bluuebunny/crossref_metadata_2025_split huggingface dataset:
Effect of Sodium Hypochlorite on Biofilm-Producing Organisms Isolated from A Hospital Drinking Water
Authors: BHASIN Ashna , JAIN Manisha , MISHRA Bibhabati , LOOMBA Poonam , SHARMA Abha , AGGRAWAL Tanvi 
Published: March 2023

Objectives: Providing safe drinking water is essential for maintaining healthcare quality. The presence of biofilms in the water supply protects the organism from the antimicrobial effects of disinfectants leading to the formation of the MDR pathogen pool. Therefore, this study was taken up to determine the prevalence of biofilm formation in the bacteria isolated from the water system of a tertiary health care setup and study the effect of disinfectants on biofilms.
Methods: Thirty-four drinking water samples were collected in sterile glass stopper bottles and transported to the lab. Standard bacteriological procedures identified isolates. Biofilm detection was carried out by the tissue culture plate (TCP) method. The effect of disinfectant (sodium hypochlorite) at various concentrations (0, 0.25, 0.5, 1, 2, and 4 %) on biofilm-producing organism were studied for 30 minutes and analyzed.
Results: The culture positivity was 76.4% (26/34). Twenty samples showed monomicrobial growth, while only six samples showed polymicrobial growth of organisms. The most common organism isolated was Pseudomonas aeruginosa. Biofilm production was seen more in polymicrobial organisms, 91.66 % (11/12). A high level of resistance to chlorine compounds was seen in biofilm-producing microorganisms, especially those that produced robust biofilms.
Conclusion: Resistance of biofilms against high levels of chlorine has implications for the delivery of safe drinking water. Drug resistance was seen in these organisms, which can be transmitted from drinking water sources to humans. Therefore, it is recommended that biofilm production should be evaluated in drinking water samples regularly..J Microbiol Infect Dis 2022; 12(4):17-24.
Development of human resources for health in Tanzania
Authors: Amani Paul J. , NGOWI1 RICHARD , DRATLER SANDRA 
Published: March 2023

Introduction
The Mzumbe University MSc Health Monitoring and Evaluation (M&E) Program, launched in 2013, is aimed at building human resources capacity in Tanzania and East Africa by developing high-caliber M&E professionals to provide leadership in public health systems and the private sector. This case study aimed to describe the process of establishing the program and report results of an interim evaluation.
Case
The program’s innovative curriculum focuses on enabling graduates to implement M&E systems that respond to organizational challenges. Program content was driven by results of a training needs assessment, which sought input from stakeholder organizations. The curriculum is competency-based with content determined by learning objectives established for each course. It is delivered over three academic semesters followed by a fourth semester during which students implement field projects that serve as their master’s dissertations. The program draws on outside faculty and M&E practitioners to assure that student learning is balanced between theory and practice. Graduates are expected to assume influential positions in their workplaces, including public and private health organizations, hospitals, central and local government health authorities as well as international health organizations.
Discussion
The MSc Health M&E Program at Mzumbe University serves as a model for sustainable human resources for health M&E capacity and development in the East African region and beyond. The interim evaluation validated the success of the methods used in program development and implementation. Student feedback indicates that they have acquired the required skills to serve successfully in M&E leadership positions post-graduation.
An early assessment of Uganda’s roll-out of Option B+:
Authors: BARYAMUTUMA ROSE , KANSIIME EDGAR , NUWAGABA CHARITY KYOMUGISHA , NABITAKA LINDA , MUHUMUZA SIMON , AKELLO EVELYN , MUSINGUZI JOSHUA , BAZEYO WILLIAM , CELENTANO JESSICA , LINDAN3 CHRISTINA 
Published: March 2023

