bluuebunny/crossref_metadata_2025_split huggingface dataset:
Ethnomedicinal health seeking practices and their associated treatment outcomes in managing diarrheal diseases among under-five-year-old children in Korogwe and Handeni Districts, Tanzania: Protocol for a cross-sectional mixed method study
Authors: Liheluka Edwin , Gibore Sophia Nyasiro , Lusingu John P. A. , Gesase Samwel , Minja Daniel T. R. , Lamshöft Maike , Dekker Denise , Bali Theodora 
Published: February 2023

AbstractBackgroundEthnomedicinal remedies relevant for treating a range of ailments including diarrheal diseases among children aged less than five years is an integral component of the long-standing culture that communities have inherited from previous generations. The treatment also has mutual impact on the practice of health seeking behavior built within the family and clan level.Study ObjectiveTo assess ethnomedicinal health seeking practices and their associated treatment outcomes for managing diarrheal diseases among children aged below five years children in Korogwe and Handeni Districts, TanzaniaMethodsA mixed method approach will be employed whereby both qualitative and quantitative research approaches will be utilized. Narrative and cross-sectional research designs will be used for qualitative and quantitative research, respectively. The study population will include caretakers of under-five-year-old children, pediatric health care workers and traditional healers. Purposive sampling method will be used to select participants for qualitative research while a systematic random sampling will be used to select participants for quantitative research. Social Ecological Model (SEM) theory will be employed to elicit the target population perceptions and context-specific factors, which will explain the ethnomedicinal health seeking practices and their associated treatment outcomes in managing diarrheal diseases among under-five-year-old children in Korogwe and Handeni Districts, Tanzania.
Network Pharmacology and Bioinformatics Methods Reveal the Mechanism of Sishenwan in the Treatment of diabetic nephropathy
Authors: Deng Yuanyuan , Ma Yu , Zhang Sai , Zhang Mianzhi 
Published: February 2023

AbstractObjective. In order to decipher the bioactive components and potential mechanisms of the traditional Chinese medicine (TCM) formula Sishenwan (SSW) for diabetic nephropathy (DN), we integrated network pharmacology and bioinformatics.Methods. The candidate compounds of SSW and relative targets were obtained from the TCMSP, BATMAN-TCM, SiwssTartgetPrediction, STITCH, and ChEMBL web servers. The UniProt database was used to translate the target names into gene names, and then constructed the herbal-compound-target network. DN-related targets were ascertained based on OMIM, CTD, GeneCards, DisGeNET, and GEO. Furthermore, there was a protein-protein interaction (PPI) network to explore the overlapping targets between SSW and DN, which focused on screening the pivotal targets by topology. GO and KEGG enrichment analyses were carried out to further understand the potential functions associated with the effect of SSW against DN. Eventually, molecular docking simulations were performed to validate the binding affinity between major bioactive components and hub genes.Results.A total of 120 candidate active compounds and 542 corresponding drug targets were derived, in which 195 targets intersected with DN. Then, KEGG pathway analysis showed that several signaling pathways were closely related to the process of SSW against DN, including the AGE-RAGE signaling pathway in diabetic complications, the TNF signaling pathway, and IL-17 signaling pathway, ect. The PPI network analysis identifiedPTGS2, CREB1, ESR1, TNF, IL1B, INS, AKT1, PPARG, andJUNwere the top 9 hub targets. The molecular docking confirmed that the bioactive compounds of SSW had a firm binding affinity with hub targets.Conclusions. As a whole, the present study revealed that SSW exerted therapeutic effects on DN via modulating multi-targets with multi-compounds through multi-pathways.
Diffuse myocardial fibrosis associates with incident ventricular arrhythmia in implantable cardioverter defibrillator recipients
Authors: Olausson Eric , Wertz Jonathon , Fridman Yaron , Bering Patrick , Maanja Maren , Niklasson Louise , Wong Timothy C , Fukui Miho , Cavalcante João L. , Cater George , Kellman Peter , Bukhari Syed , Miller Christopher A. , Saba Samir , Ugander Martin , Schelbert Erik B. 
Published: February 2023

