bluuebunny/crossref_metadata_2025_split huggingface dataset:
Cataracts: the essentials for patient care
Authors: Stanford Penelope 
Published: May 2023

It is estimated that over 2.2 billion people globally have a visual impairment. Cataract is one such form of impairment, which can be surgically corrected. However, disruptions in ophthalmic services due to the pandemic have resulted in long wait times—estimated to take up to 5 years to clear. Considering these issues, there is no doubt that individuals affected by the condition will be negatively impacted. In this article, Penelope Stanford provides information on the anatomy and altered physiology of the crystalline lens, and informs on the essentials of patient care.
Developing an understanding of the risk factors for falls among adults with intellectual disabilities: a commentary
Authors: Doherty Alison J , O'Donoghue Annette , Harrison Joanna 
Published: May 2023

Commentary on: Pope J, Truesdale M, Brown M. Risk factors for falls among adults with intellectual disabilities: A narrative review. J Appl Res Intellect Disabil. 2021; 34: 274–285. 10.1111/jar.12805 Falls are a serious and common problem for people with intellectual disabilities (ID). Whilst there is available evidence on falls risk factors for the general population, there is a lack of awareness and understanding of the contributing risk factors for this population. This commentary critically appraises a recent narrative review which sought to identify the risk factors for falls among people with ID. Clinical practice implications: Community nurses may identify people with ID at risk of falls, and work alongside other healthcare professionals and carers to provide tailored multidisciplinary falls-prevention interventions for individuals with ID living in the community.
Body shape and performance on the US Army Combat Fitness Test: Insights from a 3D body image scanner
Authors: Smith Maria , Turner Dusty , Spencer Charlotte , Gist Nicholas , Ferreira Sarah , Quigley Kevin , Walsh Tyson , Clark Nicholas , Boldt William , Espe Justin , Thomas Diana M. 
Published: May 2023

Objective
To identify relationships between body shape, body composition, sex and performance on the new US Army Combat Fitness Test (ACFT).

Methods
Two hundred and thirty-nine United States Military Academy cadets took the ACFT between February and April of 2021. The cadets were imaged with a Styku 3D scanner that measured circumferences at 20 locations on the body. A correlation analysis was conducted between body site measurements and ACFT event performance and evaluated using Pearson correlation coefficients and p-values. A k-means cluster analysis was performed over the circumference data and ACFT performance were evaluated between clusters using t-tests with a Holm-Bonferroni correction.

Results
The cluster analysis resulted in 5 groups: 1. “V” shaped males, 2. larger males, 3. inverted “V” shaped males and females, 4. “V” shaped smaller males and females, and 5. smallest males and females. ACFT performance was the highest in Clusters 1 and 2 on all events except the 2-mile run. Clusters 3 and 4 had no statistically significant differences in performance but both clusters performed better than Cluster 5.

Conclusions
The association between ACFT performance and body shape is more detailed and informative than considering performance solely by sex (males and females). These associations may provide novel ways to design training programs from baseline shape measurements.
Improving primary care based post-diagnostic support for people living with dementia and carers: Developing a complex intervention using the Theory of Change
Authors: Bamford Claire , Wilcock Jane , Brunskill Greta , Wheatley Alison , Harrison Dening Karen , Manthorpe Jill , Allan Louise , Banerjee Sube , Booi Laura , Griffiths Sarah , Rait Greta , Walters Kate , Robinson Louise ,   on behalf of the PriDem study team
Published: May 2023

Background
The need to improve support following a diagnosis of dementia is widely recognised, but it is unclear how this can best be achieved within UK health and social care systems. A task-shared and task-shifted approach has been recommended, but there is limited guidance on how to achieve this in practice. As part of a programme of research, we developed an intervention to enhance the role of primary care in post-diagnostic care and support for people living with dementia and carers.

Methods
We used the Theory of Change to develop a complex intervention informed by initial literature reviews and qualitative work. The intervention was developed through an iterative series of workshops, meetings and task groups with a range of stakeholders, including the multidisciplinary project team, people living with dementia and carers, service managers, frontline practitioners, and commissioners.