Background: Uganda was one of the first countries in sub-Saharan Africa to implement Option B+as its national strategy for prevention-of-mother-to-child transmission (PMTCT) of HIV, doing so in 2013. We report on two evaluations designed to assess the capacity of the health care system to implement Option B+,and to obtain preliminary information on the maternal-to-child-transmission rate of HIV.
Methods: We performed: 1) a cross-sectional assessment in 2014 of 505 health care facilities (49 district hospitals, 83 Health Center [HC] IVs, and 373 HCIIIs)in 62 of Uganda’s 112 districts to evaluate whether services and commodities required for Option B+ were being provided; and 2) a retrospective record review of 283 HIV-exposed infants enrolled in post-natal care in 2013 in the Central Region to evaluate infant outcomes at 18-months of age.
Results: Less than 50% of HCIIIs performed routine diagnostics, including syphilis, hemoglobin, and urinalysis testing, required at all ante-natal clinics; almost all facilities performed a baseline CD4 cell count, but only 44.5% of HCIIIs and 60.2% of HCIVs performed follow-up testing. The proportion of facilities monitoring anti retroviral therapy (ART) (47.2-69.4%) and clinic adherence (50.0-67.3%) was low. Many facilities (20.4-45.8%) reported stock-outs of ART and HIV test kits in the prior month. At 18 months, 53.7% of HIV-exposed infants were lost to follow-up (LTFU). Among those retained, 6.5% were HIV infected.
Conclusion: Significant shortcomings in service provision and high LTFU of HIV-exposed infants are barriers to Uganda’s ability to implement Option B+ successfully.
Determinants of Male Partner Involvement in Antenatal and Postnatal Care in Bumula Sub-County, Kenya
Authors: WANYAMA INVIOLATA NAFULA , NDUNYU LOUISA , GUYAH BERNARD , FELIX HUMWA 
Published: March 2023

Introduction
Men play a significant role in health-seeking behaviour of their families. While determinants of men’s involvement in reproductive health matters have been studied, the same are likely to vary on the basis of social context. The objective of this study was to determine socio-demographic, cultural and health facility factors influencing male partner involvement in Antenatal Care (ANC) and Postnatal Care (PNC). Moreover, the study intended to determine perceived benefits of male involvement in ANC and PNC services.
Methods
This was a cross-sectional household survey. Simple random sampling was used to select 398 men and women participants out of 1,716 households in Bumula Sub-County. The men and women interviewed were not necessarily couples. Questionnaires were administered to participants within the households by face-to-face interview. The data collected through the questionnaires were on their sociodemographic, cultural, and health-related factors, and perceived benefits of male involvement in ANC and PNC. Key informant interviews were conducted among 14 health workers.
Results
Participants having college education were more likely to report male involvement (adjusted Odds Ratio (AOR) = 3.25, 95% CI [1.03-10.25], p=0.044) compared to those with no education. Participants who made joint decisions with partners (p<0.0001) and who viewed PNC as necessary (p=0.021) were more likely to report male involvement. Cultural practices were a major impediment to male involvement because of the portrayal of male dominance in roles of financial support and inferiority if a male accompanies a spouse to a clinic.
Conclusion
Education had a favorable influence on male involvement. Cultural practices were a major impediment to male involvement due to its portrayal of male dominance in roles of financial support and inferiority if male accompanies spouse to PNC and ANC. The study recommends intensified health education messaging to increase support for male involvement and a further study to explore specific societal norms and beliefs that undermine male partner participation in ANC and PNC.
Real-Time Telepathology Is Substantially Equivalent to In-Person Intraoperative Frozen Section Diagnosis
Authors: Rohr Joseph M. , Ginnebaugh Kevin , Tuthill Mark , Pimentel Jason , Markin Rodney 
Published: March 2023

Context.—
Intraoperative diagnosis by frozen section is a mainstay of surgical pathology practice, providing immediate feedback to the surgical team. Despite good accuracy with modern methods, access to intraoperative surgical pathology with an appropriate turnaround time (TAT) has been a limiting factor for small or remote surgical centers, with negative impacts on cost and patient care. Telepathology offers immediate expert anatomic pathology consultation to sites without an in-house or subspecialized pathologist.