AbstractBackgroundDiffuse myocardial fibrosis (DMF) quantified by extracellular volume (ECV) may represent a vulnerable phenotype and associate with life threatening ventricular arrhythmias more than focal myocardial fibrosis. This principle remains important because 1) risk stratification for implantable cardioverter defibrillators (ICD) remains challenging, and 2) DMF may respond to current or emerging medical therapies (reversible substrate).ObjectivesTo evaluate the association between quantified by ECV in myocardium without focal fibrosis by late gadolinium enhancement (LGE) with time from ICD implantation to 1) appropriate shock, or 2) shock or anti-tachycardia pacing.MethodsAmong patients referred for cardiovascular magnetic resonance (CMR) without congenital disease, hypertrophic cardiomyopathy, or amyloidosis who received ICDs (n=215), we used Cox regression to associate ECV with incident ICD therapy.ResultsAfter a median of 2.9 (IQR 1.5-4.2) years, 25 surviving patients experienced ICD shock and 44 experienced shock or anti-tachycardia pacing. ECV ranged from 20.2% to 39.4%. No patient with ECV<25% experienced an ICD shock. ECV associated with both endpoints, e.g., hazard ratio 2.17 (95%CI 1.17-4.00) for every 5% increase in ECV, p=0.014 in a stepwise model for ICD shock adjusting for ICD indication, age, smoking, atrial fibrillation, and myocardial infarction, whereas focal fibrosis by LGE and global longitudinal strain (GLS) did not.ConclusionsDMF measured by ECV associates with ventricular arrhythmias requiring ICD therapy in a dose-response fashion, even adjusting for potential confounding variables, focal fibrosis by LGE, and GLS. ECV-based risk stratification and DMF representing a therapeutic target to prevent ventricular arrhythmia warrant further investigation.Condensed AbstractAnalogous to heart failure and mortality outcomes, diffuse myocardial fibrosis (DMF) quantified by extracellular volume (ECV) may represent a more vulnerable phenotype for life-threatening ventricular arrhythmia than focal myocardial fibrosis. In patients referred for cardiovascular magnetic resonance, we identified 215 subsequently receiving implantable cardioverter defibrillators (ICD). After a median of 2.9 (IQR 1.5-4.2) years, 25 patients experienced ICD shock and 44 experienced shock or anti-tachycardia pacing. ECV associated with ICD therapy in Cox regression models. Focal fibrosis variables or global longitudinal strain did not. ECV-based risk stratification and DMF representing a therapeutic target to prevent ventricular arrhythmia warrant further investigation.
A Stakeholder-Led Understanding of the Implementation of Digital Technologies Within Heart Disease Diagnosis: A Qualitative Study Protocol
Authors: Abdullayev K , Chico TJA , Manktelow M , Buckley O , Condell J , Van Arkel RJ , Diaz-Zuccarini V , Matcham Faith 
Published: February 2023

AbstractIntroductionCardiovascular diseases are highly prevalent amongst the UK population, and the quality of care is being reduced due to accessibility and resource issues. Increased implementation of digital technologies into the cardiovascular care pathway has enormous potential to lighten the load on the NHS, however, it is not possible to adopt this shift without embedding the perspectives of service users and clinicians.Methods and AnalysisA series of qualitative studies will be carried out with the aim of developing a stakeholder-led perspective on the implementation of digital technologies to improve holistic diagnosis of heart disease. Focus groups will be carried out with 20 people with lived experience of heart disease, and interviews will be carried out with 10 clinicians with experience of diagnosing heart diseases. The data will be analysed using an inductive thematic analysis approach.Ethics and DisseminationThis study received ethical approval from the Sciences and Technology Cross Research Council at the University of Sussex. The findings will be disseminated through conference presentations, peer-reviewed publications and to the study participants.Strengths and LimitationsThe study materials have been informed by patient advisory boards, meaning they are sensitive to the experiences of the participants and the clinicians that will be recruited.The study will allow an in-depth understanding of the attitudes and experience of people with lived experience of heart disease and clinicians with experience of diagnosing heart disease.The use of an online research platform for participant recruitment will disadvantage those less comfortable using online resources. This may include those living in deprived areas without access to high quality technologies (which disproportionately excludes ethnic minority groups) and clinical populations with comorbidities that prevent the use of certain technologies, such as visual, auditory, physical, or learning impairments.The use of thematic analysis will not be free from the influence of the researcher’s personal experience and knowledge
The straight and narrow: a game theory model of broad- and narrow-spectrum empiric antibiotic therapy
Authors: Diamant Maya , Obolski Uri 
Published: February 2023

