bluuebunny/crossref_metadata_2025_split huggingface dataset:
What are the pathways between poverty and malaria in sub-Saharan Africa? A systematic review of mediation studies
Authors: Wafula Solomon T. , Habermann Theresa , Franke Mara Anna , May Jürgen , Puradiredja Dewi Ismajani , Lorenz Eva , Brinkel Johanna 
Published: June 2023

Abstract
Background
Malaria remains a major burden in sub-Saharan Africa (SSA). While an association between poverty and malaria has been demonstrated, a clearer understanding of explicit mechanisms through which socioeconomic position (SEP) influences malaria risk is needed to guide the design of more comprehensive interventions for malaria risk mitigation. This systematic review provides an overview of the current evidence on the mediators of socioeconomic disparities in malaria in SSA.

Methods
We searched PubMed and Web of Science for randomised controlled trials, cohort, case-control and cross-sectional studies published in English between January 1, 2000 to May 31, 2022. Further studies were identified following reviews of reference lists of the studies included. We included studies that either (1) conducted a formal mediation analysis of risk factors on the causal pathway between SEP and malaria infections or (2) adjusted for these potential mediators as confounders on the association between SEP and malaria using standard regression models. At least two independent reviewers appraised the studies, conducted data extraction, and assessed risk of bias. A systematic overview is presented for the included studies.

Results
We identified 41 articles from 20 countries in SSA for inclusion in the final review. Of these, 30 studies used cross-sectional design, and 26 found socioeconomic inequalities in malaria risk. Three formal mediation analyses showed limited evidence of mediation of food security, housing quality, and previous antimalarial use. Housing, education, insecticide-treated nets, and nutrition were highlighted in the remaining studies as being protective against malaria independent of SEP, suggesting potential for mediation. However, methodological limitations included the use of cross-sectional data, insufficient confounder adjustment, heterogeneity in measuring both SEP and malaria, and generally low or moderate-quality studies. No studies considered exposure mediator interactions or considered identifiability assumptions.

Conclusions
Few studies have conducted formal mediation analyses to elucidate pathways between SEP and malaria. Findings indicate that food security and housing could be more feasible (structural) intervention targets. Further research using well-designed longitudinal studies and improved analysis would illuminate the current sparse evidence into the pathways between SEP and malaria and adduce evidence for more potential targets for effective intervention.

Graphical Abstract
Earthquake preparedness in an urban area: the case of Dhaka city, Bangladesh
Authors: Rahman Md Mostafizur , Asikunnaby  , Chaity Nawshin Jahan , Abdo Hazem Ghassan , Almohamad Hussein , Al Dughairi Ahmed Abdullah , Al-Mutiry Motrih 
Published: June 2023

AbstractThis study aims to assess people’s preparedness for a potential earthquake in Dhaka, the capital of Bangladesh. We have employed a model with six dimensions of holistic individual preparedness. A self-reported online survey included 677 total participants. The multiple linear regression model and the Spearman rank correlation were used as needed. The majority of the participants (> 65%) did not have experience with any earthquake preparedness program, despite the fact that 92% of the population surveyed claimed to have experienced an earthquake in their region. More than 50% of those who experienced earthquakes acquired knowledge. 30% of people do not have access to immediate financial support in the event of a crisis. It was estimated that almost 50% of the population did not have earthquake insurance. Females lack the adaptability of males. A person’s level of earthquake preparedness was significantly associated with their level of education, household head occupation and monthly income, type of residential unit, and experience of earthquake preparedness program. Therefore, these factors should be considered while figuring out how to better prepare for earthquakes. A combination of holistic earthquake preparedness programs and effective education is generally required for competent holistic earthquake preparedness.
In an endotoxaemic model, antibiotic clearance can be affected by different central venous catheter positions, during renal replacement therapy
Authors: Bandert Anna , Lipcsey Miklós , Frithiof Robert , Larsson Anders , Smekal David 
Published: June 2023

Abstract
Background
In intensive care, different central venous catheters (CVC) are often used for infusion of drugs. If a patient is treated with continuous renal replacement therapy (CRRT) a second catheter, a central venous dialysis catheter (CVDC), is needed. Placing the catheters close together might pose a risk that a drug infused in a CVC could be directly aspirated into a CRRT machine and cleared from the blood without giving the effect intended. The purpose of this study was to elucidate if drug clearance is affected by different catheter placement, during CRRT. In this endotoxaemic animal model, an infusion of antibiotics was administered in a CVC placed in the external jugular vein (EJV). Antibiotic clearance was compared, whether CRRT was through a CVDC placed in the same EJV, or in a femoral vein (FV). To reach a target mean arterial pressure (MAP), noradrenaline was infused through the CVC and the dose was compared between the CDVDs.