Objective.—
To assess the utility of live telepathology in frozen section practice.

Design.—
Frozen section diagnoses by telemicroscopy from 2 tertiary care centers with a combined 3 satellite hospitals were queried for anatomic site, TAT per block, pathologist, and concordance with paraffin diagnosis. TAT and concordance were compared to glass diagnoses in the same period.

Results.—
For 748 intraoperative diagnoses by telemicroscopy, 694 had TATs with a mean of 18 minutes 56 seconds ± 8 minutes 45 seconds, which was slower than on glass (14 minutes 25 seconds ± 7 minutes 8 seconds, P &lt; .001). Twenty-two (2.89% of available) were discordant, which was not significantly different from the on-glass rate (P = .44) or categorical distribution (P = .31). Two cases (0.27%) had technical failures.

Conclusions.—
Although in-person diagnoses were statistically faster, the great majority of telemicroscopic diagnoses were returned in less than 20 minutes. This remained true through numerous pathologists, pathology assistants and/or technicians, different hospitals, and during a combined 6 years. The concentration of discordant diagnoses among relatively few pathologists suggests individual comfort with telepathology and/or frozen section diagnosis. In rare cases, technical issues prevented telemicroscopic diagnosis. Overall, this justifies continued use and expansion of telemicroscopic services in primary intraoperative diagnoses.
Update on Sinonasal Tract Malignancies: Advances in Diagnostic Modalities
Authors: Gubbiotti Maria A. , LiVolsi Virginia , Montone Kathleen T. 
Published: March 2023

Context.—
Sinonasal tract malignancies are rare cancers with frequent morphologic overlap. Given the similar histologic profiles seen in many of these entities, they often present a diagnostic challenge to the practicing pathologist.

Objective.—
To provide a streamlined algorithm using histologic clues, immunohistochemical profiles, and molecular assays to aid in diagnosis of these lesions.

Data Sources.—
Sources were the World Health Organization Tumor Classification, literature review, and institutional experience.

Conclusions.—
Although many sinonasal tract malignancies show similar histology, distinct immunohistochemical and molecular profiles can help parse out differences, thereby facilitating diagnosis for the pathologist.
Health-related quality of life and associated factors after hip fracture. Results from a six-month prospective cohort study
Authors: Deutschbein Johannes , Lindner Tobias , Möckel Martin , Pigorsch Mareen , Gilles Gabriela , Stöckle Ulrich , Müller-Werdan Ursula , Schenk Liane 
Published: March 2023

BackgroundHip fractures are a major public health problem with increasing relevance in aging societies. They are associated with high mortality rates, morbidity, and loss of independence. The aim of the EMAAge study was to determine the impact of hip fractures on patient-reported health-related quality of life (HRQOL), and to identify potential risk factors for worse outcomes.MethodsEMAAge is a multicenter, prospective cohort study of patients who suffered a hip fracture. Patients or, if necessary, proxies were interviewed after initial treatment and after six months using standardized questionnaires including the EQ-5D-5L instrument, the Oxford Hip Score, the PHQ-4, the Short Nutritional Assessment Questionnaire, and items on patients living situation. Medical data on diagnoses, comorbidities, medications, and hospital care were derived from hospital information systems.ResultsA total of 326 patients were included. EQ-5D index values decreased from a mean of 0.70 at baseline to 0.63 at six months. The mean self-rated health on the EQ-VAS decreased from 69.9 to 59.4. Multivariable linear regression models revealed three relevant associated factors with the six-months EQ-5D index: symptoms of depression and anxiety, pre-fracture limitations in activities of daily living, and no referral to a rehabilitation facility had a negative impact. In addition, the six-months EQ-VAS was negatively associated with polypharmacy, living in a facility, and migration background.ConclusionsHip fractures have a substantial negative impact on patients HRQOL. Our results suggest that there are modifying factors that need further investigation including polypharmacy and migration background. Structured and timely rehabilitation seems to be a protective factor.
The effect of a combined sprint training intervention on sprint force-velocity characteristics in junior Australian football players
Authors: Hicks Dylan Shaun , Drummond Claire , Williams Kym J. , van den Tillaar Roland 
Published: March 2023

