and completeness of data. Qualitative data generated through in-depth interviews of key informants were coded and analyzed using NVivo 12.

Results
During high conflict intensity (2018 and 2019), average data timeliness and completeness were 16.3% and 67.2%, respectively, increasing to 40.7% and 80.2%, respectively, in 2020 when the conflict intensity had reduced. There was a statistically significant weak correlation between reduced conflict intensity and increased data timeliness (R2 = 0.17, p = 0.016) and there was also a weak correlation between reduced conflict intensity and data completeness but this was not statistically significant (R2 = 0.01, p = 0.642). During high conflict intensity, the Kumba and Buea health districts had the highest data timeliness (17.2% and 96.2%, respectively) and data completeness (78.8% and 40.4%, respectively) possibly because of proximity to reporting sites and effective performance based financing. Components of IDSR that should be maintained included the electronic report aspect of the DHIS2 and the supportive supervision conducted during the outbreak. Staff demotivation, the parallel multiplicity of data entry tools, poor communication, shortage of staff and the non-usability of data generated by the DHIS2 were systemic challenges to the early alert dimension of the IDSR system. Non–systemic challenges included high levels of insecurity, far to reach outbreak sites and health personnel being targeted during the conflict.

Conclusion
In general, routine IDSR data was not a reliable way of providing early warning of the 2018 cholera outbreak because of incomplete and late reports. Nonetheless, reduced conflict intensity correlated with increased timeliness and completeness of data reporting. The IDSR was substantially challenged during the crisis, and erroneous data generated by the DHIS 2 significantly undermined the efforts and resources invested to control the outbreak. The Ministry of Public Health should reinforce efforts to build a reporting system that produces people-centered actionable data that engages health risk management during socio-political crises.
Rationale for sequential extracorporeal therapy (SET) in sepsis
Authors: Ronco Claudio , Chawla Lakhmir , Husain-Syed Faeq , Kellum John A. 
Published: February 2023

AbstractSepsis and septic shock remain drivers for morbidity and mortality in critical illness. The clinical picture of patients presenting with these syndromes evolves rapidly and may be characterised by: (a) microbial host invasion, (b) establishment of an infection focus, (c) opsonisation of bacterial products (e.g. lipopolysaccharide), (d) recognition of pathogens resulting in an immune response, (e) cellular and humoral effects of circulating pathogen and pathogen products, (f) immunodysregulation and endocrine effects of cytokines, (g) endothelial and organ damage, and (h) organ crosstalk and multiple organ dysfunction. Each step may be a potential target for a specific therapeutic approach. At various stages, extracorporeal therapies may target circulating molecules for removal. In sequence, we could consider: (a) pathogen removal from the circulation with affinity binders and cartridges (specific), (b) circulating endotoxin removal by haemoperfusion with polymyxin B adsorbers (specific), (c) cytokine removal by haemoperfusion with sorbent cartridges or adsorbing membranes (non-specific), (d) extracorporeal organ support with different techniques for respiratory and cardiac support (CO2removal or extracorporeal membrane oxygenation), and renal support (haemofiltration, haemodialysis, or ultrafiltration). The sequence of events and the use of different techniques at different points for specific targets will likely require trials with endpoints other than mortality. Instead, the primary objectives should be to achieve the desired action by using extracorporeal therapy at a specific point.Graphical Abstract
Project T-SHARP: study protocol for a multi-site randomized controlled trial of tele-harm reduction for people with HIV who inject drugs
Authors: Tookes Hansel E. , Oxner Asa , Serota David P. , Alonso Elizabeth , Metsch Lisa R. , Feaster Daniel J. , Ucha Jessica , Suarez Edward , Forrest David W. , McCollister Kathryn , Rodriguez Allan , Kolber Michael A. , Chueng Teresa A. , Zayas Sheryl , McCoy Bernice , Sutherland Kyle , Archer Chetwyn , Bartholomew Tyler S. 
Published: February 2023

Abstract
Background
The resurgence of HIV outbreaks and rising prevalence among people who inject drugs (PWID) remain exigent obstacles to Ending the HIV Epidemic in the USA. Adapting a low threshold, comprehensive treatment model for PWID with HIV can leverage syringe services programs (SSPs) to increase availability and accessibility of antiretrovirals (ART), medications for opioid use disorder (MOUD), and hepatitis C cure. We developed Tele-Harm Reduction, a telehealth-enhanced, harm reduction intervention delivered within an SSP venue.