Results
The main finding in this study was that clearance of antibiotics was higher when both catheter tips were in the EJV, close together, compared to in different vessels, during CRRT. The clearance of gentamicin was 21.0 ± 7.3 vs 15.5 ± 4.2 mL/min (p 0.006) and vancomycin 19.3 ± 4.9 vs 15.8 ± 7.1 mL/min (p 0.021). The noradrenaline dose to maintain a target MAP also showed greater variance with both catheters in the EJV, compared to when catheters were placed in different vessels.

Conclusion
The results in this study indicate that close placement of central venous catheter tips could lead to unreliable drug concentration, due to direct aspiration, during CRRT.
Cognitive Impairment and Self-Reported Dementia in UK Retired Professional Soccer Players: A Cross Sectional Comparative Study
Authors: Macnab Tara-Mei Povall , Espahbodi Shima , Hogervorst Eef , Thanoon Ahmed , Fernandes Gwen Sascha , Millar Bonnie , Duncan Ashley , Goodwin Maria , Batt Mark , Fuller Colin W. , Fuller Gordon , Ferguson Eamonn , Bast Tobias , Doherty Michael , Zhang Weiya 
Published: June 2023

AbstractBackgroundPrevious studies based on death certificates have found professional soccer players were more likely to die with neurodegenerative diseases, including dementia. Therefore, this study aimed to investigate whether retired professional male soccer players would perform worse on cognitive tests and be more likely to self-report dementia diagnosis than general population control men.MethodsA cross-sectional comparative study was conducted between August 2020 and October 2021 in the United Kingdom (UK). Professional soccer players were recruited through different soccer clubs in England, and general population control men were recruited from the East Midlands in the UK. We obtained self-reported postal questionnaire data on dementia and other neurodegenerative diseases, comorbidities and risk factors from 468 soccer players and 619 general population controls. Of these, 326 soccer players and 395 general population controls underwent telephone assessment for cognitive function.ResultsRetired soccer players were approximately twice as likely to score below established dementia screening cut-off scores on the Hopkins Verbal Learning Test (OR 2.06, 95%CI 1.11–3.83) and Verbal Fluency (OR 1.78, 95% CI 1.18–2.68), but not the Test Your Memory, modified Telephone Interview for Cognitive Status, and Instrumental Activities of Daily Living. Analyses were adjusted for age, education, hearing loss, body mass index, stroke, circulatory problems in the legs and concussion. While retired soccer players were younger, had fewer cardiovascular diseases and other morbidities and reported healthier lifestyles, 2.8% of retired soccer players reported medically diagnosed dementia and other neurodegenerative disease compared to 0.9% of controls (OR = 3.46, 95% CI 1.25–9.63) after adjustment for age and possible confounders.ConclusionsUK male retired soccer players had a higher risk of performing below established cut-off scores of dementia screening tests and were more likely to self-report medically diagnosed dementia and neurodegenerative diseases, despite having better overall physical health and fewer dementia risk factors. Further study is needed to determine specific soccer-related risk factors.
Protocol for the formative phase of a trial (SHE-CAN) to test co-designed implementation strategies for HPV-based cervical screening among vulnerable women in two diverse settings in India
Authors: Oommen Anu Mary , Basu Partha , Cherian Anne George , Zomawia Eric , Manoharan Ravikumar , Pricilla Ruby Angeline , Viswanathan Vidhya , Oldenburg Brian , Subramanian Sujha , Hawkes David , Saville Marion , Brotherton Julia M. L. ,   on behalf of the SHE-CAN collaborators, Peedicayil Abraham , Pautu Jeremy L. , Sangzuala  , Vanremmawii  , Hmangaihzuali Evelyn V. L. , Lalropuii  , Singarayar Pravin , George Kuryan , Grace Rebekah J. , George Tarun , Prasad Jasmine , Marcus Tobey , Thomas Anitha , Thomas Vinotha , Thomas Dhanya S. , Daniel Sherin , Varghese Kripa M. , Abraham Vinod J. , Muliyil Divya E. , Kannangai Rajesh , Abraham Priya , Rose Anuradha , Jeyapaul Shalini , Malini Tabeetha , Ram Thomas S. , John Neenu O. , Priya Ranjani D. , Kavitha K. , Meenatchi G. , Paul John , Mukherjee Pavan K. , Umesh Sasikala , John K. R. , Nightingale Claire , Kane Sumit , Ashfaq Maleeha , Chandran Arunah , Mosquera Isabel , Muwonge Richard , Carvahlo Andre 
Published: June 2023

