bluuebunny/crossref_metadata_2025_split huggingface dataset:
Evaluation of a continuing professional development strategy on COVID-19 for 10 000 health workers in Ghana: a two-pronged approach
Authors: Salehi Roxana , de Young Stephanie , Asamoah Augustine , Aryee Sawdah Esaka , Eli Raymond , Couper Barbara , Smith Brian , Djokoto Charity , Agyeman Yaa Nyarko , Zakaria Abdul-Fatawu Suglo , Butt Nancy , Boadu Amma , Nyante Felix , Merdiemah Gifty , Oliver-Commey Joseph , Ofori-Boadu Lawrence , Akoriyea Samuel Kaba , Parry Megan , Fiore Cindy , Okae Faustina , Adams Archibald , Acquah Hannah 
Published: March 2023

Abstract
Background
COVID-19 has created unprecedented challenges for health systems worldwide. Since the confirmation of the first COVID-19 case in Ghana in March 2020 Ghanian health workers have reported fear, stress, and low perceived preparedness to respond to COVID-19, with those who had not received adequate training at highest risk. Accordingly, the Paediatric Nursing Education Partnership COVID-19 Response project designed, implemented, and evaluated four open-access continuing professional development courses related to the pandemic, delivered through a two-pronged approach: e-learning and in-person.

Methods
This manuscript presents an evaluation of the project's implementation and outcomes using data for a subset of Ghanaian health workers (n = 9966) who have taken the courses. Two questions were answered: first, the extent to which the design and implementation of this two-pronged strategy was successful and, second, outcomes associated with strengthening the capacity of health workers to respond to COVID-19. The methodology involved quantitative and qualitative survey data analysis and ongoing stakeholder consultation to interpret the results.

Results
Judged against the success criteria (reach, relevance, and efficiency) the implementation of the strategy was successful. The e-learning component reached 9250 health workers in 6 months. The in-person component took considerably more resources than e-learning but provided hands-on learning to 716 health workers who were more likely to experience barriers to accessing e-learning due to challenges around internet connectivity, or institutional capacity to offer training. After taking the courses, health workers' capacities (addressing misinformation, supporting individuals experiencing effects of the virus, recommending the vaccine, course-specific knowledge, and comfort with e-learning) improved. The effect size, however, varied depending on the course and the variable measured. Overall, participants were satisfied with the courses and found them relevant to their well-being and profession. An area for improvement was refining the content-to-delivery time ratio of the in-person course. Unstable internet connectivity and the high upfront cost of data to access and complete the course online were identified as barriers to e-learning.

Conclusions
A two-pronged delivery approach leveraged distinct strengths of respective e-learning and in-person strategies to contribute to a successful continuing professional development initiative in the context of COVID-19.
Higher plasma levels of thymosin-α1 are associated with a lower waning of humoral response after COVID-19 vaccination: an eight months follow-up study in a nursing home
Authors: Pozo-Balado María del Mar , Bulnes-Ramos Ángel , Olivas-Martínez Israel , Garrido-Rodríguez Vanesa , Lozano Carmen , Álvarez-Ríos Ana I. , Sánchez-Sánchez Berta , Sánchez-Bejarano Encarnación , Maldonado-Calzado Isabel , Martín-Lara José Manuel , Santamaría Juan Antonio , Bernal Rafael , González-Escribano María Francisca , Leal Manuel , Pacheco Yolanda M. 
Published: March 2023

Abstract
Background
Older people achieve lower levels of antibody titers than younger populations after Covid-19 vaccination and show a marked waning humoral immunity over time, likely due to the senescence of the immune system. Nevertheless, age-related predictive factors of the waning humoral immune response to the vaccine have been scarcely explored. In a cohort of residents and healthcare workers from a nursing home that had received two doses of the BNT162b2 vaccine, we measured specific anti-S antibodies one (T1), four (T4), and eight (T8) months after receiving the second dose. Thymic-related functional markers, including thymic output, relative telomere length, and plasma thymosin-α1 levels, as well as immune cellular subsets, and biochemical and inflammatory biomarkers, were determined at T1, and tested for their associations with the magnitude of the vaccine response (T1) and the durability of such response both, at the short- (T1-T4) and the long-term (T1-T8). We aimed to identify age-related factors potentially associated with the magnitude and persistence of specific anti-S immunoglobulin G (IgG)-antibodies after COVID-19 vaccination in older people.