Results
142 participants contributed to intervention development through face-to-face or virtual meetings. The intervention comprises three complementary strands of work focusing on: developing systems, delivering tailored care and support, and building capacity and capability. Clinical dementia leads, based in primary care networks, will facilitate the intervention providing tailored expertise and support.

Conclusion
The Theory of Change proved useful in providing structure and engaging stakeholders. The process was challenging, took longer and was less participative than intended due to restrictions caused by the COVID-19 pandemic. We will next conduct a feasibility and implementation study to explore whether the intervention can be successfully delivered within primary care. If successful, the intervention offers practical strategies for delivering a task-shared and task-shifted approach to post-diagnostic support that could be adapted for similar health and social care contexts internationally.
Premature mortality and years of potential life lost from cardiovascular diseases: Protocol of a systematic review and meta-analysis
Authors: Rodzlan Hasani Wan Shakira , Muhamad Nor Asiah , Maamor Nur Hasnah , Hanis Tengku Muhammad , Xin Wee Chen , Abu Hassan Muhammad Radzi , Abdul Karim Zulkarnain , Musa Kamarul Imran 
Published: May 2023

Introduction
Despite the burden of cardiovascular disease (CVD) continuing to increase globally, no comprehensive meta-analyses have been conducted quantifying premature CVD mortality. This paper reports the protocol for a systematic review and meta-analysis to derive updated estimates of premature CVD mortality.

Methods and expected outputs
This review will include the studies that reported premature CVD mortality based on standard premature mortality indicators, including years of life lost (YLL), age standardized mortality rate (ASMR) or standardised mortality ratio (SMR). PUBMED, Scopus, Web of Science (WoS), CINAHL, and Cochrane Central Register of Controlled Trials (CENTRAL) will be used as the literature databases. The study selection as well as the evaluation of the quality of the included articles will be done independently by two reviewers. Pooled estimates of YLL, ASMR, and SMR will be computed by applying random-effects meta-analysis. Heterogeneity among selected studies will be assessed using the I2 statistic and Q statistic with associated p-values. A funnel plot analysis and Egger’s test will be conducted to assess the potential impact of publication bias. Depending on data availability, we propose to conduct subgroup analyses by sex, geographic location, main CVD types, and study time. Reporting of our findings will follow the Preferred Reporting Items for Systematic Review and Meta-Analyses (PRISMA) guidelines.

Conclusion
Our meta-analysis will provide a comprehensive synthesis of the available evidence on premature CVD mortality, which is a major public health concern worldwide. The results of this meta-analysis will have important implications for clinical practice and public health policy, providing insights into strategies to prevent and manage premature CVD mortality.

Trial registration
Systematic review registration: PROSPERO CRD42021288415. https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42021288415.
Creatinine clearance is key to solving the enigma of sex difference in in-hospital mortality after STEMI: Propensity score matching and mediation analysis
Authors: Janjani Parisa , Salehi Nahid , Rouzbahani Mohammad , Siabani Soraya , Olfatifar Meysam 
Published: May 2023

Background
The precise impact of sex difference on in-hospital mortality in ST-elevation myocardial infarction (STEMI) patients are unclear, and the studies are no longer consistent. Therefore, we sought to evaluate the impact of sex differences in a cohort of STEMI patients.

Methods
We analyzed the data of 2647 STEMI patients enrolled in the Kermanshah STEMI Cohort from July 2017 to May 2020. To accurately clarify the relationship between sex and hospital mortality, propensity score matching (PSM) and causal mediation analysis was applied to the selected confounder and identified intermediate variables, respectively.

Results
Before matching, the two groups differed on almost every baseline variable and in-hospital death. After matching with 30 selected variables, 574 male and female matched pairs were significantly different only for five baseline variables and women were no longer at greater risk of in-hospital mortality (10.63% vs. 9.76%, p = 0.626). Among the suspected mediating variables, creatinine clearance (CLCR) alone accounts for 74% (0.665/0.895) of the total effect equal to 0.895(95% CI: 0.464–1.332). In this milieu, the relationship between sex and in-hospital death was no longer significant and reversed -0.233(95% CI: -0.623–0.068), which shows the full mediating role of CLCR.