AbstractBackgroundIn view of the WHO’s call for the elimination of cervical cancer as a public health problem, and current low screening coverage, Indian policy makers need evidence on how to effectively implement cervical screening programmes, ensuring equity in access.Our study will follow the INSPIRE implementation framework to co-design and test HPV-based screening approaches in two states of India with different health system organisation, based on understanding the status of screening as currently implemented, readiness and challenges to transition to HPV-based screening, and preferences of key stakeholders. Here, we describe our protocol for the formative phase of the study (SHE-CAN).MethodsThe study population includes women from vulnerable populations, defined as residents of tribal areas, rural villages, and urban slums, in the states of Mizoram and Tamil Nadu. The baseline assessment will use mixed methods research, with desktop reviews, qualitative studies, and surveys. A capacity assessment survey of screening and treatment facilities will be done, followed by interviews with healthcare providers, programme managers, and community health workers. Interviews will be conducted with previously screened women and focus group discussions with under and never-screened women and community members. Stakeholder workshops will be held in each state to co-design the approaches to delivering HPV-based screening among 30–49-year-old women.DiscussionThe quality and outcomes of existing screening services, readiness to transition to HPV-based screening, challenges in providing and participating in the cervical cancer care continuum, and acceptability of screening and treatment approaches will be examined. The knowledge gained about the current system, as well as recognition of actions to be taken, will inform a stakeholder workshop to co-design and evaluate implementation approaches for HPV-based screening through a cluster randomised implementation trial.
Low prevalence of colistin-resistant Escherichia coli from companion animals, China, 2018–2021
Authors: Jiang Junyao , Ma Shizhen , Chen Siyu , Schwarz Stefan , Cao Yingqi , Dang Xukun , Zhai Weishuai , Zou Zhiyu , Shen Jianzhong , Lyu Yanli , Xia Zhaofei , Wang Yang 
Published: June 2023

AbstractChina banned colistin as growth promoter for animals in the year of 2017. A decrease of colistin-resistant Escherichia coli (COREC) and mcr-1-positive Escherichia coli (MCRPEC) were observed in livestock (pigs and chickens) and humans after the ban policy. However, the prevalence of COREC among Chinese companion animals after the ban policy has not been investigated. Here, we recovered 771 E. coli isolates from the China Antimicrobial Resistance Surveillance Network for Pets (CARPet) surveillance system (19 provinces/municipalities) from 2018 to 2021. We identified 12 COREC from eight dogs and four cats, among which one feline and three canine isolates were MCRPEC. The prevalence of COREC and MCRPEC in pets from 2018–2021 (1.1%–2.2% and 0.8%–1.1%) were lower than those from 2012–2016 (7.1%–17.8% and 6.1%–14.3%). The phylogenetic analysis revealed that the four MCRPEC isolates displayed genetic diversity, while one canine isolate exhibited only 26 SNPs difference with one human MCRPEC isolate in the same city, suggesting the exchange of MCRPEC isolates between companion animals and humans. In three MCRPEC isolates, mcr-1 was located on an IncI2 plasmid, which exhibited 99.5%–99.9% nucleotide sequence identity with plasmid pHNSD133-MCR from E. coli of chicken origin. In the remaining MCRPEC, mcr-1 was chromosomally located flanked by intact ISApl1 elements forming a unit of ISApl1-mcr-1-pap2-ISApl1. Despite the low prevalence of COREC and MCRPEC observed in companion animals after the ban policy, the association of pet-derived MCRPEC and mcr-carrying plasmids with those from humans and farm animals suggest that annual surveillance of colistin resistance in bacteria of pet origin is essential.
The Fake IQ Test: a novel measure of self-reflection in major depressive disorder
Authors: Marwood Lindsey , Kerr-Gaffney Jess , Wise Toby , Strawbridge Rebecca , Perkins Adam M. , Cleare Anthony J. 
Published: June 2023