Background
Sprint performance in junior Australian football (AF) players has been shown to be a differentiating quality in ability level therefore developing sprint characteristics via sprint-specific training methods is an important aspect of their physical development. Assisted sprint training is one training method used to enhance sprint performance yet limited information exists on its effect on sprint force-velocity characteristics. Therefore, the main aim of this study was to determine the influence of a combined sprint training intervention using assisted and maximal sprint training methods on mechanical characteristics and sprint performance in junior Australian football players.

Methods
Upon completing familiarization and pre-testing, twenty-two male junior Australian football (AF) players (age 14.4 ± 0.3 years, body mass 58.5 ± 10.0 kg, and height 1.74 ± 0.08 m) were divided into a combined sprint training (CST) group (n = 14), and a maximal sprint training (MST) group (n = 8) based on initial sprint performance over 20-meters. Sprint performance was assessed during maximal 20-meter sprint efforts via a radar gun (36 Hz), with velocity-time data used to derive force-velocity characteristics and split times. All subjects then completed a 7-week in-season training intervention consisting of maximal sprinting (MST & CST groups) and assisted sprinting (CST only), along with their usual football specific exercises.

Results
Moderate to large pre-post within group effects (−0.65 ≤ ES ≥ 0.82. p ≤ 0.01) in the CST group for relative theoretical maximal force (F0) and power (Pmax) were reflected in improved sprint performance from 0–20 m, thereby creating a more force-oriented F-v profile. The MST group displayed statistically significant pre-post differences in sprint performance between 10–20 m only (ES = 0.18, p = 0.04). Moderate to high relative reliability was achieved across all sprint variables (ICC = 0.65–0.91), except for the force-velocity slope (SFV) and decrement in ratio of forces (DRF) which reported poor reliability (ICC = 0.41–0.44), while the CST group exceeded the pre-post minimal detectable change (MDC) in most sprint variables suggesting a ‘true change’ in performance across the intervention.

Conclusion
It is concluded that implementing a short-term, combined sprint training intervention consisting of assisted and maximal sprint training methods may enhance sprint mechanical characteristics and sprint performance to 20-meters in junior AF players.
Metabolomics combined with clinical analysis explores metabolic changes and potential serum metabolite biomarkers of antineutrophil cytoplasmic antibody-associated vasculitis with renal impairment
Authors: Liu Siyang , Xu Qing , Wang Yiru , Lv Yongman , Liu Qing quan 
Published: March 2023

Background
Antineutrophil cytoplasmic antibody (ANCA)-associated vasculitis (AAV) is an autoimmune systemic disease, and the majority of AAV patients have renal involvement presenting as rapid progressive glomerulonephritis (GN). Currently, the clinically available AAV markers are limited, and some of the newly reported markers are still in the nascent stage. The particular mechanism of the level changes of various markers and their association with the pathogenesis of AAV are not well defined. With the help of metabolomics analysis, this study aims to explore metabolic changes in AAV patients with renal involvement and lay the foundation for the discovery of novel biomarkers for AAV-related kidney damage.

Methods
We performed liquid chromatography-tandem mass spectrometry (LC-MS/MS)-based on serum samples from patients with AAV (N = 33) and healthy controls (N = 33) in order to characterize the serum metabolic profiling. The principal component analysis (PCA) and orthogonal partial least-squares-discriminant analysis (OPLS-DA) were used to identify the differential metabolites. Least Absolute Shrinkage and Selection Operator (LASSO) and eXtreme Gradient Boosting (XGBoost) analysis were further conducted to identify the potential diagnostic biomarker. A receiver operating characteristic (ROC) curve analysis was conducted to evaluate the diagnostic performance of the identified potential biomarker.