Methods
The T-SHARP trial is an open-label, multi-site, randomized controlled superiority trial with two parallel treatment arms. Participants (n=240) recruited from SSPs in Miami, Ft. Lauderdale, and Tampa, Florida, who are PWID with uncontrolled HIV (i.e., HIV RNA>200) will be randomized to Tele-Harm Reduction or off-site linkage to HIV care. The primary objective is to compare the efficacy of Tele-Harm Reduction for initiation of ART at SSPs vs. off-site linkage to an HIV clinic with respect to viral suppression across follow-up (suppression at 3, 6, and 12 months post randomization). Participants with HIV RNA<200 copies/ml will be considered virally suppressed. The primary trial outcome is time-averaged HIV viral suppression (HIV RNA <200 copies/ml) over 3-, 6-, and 12-month follow-up. Secondary outcomes include initiation of MOUD measured by urine drug screen and HCV cure, defined as achieving 12-week sustained virologic response (negative HCV RNA at 12 weeks post treatment completion). A cost-effectiveness analysis will be performed.

Discussion
The T-SHARP Trial will be the first to our knowledge to test the efficacy of an innovative telehealth intervention with PWID with uncontrolled HIV delivered via an SSP to support HIV viral suppression. Tele-Harm Reduction is further facilitated by a peer to support adherence and bridge the digital divide. This innovative, flipped healthcare model sets aside the traditional healthcare system, reduces multi-level barriers to care, and meets PWID where they are. The T-SHARP trial is a pragmatic clinical trial that seeks to transform the way that PWID access HIV care and improve HIV clinical outcomes.

Trial registration
ClinicalTrials.gov NCT05208697. Trial registry name: Tele-Harm Reduction. Registration date: January 26, 2022.
“Nothing to lose and the possibility of gaining”: a qualitative study on the feasibility and acceptability of registry-based randomised controlled trials among cancer patients and clinicians
Authors: Prang Khic-Houy , Karanatsios Bill , Zhang Angela , Verbunt Ebony , Wong Hui-li , Wong Vanessa , Gately Lucy , Tran Ben , Gibbs Peter , Kelaher Margaret 
Published: February 2023

AbstractBackgroundRandomised controlled trials (RCTs) are considered the “gold standard” for evaluating the effectiveness of interventions in clinical research. However, conventional RCTs are typically complex, expensive, and have narrow eligibility criteria, which limits generalisability. Registry-based randomised controlled trials (RRCTs) are an alternative approach that integrates the internal validity of an RCT with the external validity of a clinical registry by recruiting real-world patients and leveraging an existing registry platform for data collection. As RRCT is a novel research design, there has been limited research on the feasibility and acceptability of RRCTs from the patients’ and trial team’s perspectives. This study aims to explore patients’, clinicians’, and study coordinators’ perspectives towards participation in and conduct of oncology RRCTs in Australia.MethodsThirty-seven semi-structured interviews were conducted with 15 cancer patients, 15 clinicians, and 7 study coordinators. Interviews were audio-recorded and transcribed verbatim. The data were analysed using thematic analysis.ResultsThree overarching themes were identified: (1) enablers and barriers to recruitment and enrolment of patients in RRCTs, (2) experiences of patients participating in RRCTs, and (3) recommendations for the implementation of future RRCTs. For patients, altruism and “trust in the clinician” were key reasons to participate in a RRCT. For clinicians and clinical trial coordinators, the RRCT study design was perceived as “simple and straightforward” but “less exciting” than RCTs. Competition from commercially sponsored RCTs poses challenges for investigator-led RRCTs recruitment, particularly if eligible patient numbers are low. There were limited impacts on patients’ treatment experiences and clinicians’ clinical workflow given that the RRCTs explored different standards of care. Recommendations to improve the enrolment of patients in RRCTs included generating greater buy-in from clinicians by increasing awareness of RRCTs via education initiatives and broader promotion of the “selling point” of RRCTs and providing monetary compensation to hospitals for enrolling patients.ConclusionsWhilst patients, clinicians, and study coordinators were generally supportive of RRCTs, several barriers to effective RRCT implementation in oncology were identified. Developing strategies to increase acceptance of the methodology by clinicians will help enhance the uptake of RRCTs in Australia and internationally.
Chronic anemia complicated by cardiac failure, pulmonary hypertension, and pericardial effusion: a case report
Authors: Yousaf Muhammad , iIlahi Memon , Bibi Aisha , Elhassan Hadeel , Sharif Muhammad , Abid Abdul Rehman , Omran Maya Ali , Hassan Arwa , Haroon Khawaja Hassan 
Published: February 2023