AbstractPhysicians prescribe empiric antibiotic treatment when definitive knowledge of the pathogen causing an infection is lacking. The options of empiric treatment can be largely divided into broad- and narrow-spectrum antibiotics. Prescribing a broad-spectrum antibiotic increases the chances of covering the causative pathogen, and hence benefits the current patient’s recovery. However, prescription of broad-spectrum antibiotics also accelerates the expansion of antibiotic resistance, potentially harming future patients. We analyze the social dilemma using game theory. In our game model, physicians choose between prescribing broad and narrow-spectrum antibiotics to their patients. Their decisions rely on the probability of an infection by a resistant pathogen before definitive laboratory results are available. We prove that whenever the equilibrium strategies differ from the socially optimal policy, the deviation is always towards a more excessive use of the broad-spectrum antibiotic. We further show that if prescribing broad-spectrum antibiotics only to patients with a high probability of resistant infection is the socially optimal policy, then decentralization of the decision making may make this policy individually irrational, and thus sabotage its implementation. We discuss the importance of improving the probabilistic information available to the physician and promoting centralized decision making.
Impact of online health information-seeking behavior on shared decision-making in patients with systemic lupus erythematosus: the TRUMP2-SLE project
Authors: Ichikawa Takanori , Kishida Dai , Shimojima Yasuhiro , Yajima Nobuyuki , Oguro Nao , Yoshimi Ryusuke , Sakurai Natsuki , Hidekawa Chiharu , Sada Ken-ei , Miyawaki Yoshia , Hayashi Keigo , Shidahara Kenta , Ishikawa Yuichi , Sekijima Yoshiki , Kurita Noriaki 
Published: February 2023

ABSTRACTObjectiveProviding appropriate health information to patients with systemic lupus erythematosus (SLE) is advantageous in the treatment decision-making process. We aimed to investigate how online health information-seeking behavior affects shared decision-making (SDM) in patients with SLE.MethodsThis cross-sectional study included 464 patients with SLE from five institutions. The main exposure was time spent on the Internet per day, which was divided into four categories (none, <1 h, 1–<2 h, and ≥2 h). Participants categorized their preferred first source of health information as physicians, the Internet, or other media. The outcome was the degree of SDM measured via the 9-item Shared Decision-Making Questionnaire (SDM-Q-9). A general linear model was applied.ResultsCompared with no Internet use, longer internet use was associated with a higher SDM-Q-9 score: <1 h, 6.9 points (95% confidence interval [CI] 0.32 to 13.6) and ≥2 h, 8.75 points, (95% CI 0.61 to 16.9). The SDM-Q-9 did not differ between those who chose physicians and those who chose the Internet as their preferred first source of health information (-2.1 points [95% CI -6.7 to 2.6]). Those who chose other media had significantly lower SDM-Q-9 scores than those who chose physicians (-7.6 points [95% CI -13.2 to -1.9]).ConclusionsThe present study suggests that SDM between physicians and patients is positively (rather than adversely) associated with online information-seeking behavior, with no negative influence associated with accessing the Internet prior to visits to a rheumatologist. Rheumatologists may need to introduce their patients to websites offering high-quality health information to establish a productive physician–patient relationship for SDM.
An economic evaluation ofWolbachiadeployments for dengue control in Vietnam
Authors: Turner Hugo C , Quyen Duong Le , Dias Reynold , Huong Phan Thi , Simmons Cameron P. , Anders Katherine L 
Published: February 2023

AbstractBackgroundDengue is a major public health challenge and a growing problem due to climate change. The release ofAedes aegyptimosquitoes infected with the intracellular bacteriumWolbachiais a novel form of vector control against dengue. However, there remains a need to evaluate the benefits of such an intervention at a large scale. In this paper, we evaluate the potential economic impact and cost-effectiveness of scaledWolbachiadeployments as a form of dengue control in Vietnam – targeted at the highest burden urban areas.MethodsTen settings within Vietnam were identified as priority locations for potential futureWolbachiadeployments (using a population replacement strategy). The effectiveness ofWolbachiadeployments in reducing the incidence of symptomatic dengue cases was assumed to be 75%. We assumed that the intervention would maintain this effectiveness for at least 20 years (but tested this assumption in the sensitivity analysis). A cost-utility analysis and cost-benefit analysis were conducted.ResultsFrom the health sector perspective, theWolbachiaintervention was projected to cost US$420 per disability-adjusted life year (DALY) averted. From the societal perspective, the overall cost-effectiveness ratio was negative, i.e. the economic benefits outweighed the costs. These results are contingent on the long-term effectiveness ofWolbachiareleases being sustained for 20 years. However, the intervention was still classed as cost-effective across the majority of the settings when assuming only 10 years of benefits.ConclusionOverall, we found that targeting high burden cities withWolbachiadeployments would be a cost-effective intervention in Vietnam and generate notable broader benefits besides health gains.
Adaptive metrics for an evolving pandemic A dynamic approach to area-level COVID-19 risk designations
Authors: Bilinski Alyssa M. , Salomon Joshua A. , Hatfield Laura A. 
Published: February 2023