Conclusion
Our research could help address sex disparities in STEMI mortality and provide a consequence. Moreover, CLCR alone can fully explain this relationship, which can highlight the importance of CLCR in predicting the short-term outcomes of STEMI patients and provide a useful indicator for clinicians.
Exploring factors influencing the selection of primary health care delivery models in conflict-affected settings of North West and South West regions of Cameroon and North-East Nigeria: A study protocol
Authors: Omam Lundi-Anne , O’Laughlin Kelli , Tendongfor Nicholas , Wudiri Zara , Hassan Mohammed Ngubdo , Metuge Alain , Oluwafemi Ooju , Omam Esther , Parkes-Ratanshi Rosalind 
Published: May 2023

Background
In conflict-affected settings, access to health care for displaced populations is constrained by barriers including geographical, cultural, communication, logistical, financial and insecurity. A six year humanitarian crises in the North West and South West regions of Cameroon has caused 27% of health facilities to be non-functional. The eleven year crisis in North-East Nigeria, has caused the closure of 26% of health facilities. These closure of health facilities and population displacement led to health care delivery using humanitarian funding by multiple different agencies. However, there is a paucity of evidence on the selection and design of the primary health care delivery models used in humanitarian settings. To ensure efficient use of resources and quality of services, model of care selection should be evidence based and informed by the specific humanitarian context. This research protocol aims to explore how primary health care models are selected by humanitarian organizations.

Methods
We will conduct a cross sectional quantitative survey to map the range of primary health care delivery models used by humanitarian organisations in Cameroon and Nigeria. Using in-depth interviews and focus group discussions with staff from humanitarian organizations and internally displaced persons, we will explore the factors influencing the selection of primary health care models in these settings and determine the coverage and gaps in services across the different primary health care models. Quantitative data will be analysed in a descriptive manner and qualitative data will be analysed thematically.

Discussion
Different models of care have been reported to be used by humanitarian organisations in conflict-affected settings, yet evidence on how different models are selected is lacking. A detailed understanding of the rationale for selection, the design and quality considerations of the strategies used to deliver health care will be obtained using a survey, in-depth interviews and focus group discussions.
Perspectives of pharmacy employees on an inappropriate use of antimicrobials in Kathmandu, Nepal
Authors: Shrestha Nistha , Manandhar Sulochana , Maharjan Nhukesh , Twati Devina , Dongol Sabina , Basnyat Buddha , Baker Stephen , Karkey Abhilasha 
Published: May 2023

Background
Unregulated antimicrobial use is common in both hospital and community settings of low- and middle-income countries (LMICs). However, discrete data regarding the use/misuse of antimicrobials at pharmacies in LMICs are limited. This study was conducted to understand knowledge, attitude, and practice of pharmacy employees on antimicrobial dispensing in Nepal.

Methods
We conducted a cross-sectional survey using a structured questionnaire on 801 pharmacy employees working in community and hospital pharmacies located in Lalitpur metropolitan city (LMC) of Kathmandu, Nepal between April 2017 and March 2019.

Results
A majority (92%) of respondents agreed that demand for non-prescription antimicrobials was common. Asking for prescription before dispensing was ranked as the first preference by majority (69%) of participants. Suspected respiratory tract infection was the most common reason demanding for non-prescription antimicrobials with the highest mean rank of 1.5. Azithromycin was the most commonly prescribed and sold antimicrobial, as reported by 46% and 48% of participants respectively. A majority (87%) of respondents agreed on antimicrobial resistance (AMR) to be a global public health threat; and misuse/overuse of antimicrobials was perceived as the most common cause of AMR with a mean rank of 1.93.