Abstract
Background
Worldwide, iron deficiency anaemia (IDA) is the most common cause of anaemia. Iron deficiency alone has an association with heart failure and pulmonary hypertension. Chronic iron deficiency anemia triggers various physiologic adjustments, leading to hyperdynamic circulation and enhanced hypoxic pulmonary vasoconstriction. Those mechanisms may result in the development of high output cardiac failure and pulmonary hypertension; however, pericardial effusion remains a rare association.

Case presentation
A 44-year-old Nepalese man presented with fatigability and swollen ankles. Except for a hemorrhoidectomy 4 years ago, he had no comorbidities. Labs confirmed severe iron deficiency anemia (hemoglobin 1.8 grams per deciliter) likely secondary to hemorrhoids. An echocardiogram revealed high output cardiac failure, pericardial effusion, and severe pulmonary hypertension. He responded well to the correction of anemia and diuretics with the resolution of vascular complications.

Conclusion
We report a unique presentation of chronic severe iron deficiency anemia complicated by heart failure, pulmonary hypertension, and pericardial effusion. We believe it to be the first-ever such case reported in the literature. These cardiovascular complications seem to result from internal homeostatic mechanisms against the chronic tissue hypoxemia observed in severe anemia. Furthermore, iron deficiency alone has an association with heart failure and pulmonary hypertension. After excluding other potential causes, we confirmed iron deficiency anaemia as the cause of those complications. The correction of anemia led to an excellent recovery without any sequelae. Our case report highlights the fact that management of such a case should be focused on underlying etiology rather than the complications.
Segmentation and morphological analysis of amyloid fibrils from cryo-EM image data
Authors: Weber Matthias , Neumann Matthias , Schmidt Matthias , Pfeiffer Peter Benedikt , Bansal Akanksha , Fändrich Marcus , Schmidt Volker 
Published: February 2023

AbstractFast assessment of the composition of amyloid fibril samples from cryo-EM data poses a serious challenge to existing image analysis tools. We develop a method for automated segmentation of single fibrils requiring only little user input during the training process. This is achieved by combining a binary segmentation based on a convolutional neural network with preprocessing steps to allow for easy manual generation of training data. Subsequent skeletonization turns the binary segmentation into a single-object segmentation. Then, we compute properties of shape and texture of each segmented fibril, including an estimation of the fibril width. We discuss the composition of the sample based on the distributions of these computed properties and outline how a classification of fibril morphologies might be performed using these properties.
Implementation of an integrated infectious disease and substance use disorder team for injection drug use-associated infections: a qualitative study
Authors: Hervera Belén , Seo Grace , Bartholomew Tyler S. , Chueng Teresa A. , Suarez Edward , Forrest David W. , Hernandez Salma , Rodriguez Allan E. , Tookes Hansel E. , Doblecki-Lewis Susanne , Serota David P. 
Published: February 2023