BackgroundExcessive negative self-referential processing plays an important role in the development and maintenance of major depressive disorder (MDD). Current measures of self-reflection are limited to self-report questionnaires and invoking imagined states, which may not be suitable for all populations.AimsThe current study aimed to pilot a new measure of self-reflection, the Fake IQ Test (FIQT).MethodParticipants with MDD and unaffected controls completed a behavioural (experiment 1,n= 50) and functional magnetic resonance imaging version (experiment 2,n= 35) of the FIQT.ResultsBehaviourally, those with MDD showed elevated negative self-comparison with others, higher self-dissatisfaction and lower perceived success on the task, compared with controls; however, FIQT scores were not related to existing self-report measures of self-reflection. In the functional magnetic resonance imaging version, greater activation in self-reflection versus control conditions was found bilaterally in the inferior frontal cortex, insula, dorsolateral prefrontal cortex, motor cortex and dorsal anterior cingulate cortex. No differences in neural activation were found between participants with MDD and controls, nor were there any associations between neural activity, FIQT scores or self-report measures of self-reflection.ConclusionsOur results suggest the FIQT is sensitive to affective psychopathology, but a lack of association with other measures of self-reflection may indicate that the task is measuring a different construct. Alternatively, the FIQT may measure aspects of self-reflection inaccessible to current questionnaires. Future work should explore relationships with alternative measures of self-reflection likely to be involved in perception of task performance, such as perfectionism.
Analysis of Cancer Research Projects in Sub-Saharan Africa: A Quantitative Perspective on Unmet Needs and Opportunities
Authors: Davies Lynne , Milner Danny A. , Shulman Lawrence N. , Kyokunda Lynnette , Bedada Alemayehu , Vuylsteke Peter , Masalu Nestory , Jackson Paul , Jennings Natanya , Odunlami Adesumbo , Mtshali Phangisile , Dugan Ute 
Published: June 2023

PURPOSE To evaluate the scope and types of cancer research projects in sub-Saharan Africa (SSA) to identify research gaps and inform future efforts. METHODS This retrospective observational study summarized information on cancer research projects in SSA from the International Cancer Research Partnership (ICRP) between 2015 and 2020, alongside 2020 cancer incidence and mortality data from the Global Cancer Observatory. SSA cancer research projects were identified as led by investigators in SSA countries, or by investigators in non-SSA countries with collaborators in SSA, or in database keyword searches. Projects from the Coalition for Implementation Research in Global Oncology (CIRGO) were also summarized. RESULTS A total of 1,846 projects were identified from the ICRP database, funded by 34 organizations in seven countries (only one, Cancer Association of South Africa, based in SSA); only 156 (8%) were led by SSA-based investigators. Most projects focused on virally induced cancers (57%). Across all cancer types, projects were most frequently related to cervical cancer (24%), Kaposi sarcoma (15%), breast cancer (10%), or non-Hodgkin lymphoma (10%). Gaps were observed for several cancers with higher incidence/mortality burden in SSA; for example, prostate cancer accounted for only 4% of projects but 8% of cancer-related deaths and 10% of new cases. Approximately 26% were dedicated to etiology. Treatment-related research declined over the study period (14%-7% of all projects), while projects related to prevention (15%-20%) and diagnosis/prognosis (15%-29%) increased. Fifteen CIRGO projects were identified; seven were relevant across multiple cancer types, and 12 focused either wholly or partially on cancer control (representing 50% of the total research effort). CONCLUSION This analysis shows notable discrepancies between cancer burden and research projects and identifies opportunities for future strategic investments in cancer care in SSA.
Barriers and Facilitators to Implementing Cost-Effective Evidence-Based Childhood Cancer Treatment in a Resource-Limited Setting in Egypt: A Qualitative Interview Study
Authors: Soliman Ranin , Heneghan Carl , Boylan Anne-Marie , Oke Jason , Eweida Wael , Elhaddad Alaa 
Published: June 2023