Conclusion
Our study revealed that unfounded dispensing and use of antimicrobials is prevalent among pharmacies in Kathmandu, Nepal. This over reliance on antimicrobials, notably azithromycin, may escalate burden of AMR. We identified several drivers of inappropriate antimicrobial dispensing practice in pharmacies, which will aid public health authorities in addressing these issues. Further studies considering role of other stakeholders, such as doctors, veterinarians, general public, and policy makers are required to obtain a more holistic perspectives on practices of antimicrobial use so to curb the extant AMR crisis.
Topics most predictive of favorable overall assessment in outpatient radiology
Authors: Ajam Amna A. , Berkheimer Colin , Xing Bin , Umerani Aadil , Rasheed Shayaan , Nguyen Xuan V. 
Published: May 2023

BackgroundPatients’ subjective experiences during clinical interactions may affect their engagement in healthcare, and better understanding of the issues patients consider most important may help improve service quality and patient-staff relationships. While diagnostic imaging is a growing component of healthcare utilization, few studies have quantitatively and systematically assessed what patients deem most relevant in radiology settings. To elucidate factors driving patient satisfaction in outpatient radiology, we derived quantitative models to identify items most predictive of patients’ overall assessment of radiology encounters.MethodsPress-Ganey survey data (N = 69,319) collected over a 9-year period at a single institution were retrospectively analyzed, with each item response dichotomized as “favorable” or “unfavorable.” Multiple logistic regression analyses were performed on 18 binarized Likert items to compute odds ratios (OR) for those question items significantly predicting Overall Rating of Care or Likelihood of Recommending. In a secondary analysis to identify topics more relevant to radiology than other encounter types, items significantly more predictive of concordant ratings in radiology compared to non-radiology visits were also identified.ResultsAmong radiology survey respondents, top predictors of Overall Rating and Likelihood of Recommending were items addressing patient concerns or complaints (OR 6.8 and 4.9, respectively) and sensitivity to patient needs (OR 4.7 and 4.5, respectively). When comparing radiology and non-radiology visits, the top items more predictive for radiology included unfavorable responses to helpfulness of registration desk personnel (OR 1.4–1.6), comfort of waiting areas (OR 1.4), and ease of obtaining an appointment at the desired time (OR 1.4).ConclusionsItems related to patient-centered empathic communication were the most predictive of favorable overall ratings among radiology outpatients, while underperformance in logistical issues related to registration, scheduling, and waiting areas may have greater adverse impact on radiology than non-radiology encounters. Findings may offer potential targets for future quality improvement efforts.
An ACAT inhibitor suppresses SARS-CoV-2 replication and boosts antiviral T cell activity
Authors: Wing Peter A. C. , Schmidt Nathalie M. , Peters Rory , Erdmann Maximilian , Brown Rachel , Wang Hao , Swadling Leo ,   COVIDsortium Investigators, Newman Joseph , Thakur Nazia , Shionoya Kaho , Morgan Sophie B. , Hinks Timothy SC , Watashi Koichi , Bailey Dalan , Hansen Scott B. , Davidson Andrew D. , Maini Mala K. , McKeating Jane A. 
Published: May 2023

The severity of disease following infection with SARS-CoV-2 is determined by viral replication kinetics and host immunity, with early T cell responses and/or suppression of viraemia driving a favourable outcome. Recent studies uncovered a role for cholesterol metabolism in the SARS-CoV-2 life cycle and in T cell function. Here we show that blockade of the enzyme Acyl-CoA:cholesterol acyltransferase (ACAT) with Avasimibe inhibits SARS-CoV-2 pseudoparticle infection and disrupts the association of ACE2 and GM1 lipid rafts on the cell membrane, perturbing viral attachment. Imaging SARS-CoV-2 RNAs at the single cell level using a viral replicon model identifies the capacity of Avasimibe to limit the establishment of replication complexes required for RNA replication. Genetic studies to transiently silence or overexpress ACAT isoforms confirmed a role for ACAT in SARS-CoV-2 infection. Furthermore, Avasimibe boosts the expansion of functional SARS-CoV-2-specific T cells from the blood of patients sampled during the acute phase of infection. Thus, re-purposing of ACAT inhibitors provides a compelling therapeutic strategy for the treatment of COVID-19 to achieve both antiviral and immunomodulatory effects.
Trial registration: NCT04318314.
Electra Tiranicida. Gênero na recepção de uma deliberação heroica na tragédia de Sófocles
Authors: Pitombo Bacelar Agatha 
Published: May 2023