Results
Participants (100% men, n = 98), were subdivided into three groups: young (< 50 years-old), middle-age (50–65 years-old), and older (≥65 years-old). Older participants achieved lower antibody titers at T1 and experienced higher decreases in both the short- and long-term. In the entire cohort, while the magnitude of the initial response was mainly associated with the levels of homocysteine [β (95% CI); − 0.155 (− 0.241 to − 0.068); p = 0.001], the durability of such response at both, the short-term and the long-term were predicted by the levels of thymosin-α1 [− 0.168 (− 0.305 to − 0.031); p = 0.017, and − 0.123 (− 0.212 to − 0.034); p = 0.008, respectively].

Conclusions
Higher plasma levels of thymosin-α1 were associated with a lower waning of anti-S IgG antibodies along the time. Our results suggest that plasma levels of thymosin-α1 could be used as a biomarker for predicting the durability of the responses after COVID-19 vaccination, possibly allowing to personalize the administration of vaccine boosters.
Effect of Percutaneous Kyphoplasty on the progression of intervertebral disc degeneration: a retrospective cohort study
Authors: Wu Tiemure , Han Xiao , Tian Wei , Wang Lifang , Wang Chao 
Published: March 2023

Abstract
Background
The effect of percutaneous kyphoplasty (PKP) or rather polymethylmethacrylate (PMMA) on adjacent intervertebral discs is still controversial. The evidence from experimental study to clinical study presents bipolar conclusions. In this study, we investigated the effect of PKP on adjacent intervertebral disc degeneration (IDD).

Methods
The experimental group included adjacent intervertebral discs of vertebrae treated with the PKP procedure, and the control group included adjacent intervertebral discs of non-traumatized vertebrae. All measurements were taken by magnetic resonance imaging or X-ray. The intervertebral disc height, the modified Pfirrmann grading system (MPGS), and its differences with Klezl Z and Patel S (ZK and SP) classifications were compared.

Results
A total of 264 intervertebral discs from 66 individuals were selected for the study. The comparison of intervertebral disc height between the two groups pre and post-operatively resulted in a p-value of > 0.05. No significant change was observed in the adjacent discs in the control groups post-operatively. Post-operatively, the mean Ridit increased significantly from 0.413 to 0.587 in the upper disc and from 0.404 to 0.595 in the lower disc in the experimental group. The comparison of MPGS differences showed that the predominant value was 0 in the Low-grade leaks group and 1 in the Medium and high-grade leaks group.

Conclusions
The PKP procedure can accelerate adjacent IDD, but it does not cause disc height changes in the early stage. The quantity of cement leaking into the disc space positively correlated with the rate of disc degeneration progression.
Diagnosing rare diseases and mental well-being: a family’s story
Authors: Zhang Zheqing 
Published: March 2023

AbstractWhen we experience symptoms, most of us walk into the clinic or hospital expecting immediate answers. For individuals with a rare condition, the path to diagnosis can be tortuous, involving months to years of waiting and a seemingly interminable search for answers. All this while, physical and psychological stress can negatively impact mental health. Each diagnostic journey is unique, but they epitomise common themes and inadequacies of the medical system. This article presents the stories of two sisters whose diagnostic journeys diverged then converged, reflecting on the impact of these experiences on mental well-being and what we can learn going forward. Hopefully, with more research and knowledge, we can catch these conditions earlier and provide better recommendations for treatment, management and prevention.
Postoperative complications and antibiotic use in dogs with pyometra: a retrospective review of 140 cases (2019)
Authors: Turkki Outi Marita , Sunesson Kristina Westberg , den Hertog Erik , Varjonen Katarina 
Published: March 2023