PURPOSE Childhood cancer treatment is complex, resource-intensive, and expensive, and resource-limited settings would benefit from providing cost-effective treatment approaches on the basis of evidence. Effective implementation of cost-effective evidence-based treatment requires knowledge about factors influencing its use. In this study, we determined the clinicians' perceptions of the barriers and facilitators to implementing cost-effective evidence-based treatment for children with cancer in a resource-limited pediatric oncology setting in Egypt. METHODS We conducted a qualitative study on the basis of semistructured interviews with senior clinicians who make high-level decisions on treatment protocols and tailored decisions for the atypically complicated group of patients. Purposive sampling was used to recruit the participants. Thematic analysis was conducted semantically to develop themes of barriers and facilitators. RESULTS Fourteen participants agreed to participate in the study: nine pediatric oncologists; three surgeons; and two radiation oncologists. We identified four main themes of barriers and facilitators: awareness and orientation; knowledge, skills, and attitudes; system, resources, and context; and clinical practice. The main barriers included absence of easily available costs/cost-effectiveness data, limited resources and inability to pay for expensive novel (cost-effective) drugs, and gap between evidence and practice. The main facilitators included adopting standard treatment protocols on the basis of clinical effectiveness, leadership support, availability of patients' clinical and cost data from local context, and existing knowledge and skills in clinical research and health economic evaluation. The interview participants also provided suggestions to promote the implementation of cost-effective evidence-based treatment in priority areas. CONCLUSION Our study findings provide an understanding of the barriers and facilitators affecting the implementation of cost-effective evidence-based treatment for childhood cancers in Egypt. We provide practical recommendations to address the implementation gaps with implications on practice, policy, and research.
Somatic EPAS1 Variants in Pheochromocytoma and Paraganglioma in Patients With Sickle Cell Disease
Authors: White Gemma , Nonaka Daisuke , Chung Teng-Teng , Oakey Rebecca J , Izatt Louise 
Published: June 2023

Abstract

Context
Somatic EPAS1 variants account for 5% to 8% of all pheochromocytoma and paragangliomas (PPGL) but are detected in over 90% of PPGL in patients with congenital cyanotic heart disease, where hypoxemia may select for EPAS1 gain-of-function variants. Sickle cell disease (SCD) is an inherited hemoglobinopathy associated with chronic hypoxia and there are isolated reports of PPGL in patients with SCD, but a genetic link between the conditions has yet to be established.

Objective
To determine the phenotype and EPAS1 variant status of patients with PPGL and SCD.

Methods
Records of 128 patients with PPGL under follow-up at our center from January 2017 to December 2022 were screened for SCD diagnosis. For identified patients, clinical data and biological specimens were obtained, including tumor, adjacent non-tumor tissue and peripheral blood. Sanger sequencing of exons 9 and 12 of EPAS1, followed by amplicon next-generation sequencing of identified variants was performed on all samples.

Results
Four patients with both PPGL and SCD were identified. Median age at PPGL diagnosis was 28 years. Three tumors were abdominal paragangliomas and 1 was a pheochromocytoma. No germline pathogenic variants in PPGL-susceptibility genes were identified in the cohort. Genetic testing of tumor tissue detected unique EPAS1 variants in all 4 patients. Variants were not detected in the germline, and 1 variant was detected in lymph node tissue of a patient with metastatic disease.

Conclusion
We propose that somatic EPAS1 variants may be acquired through exposure to chronic hypoxia in SCD and drive PPGL development. Future work is needed to further characterize this association.
Approach to the Patient With Bone Fracture: Making the First Fracture the Last
Authors: Wang Mawson , Seibel Markus J 
Published: June 2023

Abstract
The global burden of osteoporosis and osteoporotic fractures will increase significantly as we enter a rapidly aging population. Osteoporotic fractures lead to increased morbidity, mortality, and risk of subsequent fractures if left untreated. However, studies have shown that the majority of patients who suffer an osteoporotic fracture are not investigated or treated for osteoporosis, leading to an inexcusable “osteoporosis care gap.” Systematic and coordinated models of care in secondary fracture prevention known as fracture liaison services (FLS) have been established to streamline and improve the care of patients with osteoporotic fractures, and employ core principles of identification, investigation, and initiation of treatment. Our approach to the multifaceted care of secondary fracture prevention at a hospital-based FLS is illustrated through several case vignettes.