Throughout the COVID-19 pandemic, policymakers have proposed risk metrics, such as the CDC Community Levels, to guide local and state decision-making. However, risk metrics have not reliably predicted key outcomes and often lack transparency in terms of prioritization of false positive versus false negative signals. They have also struggled to maintain relevance over time due to slow and infrequent updates addressing new variants and shifts in vaccine- and infection-induced immunity. We make two contributions to address these weaknesses of risk metrics. We first present a framework to evaluate predictive accuracy based on policy targets related to severe disease and mortality, allowing for explicit preferences toward false negative versus false positive signals. This approach allows policymakers to optimize metrics for specific preferences and interventions. Second, we propose a novel method to update risk thresholds in real-time. We show that this adaptive approach to designating areas as “high risk” improves performance over static metrics in predicting 3-week-ahead mortality and intensive care usage at both state and county levels. We also demonstrate that with our approach, using only new hospital admissions to predict 3-week-ahead mortality and intensive care usage has performed consistently as well as metrics that also include cases and inpatient bed usage. Our results highlight that a key challenge for COVID-19 risk prediction is the changing relationship between indicators and outcomes of policy interest. Adaptive metrics therefore have a unique advantage in a rapidly evolving pandemic context.Significance StatementIn the rapidly-evolving COVID-19 pandemic, public health risk metrics often become less relevant over time. Risk metrics are designed to predict future severe disease and mortality based on currently-available surveillance data, such as cases and hospitalizations. However, the relationship between cases, hospitalizations, and mortality has varied considerably over the course of the pandemic, in the context of new variants and shifts in vaccine- and infection-induced immunity. We propose an adaptive approach that regularly updates metrics based on the relationship between surveillance inputs and future outcomes of policy interest. Our method captures changing pandemic dynamics, requires only hospitalization input data, and outperforms static risk metrics in predicting high-risk states and counties.
Quantification of early nonpharmaceutical interventions aimed at slowing transmission of Coronavirus Disease 2019 in the Navajo Nation and surrounding states (Arizona, Colorado, New Mexico, and Utah)
Authors: Miller Ely F. , Neumann Jacob , Chen Ye , Mallela Abhishek , Lin Yen Ting , Hlavacek William S. , Posner Richard G. 
Published: February 2023

AbstractDuring an early period of the Coronavirus Disease 2019 (COVID-19) pandemic, the Navajo Nation, much like New York City, experienced a relatively high rate of disease transmission. Yet, between January and October 2020, it experienced only a single period of growth in new COVID-19 cases, which ended when cases peaked in May 2020. The daily number of new cases slowly decayed in the summer of 2020 until late September 2020. In contrast, the surrounding states of Arizona, Colorado, New Mexico, and Utah all experienced at least two periods of growth in the same time frame, with second surges beginning in late May to early June. To investigate the causes of this difference, we used a compartmental model accounting for distinct periods of non-pharmaceutical interventions (NPIs) (e.g., behaviors that limit disease transmission) to analyze the epidemic in each of the five regions. We used Bayesian inference to estimate region-specific model parameters from regional surveillance data (daily reports of new COVID-19 cases) and to quantify uncertainty in parameter estimates and model predictions. Our results suggest that NPIs in the Navajo Nation were sustained over the period of interest, whereas in the surrounding states, NPIs were relaxed, which allowed for subsequent surges in cases. Our region-specific model parameterizations allow us to quantify the impacts of NPIs on disease incidence in the regions of interest.
The role of serum brain injury biomarkers in individuals with a mild-to-moderate COVID infection and Long-COVID - results from the prospective population-based COVI-GAPP study
Authors: Telser Julia , Grossmann Kirsten , Weideli Ornella C , Hillmann Dorothea , Aeschbacher Stefanie , Wohlwend Niklas , Velez Laura , Kuhle Jens , Maleska Aleksandra , Benkert Pascal , Risch Corina , Conen David , Risch Martin , Risch Lorenz 
Published: February 2023