AbstractBackgroundPyometra is commonly seen in intact bitches and is usually treated by ovariohysterectomy. Few studies have reported the frequency of postoperative complications, particularly beyond the immediate postoperative period. Swedish national antibiotic prescription guideline provides suggestions about which antibiotics should be used and when in individuals undergoing surgery. Studies on how well clinicians adhere to these guidelines, and on the outcome for these patients, have not been evaluated for cases of canine pyometra. This retrospective study conducted at a private Swedish companion animal hospital assessed complications that developed within 30 days of pyometra surgery, and whether clinicians followed the current national guidelines in regard to antibiotic use. We also assessed whether antibiotic use affected the rate of postoperative complications seen in this cohort of dogs, where antibiotics were predominantly used in cases presenting with a more severely depressed general demeanour.ResultsThe final analysis included 140 cases, 27 of which developed complications. In total, 50 dogs were treated with antibiotics before or during surgery and in 90 cases, antibiotics were either not given at all or treatment was initiated postoperatively (9/90) due to a perceived risk of infection developing. Superficial surgical site infection was the most common complication, followed by an adverse reaction to the suture material. Three dogs died or were euthanised during the immediate postoperative period. Clinicians adhered to national antibiotic prescription guidelines on when antibiotics should be given in 90% of cases. SSI only developed in dogs that were not given pre- or intra-operative antibiotics, while suture reactions did not appear to be affected by antibiotic use. Ampicillin/ amoxicillin was used in 44/50 cases given antibiotics before or during surgery, including most cases showing signs of concurrent peritonitis.ConclusionSerious complications following the surgical treatment of pyometra were uncommon. Excellent adherence to national prescription guidelines was observed (90% of cases). SSI was relatively common and only seen in dogs that were not given antibiotics before or during surgery (10/90). Ampicillin/ amoxicillin was an effective first choice antimicrobial in cases requiring antibiotic treatment. Further studies are needed to identify cases benefiting from antibiotic treatment, as well as the duration of treatment needed to reduce the infection rate while also avoiding unnecessary preventive treatment.
Extracorporeal cardiopulmonary resuscitation for adult out-of-hospital cardiac arrest patients: time-dependent propensity score-sequential matching analysis from a nationwide population-based registry
Authors: Choi Yeongho , Park Jeong Ho , Jeong Joo , Kim Yu Jin , Song Kyoung Jun , Shin Sang Do 
Published: March 2023

Abstract
Background
There is inconclusive evidence regarding the effectiveness of extracorporeal cardiopulmonary resuscitation (ECPR) for out-of-hospital cardiac arrest (OHCA) patients. We aimed to evaluate the association between ECPR and neurologic recovery in OHCA patients using time-dependent propensity score matching analysis.

Methods
Using a nationwide OHCA registry, adult medical OHCA patients who underwent CPR at the emergency department between 2013 and 2020 were included. The primary outcome was a good neurological recovery at discharge. Time-dependent propensity score matching was used to match patients who received ECPR to those at risk for ECPR within the same time interval. Risk ratios (RRs) and 95% confidence intervals (CIs) were estimated, and stratified analysis by the timing of ECPR was also performed.

Results
Among 118,391 eligible patients, 484 received ECPR. After 1:4 time-dependent propensity score matching, 458 patients in the ECPR group and 1832 patients in the no ECPR group were included in the matched cohort. In the matched cohort, ECPR was not associated with good neurological recovery (10.3% in ECPR and 6.9% in no ECPR; RR [95% CI] 1.28 [0.85–1.93]). In the stratified analyses according to the timing of matching, ECPR with a pump-on within 45 min after emergency department arrival was associated with favourable neurological outcomes (RR [95% CI] 2.51 [1.33–4.75] in 1–30 min, 1.81 [1.11–2.93] in 31–45 min, 1.07 (0.56–2.04) in 46–60 min, and 0.45 (0.11–1.91) in over 60 min).