Abstract
Background
Hospitalizations for severe injection drug use-related infections (SIRIs) are characterized by high costs, frequent patient-directed discharge, and high readmission rates. Beyond the health system impacts, these admissions can be traumatizing to people who inject drugs (PWID), who often receive inadequate treatment for their substance use disorders (SUD). The Jackson SIRI team was developed as an integrated infectious disease/SUD treatment intervention for patients hospitalized at a public safety-net hospital in Miami, Florida in 2020. We conducted a qualitative study to identify patient- and clinician-level perceived implementation barriers and facilitators to the SIRI team intervention.

Methods
Participants were patients with history of SIRIs (n = 7) and healthcare clinicians (n = 8) at one implementing hospital (Jackson Memorial Hospital). Semi-structured qualitative interviews were performed with a guide created using the Consolidated Framework for Implementation Research (CFIR). Interviews were transcribed, double coded, and categorized by study team members using CFIR constructs.

Results
Implementation barriers to the SIRI team intervention identified by participants included: (1) complexity of the SIRI team intervention; (2) lack of resources for PWID experiencing homelessness, financial insecurity, and uninsured status; (3) clinician-level stigma and lack of knowledge around addiction and medications for opioid use disorder (OUD); and (4) concerns about underinvestment in the intervention. Implementation facilitators of the intervention included: (1) a non-judgmental, harm reduction-oriented approach; (2) the team’s advocacy for PWID as a means of institutional culture change; (3) provision of close post-hospital follow-up that is often inaccessible for PWID; (4) strong communication with patients and their hospital physicians; and (5) addressing diverse needs such as housing, insurance, and psychological wellbeing.

Conclusion
Integration of infectious disease and SUD treatment is a promising approach to managing patients with SIRIs. Implementation success depends on institutional buy-in, holistic care beyond the medical domain, and an ethos rooted in harm reduction across multilevel (inner and outer) implementation contexts.
“It was really poor prior to the pandemic. It got really bad after”: A qualitative study of the impact of COVID-19 on prison healthcare in England
Authors: Wainwright Lucy , Senker Sarah , Canvin Krysia , Sheard Laura 
Published: February 2023

Abstract
Background
The impact of COVID-19 has been exceptional, particularly on the National Health Service which has juggled COVID affected patients alongside related staff shortages and the existing (and growing) health needs of the population. In prisons too, healthcare teams have been balancing patient needs against staffing shortfalls, but with additional strains unique to the prison population. Such strains include drastic lockdown regimes and prolonged isolation, the need to consider health alongside security, known health inequalities within prisoner groups, and an ageing and ethnically diverse population (both groups disproportionately affected by COVID). The aim of this paper is to contribute to emerging research on the impact of COVID-19 on prison healthcare.

Methods
We conducted 44 in depth interviews (over phone or video) across three groups: prison leavers, healthcare staff and decision makers, between July and December 2021. Framework analysis was undertaken.

Results
Three themes were found. First, we found that Covid-19 had a significant impact on prison healthcare which involved reduced access and changes to how healthcare was delivered. This affected the health of prisoners by exacerbating existing conditions, new conditions being undiagnosed and mental health needs increasing. Second, the pandemic impacted on healthcare staff through creation of stress, frustration and exhaustion due to minimal staffing levels in an already under-resourced system. Third, an emerging conflict was witnessed. People in prison felt neglected regarding their healthcare needs but staff reported doing the best they could in an unprecedented situation. Healthcare staff and decision makers felt that prison healthcare was seen as a poor relation when compared with healthcare in the community, with no extra resource or staffing for Covid-19 testing or vaccinations.