AbstractBackgroundDuring and after mild (no hospitalization) or moderate (hospitalization without ICU) SARS-CoV-2 infections, a wide range of symptoms, including neurological disorders have been reported. It is, however, unknown if these neurological symptoms are associated with brain injury and whether brain injury and related symptoms also emerge in patients suffering from Long-COVID. Neuronal biomarkers such as serum neurofilament light chain and glial fibrillary acidic protein can be used to elucidate neuro-axonal and astroglial injuries. We therefore investigated whether these biomarkers are associated with the COVID-19 infection status (mild-to-moderate), the associated symptoms and Long-COVID.MethodsFrom 146 individuals of the general population with a post-acute, mild-to-moderate SARS-CoV-2 infection, serum neurofilament light chain (sNfL; marker of intra-axonal neuronal injury) and serum glial fibrillary acidic protein (sGFAP; marker of astrocytic activation/injury) were measured. Samples were taken before, during and after (five and ten months) a SARS-CoV-2 infection. Individual symptoms and Long-COVID status were assessed using questionnaires.ResultsNeurological symptoms were described for individuals after a mild and moderate COVID-19 infection, however, serum markers of brain injury (sNfL/sGFAP) did not change after an infection (sNfL:P= 0.74; sGFAP:P= 0.24) and were not associated with headache (P= 0.51), fatigue (P= 0.93), anosmia (P= 0.77) and ageusia (P= 0.47). In participants with Long-COVID, sGFAP (P= 0.038), but not sNfL (P= 0.58) significantly increased but was not associated with neurological symptoms.ConclusionNeurological symptoms in individuals after a mild-to-moderate SARS-CoV-2 infection with and without Long-COVID were not associated with brain injury, although there was some astroglial injury observed in Long-COVID patients.FundingThe COVI-GAPP study received grants from the Innovative Medicines Initiative (IMI grant agreement number 101005177), the Princely House of Liechtenstein, the government of the Principality of Liechtenstein, and the Hanela Foundation (Switzerland). None of the funders played a role in the study design, data collection, data analysis, data interpretation, writing of the report, or decision to publish.
Accumulation of Tau in Extracellular Vesicles Disturbs the Astrocytic Mitochondrial System
Authors: Perbet Romain , Zufferey Valentin , Leroux Elodie , Parietti Enea , Espourteille Jeanne , Culebras Lucas , Perriot Sylvain , Pasquier Renaud Du , Bégard Séverine , Deramecourt Vincent , Déglon Nicole , Toni Nicolas , Buée Luc , Colin Morvane , Richetin Kevin 
Published: February 2023

AbstractTauopathies are neurodegenerative disorders involving the accumulation of tau isoforms in cell subpopulations such as astrocytes. The origins of the 3R and 4R isoforms of tau that accumulate in astrocytes remain unclear.Extracellular vesicles (EVs) were isolated from primary neurons overexpressing 1N3R or 1N4R tau or from human brain extracts (progressive supranuclear palsy or Pick disease patients or controls) and characterized (electron microscopy, nanoparticle tracking analysis (NTA), proteomics). After the isolated EVs were added to primary astrocytes or human iPSC-derived astrocytes, tau transfer and mitochondrial system function were evaluated (ELISA, immunofluorescence, MitoTracker staining). We demonstrated that neurons in which 3R or 4R tau accumulated had the capacity to transfer tau to astrocytes and that EVs were essential for the propagation of both isoforms of tau. Treatment with tau-containing EVs disrupted the astrocytic mitochondrial system, altering mitochondrial morphology, dynamics and redox state. Although similar levels of 3R and 4R tau were transferred, 3R tau-containing EVs were significantly more damaging to astrocytes than 4R tau-containing EVs. Moreover, EVs isolated from the brain fluid of patients with different tauopathies affected mitochondrial function in astrocytes derived from human iPSCs. Our data highlight that tau pathology spreads to surrounding astrocytes via EVs-mediated transfer and modify their function.