Conclusions
ECPR itself was not associated with good neurological recovery, but early ECPR was positively associated with good neurological recovery. Research on how to perform ECPR at an early stage and clinical trials to evaluate the effect of ECPR is warranted.
Effect of probiotic supplementation on gastrointestinal motility, inflammation, motor, non-motor symptoms and mental health in Parkinson’s disease: a meta-analysis of randomized controlled trials
Authors: Park Jong Mi , Lee Sang Chul , Ham Chorom , Kim Yong Wook 
Published: March 2023

Abstract
Background
Parkinson’s disease (PD) is the second most common neurodegenerative disease worldwide. Gut dysbiosis is hypothesized to cause PD; therefore, whether probiotics can be used as adjuvants in the treatment of PD is being actively investigated.

Aims
We performed a systematic review and meta-analysis to evaluate the effectiveness of probiotic therapy in PD patients.

Methods
PUBMED/MEDLINE, EMBASE, Cochrane, Scopus, PsycINFO and Web of Science databases were searched till February 20, 2023. The meta-analysis used a random effects model and the effect size was calculated as mean difference or standardized mean difference. We assessed the quality of the evidence using the Grade of Recommendations Assessment, Development and Evaluation (GRADE) approach.

Results
Eleven studies involving 840 participants were included in the final analysis. This meta-analysis showed high-quality evidence of improvement in Unified PD Rating Scale Part III motor scale (standardized mean difference [95% confidence interval]) (− 0.65 [− 1.11 to − 0.19]), non-motor symptom (− 0.81 [− 1.12 to − 0.51]), and depression scale (− 0.70 [− 0.93 to -0.46]). Moderate to low quality evidence of significant improvement was observed in gastrointestinal motility (0.83 [0.45–1.10]), quality of life (− 1.02 [− 1.66 to − 0.37]), anxiety scale (− 0.72 [− 1.10 to − 0.35]), serum inflammatory markers (− 5.98 [− 9.20 to − 2.75]), and diabetes risk (− 3.46 [− 4.72 to − 2.20]). However, there were no significant improvements in Bristol Stool Scale scores, constipation, antioxidant capacity, and risk of dyslipidemia. In a subgroup analysis, probiotic capsules improved gastrointestinal motility compared to fermented milk.

Conclusion
Probiotic supplements may be suitable for improving the motor and non-motor symptoms of PD and reducing depression. Further research is warranted to determine the mechanism of action of probiotics and to determine the optimal treatment protocol.
Positive impacts of leisure-time physical activity on cardiorespiratory fitness, co-morbidity level, cardiovascular health and quality of life among midlife adults: a cross-sectional study of a Nigerian population
Authors: Maruf Fatai Adesina , Ucheokoye Demelum Marylyn 
Published: March 2023

Abstract
Background
Regular physical activity (PA) improves general health and quality of life (QoL) of the general population. It is however not known if leisure-time PA (LTPA) behaviour will reduce co-morbidity and adiposity, and improve cardiorespiratory fitness and QoL in midlife men. This study explored the impacts of regular LTPA behaviour on co-morbidity, adiposity, cardiorespiratory fitness and QoL among male midlife sports club members in a Nigerian population.

Methods
This cross-sectional study involved 174 age-matched male midlife adults: 87 engaging in LTPA (LTPA group) and 87 not engaging in LTPA (non-LTPA group). Information on age, body mass index (BMI), waist circumference (WC), maximal oxygen uptake (VO2max), resting heart rate (RHR), QoL and co-morbidity level was collected using standardized procedures. Data were summarized using mean and standard deviation, and explored using frequency and proportion. Independent t-test, Chi Square and Mann–Whitney U test were employed to determine the impacts of LTPA at 0.05 significance level.

Results
The LTPA group had lower co-morbidity score (p = 0.05) and RHR (p = 0.004), and higher QoL (p = 0.01) and VO2max (p = 0.003) than non-LTPA group. While heart disease (χ2 = 10.99; p = 0.01) and hypertension (χ2 = 15.24; p = 0.004) severity levels were associated with LTPA behaviour, hypertension (p = 0.01) was the only co-morbid condition that had a significantly lower score in the LTPA group than in the non-LTPA group.