Conclusion
The Covid-19 pandemic has significantly impacted almost all aspects of prison healthcare in the UK. This includes delivery of healthcare by staff, receipt of it by people in prison and the management, planning and commissioning of it by decision makers. These three groups of people were all affected detrimentally but in vastly different ways, with some participants describing a sense of trauma. Health needs that were exacerbated or went unmet during Covid urgently need to be addressed in order to reduce health inequalities. In order for welfare and wellbeing to be maintained, and in some cases repaired, both prisoners and staff need to feel heard and recognised.
Overwintering aggregation patterns of European catfish Silurus glanis
Authors: Westrelin Samuel , Moreau Mathieu , Fourcassié Vincent , Santoul Frédéric 
Published: February 2023

AbstractAnimal aggregation, particularly in large-bodied species, is both a fascinating and intriguing phenomenon. Here we analyzed the overwintering behavior of the European catfish,Silurus glanisLinnaeus, 1758, the largest freshwater fish in Europe. By tracking 47 subadults and adults in a shallow lake in southeastern France, we reported a consistent aggregative behavior across four successive winters. By implementing time series analysis and Cox proportional hazard models, we investigated the dynamics of these aggregations (formation, stability, dislocation), and the factors that govern it, whether external (temperature, time of the day) or specific to the fish (size, key individuals). These aggregations lasted 1.5–2 months and mainly took place in a single small 4 m-deep area whose environmental conditions (temperature, oxygen, substrate) did not differ from other parts of the lake. In some periods during winter, all tagged fish were aggregated, which suggests that a large proportion of the lake population gathered there. Low temperatures (below 9 °C) triggered the formation of aggregations. They became more stable with decreasing temperatures, while individuals more frequently left the aggregation, preferentially at dusk and at night, when temperatures increased. The largest individuals swam more frequently back and forth to the aggregation. Irrespective of their size, some individuals consistently arrived earlier in the aggregation in winter and left later. This predictable seasonal grouping of individuals and, more generally, the knowledge provided by such studies on how species use space have important operational value and are useful for species conservation as well as for species control.
Identification and gene expression profiling of human gonadotrophic pituitary adenoma stem cells
Authors: Yuan Linhao , Li Peiliang , Li Jiang , Peng Jiayi , Zhouwen Jianlong , Ma Shunchang , Jia Guijun , Jia Wang , Kang Peng 
Published: February 2023

Abstract
Background
Gonadotrophic pituitary adenoma is a major subtype of pituitary adenoma in the sellar region, but it is rarely involved in the hypersecretion of hormones into blood; thus, it is commonly regarded as “non-functioning.” Its tumorigenic mechanisms remain unknown. The aim of this study was to identify human gonadotrophic pituitary adenoma stem cells (hPASCs) and explore the underlying gene expression profiles. In addition, the potential candidate genes involved in the invasive properties of pituitary adenoma were examined.

Methods
The hPASCs from 14 human gonadotrophic pituitary adenoma clinical samples were cultured and verified via immunohistochemistry. Genetic profiling of hPASCs and the matched tumor cells was performed through RNA-sequencing and subjected to enrichment analysis. By aligning the results with public databases, the candidate genes were screened and examined in invasive and non-invasive gonadotrophic pituitary adenomas using Real-time polymerase chain reaction.

Results
The hPASCs were successfully isolated and cultured from gonadotrophic pituitary adenoma in vitro, which were identified as positive for generic stem cell markers (Sox2, Oct4, Nestin and CD133) via immunohistochemical staining. The hPASCs could differentiate into the tumor cells expressing follicle-stimulating hormone in the presence of fetal bovine serum in the culture medium. Through RNA-sequencing, 1352 differentially expressed genes were screened and identified significantly enriched in various gene ontologies and important pathways. The expression levels of ANXA2, PMAIP1, SPRY2, C2CD4A, APOD, FGF14 and FKBP10 were significantly upregulated while FNDC5 and MAP3K4 were downregulated in the invasive gonadotrophic pituitary adenomas compared to the non-invasive ones.

Conclusion
Genetic profiling of hPASCs may explain the tumorigenesis and invasiveness of gonadotrophic pituitary adenoma. ANXA2 may serve as a potential therapeutic target for the treatment of gonadotrophic pituitary adenoma.