No terceiro episódio da Electra de Sófocles, a heroína, acreditando que seu irmão Orestes está morto, tenta convencer sua irmã Crisótemis a participar de um plano de matar Egisto, em um discurso que retoma as honras públicas instituídas na Atenas do século V a.C. em homenagem ao casal tiranicida, Harmódio e Aristogíton, e, portanto, aproxima as duas irmãs da imagem de campeãs da democracia (v. 947-989). Este artigo compara o tratamento dado por Comentários contemporâneos à Electra de Sófocles a este discurso com estudos recentes da cidadania ateniense que fazem uso do gênero como ferramenta metodológica, no intuito de argumentar que a ideia da pólis como um “clube de homens” depende muito mais de um estereótipo moderno sobre a política ateniense do que das evidências antigas disponíveis – um estereótipo que projeta concepções europeias do século XIX acerca do político sobre o contexto antigo e perpetua, no passado, uma dominação masculina supostamente universal. Nessa perspectiva, a atitude de Electra, certamente excepcional pela situação igualmente excepcional em que a heroína se encontra, longe de transgredir de um modo impressionante os papéis de gênero antigos, aponta para a importância da cidadania feminina na democracia ateniense.
Association of CD4 cell counts and viral load with cystatin C level in children with human immunodeficiency virus (HIV) infection
Authors: Rostania Wita , Alam Anggraini , Hilmanto Dany 
Published: May 2023

Background The ease of access to antiretroviral therapy (ART) has improved both survival rate and comorbidities in patients with human immunodeficiency virus (HIV) infection. Impaired kidney function is one of the most common comorbidities of HIV. CD4 and viral load can be used to monitor HIV progression and to determine the effectiveness of ART. The most commonly used estimated-glomerular filtration rate (e-GFR) technique is to use serum creatinine but often causes late detection of kidney dysfunction while serum cystatin increases at the beginning of the GFR decrease. This supports cystatin C serum as an early diagnostic tool to detect kidney function or biomarker early kidney disorders.
Objective To evaluate a possible association between serum cystatin C as a marker of kidney function and HIV progression through CD4 levels and viral load.
Methods This cross-sectional study was conducted through evaluation of secondary data from medical and laboratory records of pediatric patients who had routine visits to the HIV Clinic at Dr. Hasan Sadikin General Hospital, Bandung, West Java, in January-February 2020.
Results Sixty subjects were reviewed in the study. Median cystatin C-based eGFR was 28.1mL/minute/1.73m2. Subjects were categorized by viral load result into <40 and ?40 copies/mL. The median serum cystatin C was significantly higher [3.7 (range 2.61–6.55) mg/L] in the >40 copies/mL viral load group than the <40 copies/mL group [2.4 (range 0.26–13.61) mg/L]. The median absolute CD4 count, CD4 percentage, and cystatin C were 776 (range 7–1644) cells/mm3, 27.5 (range 1.6–57.4) %, and 3 (range 0.26–13.61) mg/L, respectively. There were no significant correlations (r=-0.2; P=0.1) between CD4 and serum cystatin C
Conclusion Higher viral load associates with higher cystatin C level, while CD4 shows no correlation to cystatin C. However, patients with low CD4 tend to have increased cystatin C level.
Developing a Pan-European Open Science Training Landscape
Authors: Budroni Dr. Paolo , Gómez Sánchez Alicia Fátima , de Mello Castro Giroletti Juliana , Sánchez Solís Barbara 
Published: May 2023

Abstract
In an environment designed to increasingly enable Open Science, not all researchers and research supporting units have the required competences. Moreover, there is a lack of clear data professionals’ profiles and corresponding career paths, and a high degree of fragmentation in training resources. This article presents the Horizon Europe project “Skills4EOSC” and other selected initiatives that contribute to the goals of the European Open Science Cloud, and in particular to the creation of a harmonised training landscape. The transition to Open Science implies that researchers and research-supporting experts acquire new skills, which also requires new and additional forms of training. Together, and step by step, efforts add up to a common and trusted pan-European ecosystem.