Conclusions
Regular LTPA improves cardiovascular health, physical work capacity and QoL in the sample of Nigerian mid-life men. Regular LTPA behaviour is recommended for cardiovascular health promotion, and improved physical work capacity and life satisfaction in midlife men.
Eip74EF is a dominant modifier for ALS-FTD-linked VCPR152H phenotypes in the Drosophila eye model
Authors: Chalmers Madeleine R. , Kim JiHye , Kim Nam Chul 
Published: March 2023

Abstract
Objectives
In 2012, Liu et al. reported that miR-34 is an age-related miRNA regulating age-associated events and long-term brain integrity in Drosophila. They demonstrated that modulating miR-34 and its downstream target, Eip74EF, showed beneficial effects on an age-related disease using a Drosophila model of Spinocerebellar ataxia type 3 expressing SCA3trQ78. These results imply that miR-34 could be a general genetic modifier and therapeutic candidate for age-related diseases. Thus, the goal of this study was to examine the effect of miR-34 and Eip47EF on another age-related Drosophila disease model.

Results
Using a Drosophila eye model expressing mutant Drosophila VCP (dVCP) that causes amyotrophic lateral sclerosis (ALS) and frontotemporal dementia (FTD), or multisystem proteinopathy (MSP), we demonstrated that abnormal eye phenotypes generated by dVCPR152H were rescued by Eip74EF siRNA expression. Contrary to our expectations, miR-34 overexpression alone in the eyes with GMR-GAL4 resulted in complete lethality due to the leaky expression of GMR-GAL4 in other tissues. Interestingly, when miR-34 was co-expressed with dVCPR152H, a few survivors were produced; however, their eye degeneration was greatly exacerbated. Our data indicate that, while confirming that the downregulation of Eip74EF is beneficial to the dVCPR152HDrosophila eye model, the high expression level of miR-34 is actually toxic to the developing flies and the role of miR-34 in dVCPR152H-mediated pathogenesis is inconclusive in the GMR-GAL4 eye model. Identifying the transcriptional targets of Eip74EF might provide valuable insights into diseases caused by mutations in VCP such as ALS, FTD, and MSP.
Restless leg syndrome and risk of all-cause dementia: a nationwide retrospective cohort study
Authors: Kim Keun You , Kim Eun Hwa , Lee Myeongjee , Ha Junghee , Jung Inkyung , Kim Eosu 
Published: March 2023

Abstract
Background
Restless leg syndrome (RLS) is associated with poor sleep quality, depression or anxiety, poor dietary patterns, microvasculopathy, and hypoxia, all of which are known risk factors for dementia. However, the relationship between RLS and incident dementia remains unclear. This retrospective cohort study aimed to explore the possibility that RLS could be deemed as a non-cognitive prodromal feature of dementia.

Methods
This was a retrospective cohort study using the Korean National Health Insurance Service-Elderly Cohort (aged ≥ 60). The subjects were observed for 12 years, from 2002 to 2013. Identifying patients with RLS and dementia was based on the 10th revised code of the International Classification of Diseases (ICD-10). We compared the risk of all-cause dementia, Alzheimer’s disease (AD), and vascular dementia (VaD) in 2501 subjects with newly diagnosed RLS and 9977 matched controls based on age, sex, and index date. The association between RLS and the risk of dementia was assessed using Cox regression hazard regression models. The effect of dopamine agonists on the risk of dementia among RLS patients was also explored.

Results
The baseline mean age was 73.4, and the subjects were predominantly females (63.4%). The incidence of all-cause dementia was higher in the RLS group than that in the control group (10.4% vs 6.2%). A baseline diagnosis of RLS was associated with an increased risk of incident all-cause dementia (adjusted hazard ratio [aHR] 1.46, 95% confidence interval [CI] 1.24–1.72). The risk of developing VaD (aHR 1.81, 95% CI 1.30–2.53) was higher than that of AD (aHR 1.38, 95% CI 1.11–1.72). The use of dopamine agonists was not associated with the risk of subsequent dementia among patients with RLS (aHR 1.00, 95% CI 0.76–1.32).

Conclusions
This retrospective cohort study suggests that RLS is associated with an increased risk of incident all-cause dementia in older adults, providing some evidence that requires confirmation through prospective studies in the future. Awareness of cognitive decline in patients with RLS may have clinical implications for the early detection of dementia.