Results
A total of 455 metabolites were detected by LC-MS analysis. PCA and OPLS-DA demonstrated a significant difference between AAV patients with renal involvement and healthy controls, and 135 differentially expressed metabolites were selected, with 121 upregulated and 14 downregulated. Ninety-two metabolic pathways were annotated and enriched based on the KEGG database. N-acetyl-L-leucine, Acetyl-DL-Valine, 5-hydroxyindole-3-acetic acid, and the combination of 1-methylhistidine and Asp-phe could accurately distinguish AAV patients with renal involvement from healthy controls. And 1-methylhistidine was found to be significantly associated with the progression and prognosis of AAV with renal impairment. Amino acid metabolism exhibits significant alternations in AAV with renal involvement.

Conclusion
This study identified metabolomic differences between AAV patients with renal involvement and non-AAV individuals. Metabolites that could accurately distinguish patients with AAV renal impairment from healthy controls in this study, and metabolites that were significantly associated with disease progression and prognosis were screened out. Overall, this study provides information on changes in metabolites and metabolic pathways for future studies of AAV-related kidney damage and lays a foundation for the exploration of new biomarkers of AAV-related kidney damage.
Differences in Merkel Cell Carcinoma Presentation and Outcomes Among Racial and Ethnic Groups
Authors: Mohsin Noreen , Martin Mackenzie R. , Reed Danielle J. , Vilasi Serena M. , Miao Lingling , Hill Natasha T. , Brownell Isaac 
Published: March 2023

ImportanceRacial and ethnic differences in skin cancer outcomes are understudied. Delineating these differences in Merkel cell carcinoma (MCC) is needed to better understand this rare disease.ObjectiveTo determine how MCC presentation and outcomes differ across racial and ethnic groups.Design, Setting, and ParticipantsThis retrospective cohort study included patients diagnosed with MCC and followed up from 2000 through 2018 in the 18 population-based cancer registries of the National Cancer Institute’s Surveillance, Epidemiology, and End Results Program. Patients without follow-up data were excluded. Data analysis occurred from March 12 to November 30, 2022.Main Outcomes and MeasuresA Cox proportional hazards regression was conducted to determine associations between demographic variables (race and ethnicity, age, sex, and income) and clinical variables (stage at diagnosis, primary site, and diagnosis year) with MCC-specific survival.ResultsOf the 9557 patients with MCC identified (6758 [70.7%] aged ≥70 years; 6008 [62.9%] male), 222 (2.3%) were Asian American or Pacific Islander, 146 (1.5%) Black, 541 (5.7%) Hispanic, and 8590 (89.9%) White. Hispanic patients had improved MCC-specific survival compared with White patients (hazard ratio, 0.82; 95% CI, 0.67-0.99; P = .04). Black patients had the lowest MCC-specific survival, but it was not statistically different from White patients (hazard ratio, 1.19; 95% CI, 0.86-1.60; P = .28). Hispanic and Black patients were less likely to present with a primary site of the head and neck than White patients (183 of 541 [33.8%] Hispanic patients and 45 of 146 [30.8%] Black patients vs 3736 of 8590 [43.5%] White patients; P &amp;lt; .001 and P = .002, respectively). Black patients presented more often than White patients with advanced disease at diagnosis (59 of 146 [40.4%] vs 2510 of 8590 [29.2%]; P = .004).Conclusions and RelevanceIn this cohort study, there were differences between racial and ethnic groups in observed MCC outcomes and disease characteristics. Further investigations are warranted into the findings that, compared with White patients, Hispanic patients with MCC had improved outcomes and Black patients did not have worse outcomes despite presenting with more advanced disease.