bluuebunny/crossref_metadata_2025_split huggingface dataset:
Disease-modifying therapies and cost-of-illness progression among people newly diagnosed with multiple sclerosis: a national register-based cohort study covering treatment initiation with interferons, glatiramer acetate or natalizumab
Authors: Karampampa Korinna , Gyllensten Hanna , Friberg Emilie , Murley Chantelle , Kavaliunas Andrius , Hillert Jan , Olsson Tomas , Alexanderson Kristina 
Published: May 2023

ObjectivesDisease-modifying therapies (DMTs) can slow disease progression in multiple sclerosis (MS). The objective of this study was to explore the cost-of-illness (COI) progression among newly diagnosed people with MS in relation to the first DMT received.Design and settingA cohort study using data from nationwide registers in Sweden.ParticipantsPeople with MS (PwMS) in Sweden first diagnosed in 2006–2015, when aged 20–55, receiving first-line therapy with interferons (IFN), glatiramer acetate (GA) or natalizumab (NAT). They were followed up through 2016.Outcome measuresOutcomes (in Euros, €) were: (1) secondary healthcare costs: specialised outpatient and inpatient care including out-of-pocket expenditure, DMTs including hospital-administered MS therapies, and prescribed drugs, and (2) productivity losses: sickness absence and disability pension. Descriptive statistics and Poisson regression were computed, adjusting for disability progression using the Expanded Disability Status Scale.Results3673 newly diagnosed PwMS who were treated with IFN (N=2696), GA (N=441) or NAT (N=536) were identified. Healthcare costs were similar for the INF and GA groups, while the NAT group had higher costs (p value<0.05), owing to DMT and outpatient costs. IFN had lower productivity losses than NAT and GA (p value>0.05), driven by fewer sickness absence days. NAT had a trend towards lower disability pension costs compared with GA (p value>0.05).ConclusionsSimilar trends over time for healthcare costs and productivity losses were identified across the DMT subgroups. PwMS on NAT maintained their work capacity for a longer time compared with those on GA, potentially leading to lower disability pension costs over time. COI serves as an objective measure to explore the importance of DMTs in maintaining low levels of progression of MS over time.
Burden of cardiometabolic risk factors and preclinical target organ damage among adults in Freetown, Sierra Leone: a community-based health-screening survey
Authors: Russell James Baligeh Walter , Koroma Theresa Ruba , Sesay Santigie , Samura Sallieu Kabay , Lakoh Sulaiman , Bockarie Ansumana , Abir Onome Thomas , Kanu Joseph Sam , Coker Joshua , Jalloh Abdul , Conteh Victor , Conteh Sorie , Smith Mohamed , Mahdi Othman Z , Lisk Durodami R 
Published: May 2023

ObjectiveTo investigate the prevalence of cardiometabolic risk factors (CMRFs), target organ damage (TOD) and its associated factors among adults in Freetown, Sierra Leone.DesignThis community-based cross-sectional study used a stratified multistage random sampling method to recruit adult participants.SettingThe health screening study was conducted between October 2019 and October 2021 in Western Area Urban, Sierra Leone.ParticipantsA total of 2394 adult Sierra Leoneans aged 20 years or older were enrolled.Outcome measureAnthropometric data, fasting lipid profiles, fasting plasma glucose, TOD, clinical profiles and demographic characteristics of participants were described. The cardiometabolic risks were further related to TOD.ResultsThe prevalence of known CMRFs was 35.3% for hypertension, 8.3% for diabetes mellitus, 21.1% for dyslipidaemia, 10.0% for obesity, 13.4% for smoking and 37.9% for alcohol. Additionally, 16.1% had left ventricular hypertrophy (LVH) by ECG, 14.2% had LVH by two-dimensional echo and 11.4% had chronic kidney disease (CKD). The odds of developing ECG-LVH were higher with diabetes (OR=1.255, 95% CI (0.822 to 1.916) and dyslipidaemia (OR=1.449, 95% CI (0.834 to 2.518). Associated factors for higher odds of Left Ventricular Mass Index by echo were dyslipidaemia (OR=1.844, 95% CI (1.006 to 3.380)) and diabetes mellitus (OR=1.176, 95% CI (0.759 to 1.823)). The odds of having CKD were associated with diabetes mellitus (OR=1.212, 95% CI (0.741 to 1.983)) and hypertension (OR=1.163, 95% CI (0.887 to 1.525)). A low optimal cut-off point for ECG-LVH (male 24.5 mm vs female 27.5 mm) was required to maximise sensitivity and specificity by a receiver operating characteristics curve since the odds for LVH by ECG were low.ConclusionsThis study provides novel data-driven information on the burden of CMRF and its association with preclinical TOD in a resource-limited setting. It illustrates the need for interventions in improving cardiometabolic health screening and management in Sierra Leonean.
Stakeholder’s perspectives on acceptable interventions for promoting hypertension medication adherence in Namibia: nominal group technique
Authors: Nakwafila Olivia , Sartorius Benn , Shumba Tonderai Washington , Dzinamarira Tafadzwa , Mashamba-Thompson Tivani Phosa 
Published: May 2023

ObjectiveTo determine the most acceptable hypertension intervention package to promote hypertension adherence based on stakeholders’ perspectives.DesignWe employed the nominal group technique method and purposively sampled and invited key stakeholders offering hypertension services and patients with hypertension. Phase 1 was focused on determining barriers to hypertension adherence, phase 2 on enablers and phase 3 on the strategies. We employed the ranking method based on a maximum of 60 scores to establish consensus regarding hypertension adherence barriers, enablers and proposed strategies.Setting and participants12 key stakeholders were identified and invited to participate in the workshop in Khomas region. Key stakeholders included subject matter experts in non-communicable diseases, family medicine and representatives of our target population (hypertensive patients).ResultsThe stakeholders reported 14 factors as barriers and enablers to hypertension adherence. The most important barriers were: lack of knowledge on hypertension (57 scores), unavailability of drugs (55 scores) and lack of social support (49 scores). Patient education emerged as the most important enabler (57 scores), availability of drugs emerged second (53 scores) and third having a support system (47 scores). Strategies were 17 and ranked as follows: continuous patient education as the most desirable (54 scores) strategy to help promote hypertension adherence, followed by developing a national dashboard to primarily monitor stock (52 scores) and community support groups for peer counselling (49 scores).ConclusionsMultifaceted educational intervention package targeting patient and healthcare system factors may be considered in implementing Namibia’s most acceptable hypertension package. These findings will offer an opportunity to promote adherence to hypertension therapy and reduce cardiovascular outcomes. We recommend a follow-up study to evaluate the proposed adherence package’s feasibility.
JBI systematic review protocol of text/opinions on how to best collect race-based data in healthcare contexts
Authors: Quan Cindy , Clark Nancy , Costigan Catherine L , Murphy Jill , Li Michael , David Anita , Ganesan Soma , Guzder Jaswant , Cross Barbara 
Published: May 2023

IntroductionRacialized population groups have worse health outcomes across the world compared with non-racialized populations. Evidence suggests that collecting race-based data should be done to mitigate racism as a barrier to health equity, and to amplify community voices, promote transparency, accountability, and shared governance of data. However, limited evidence exists on the best ways to collect race-based data in healthcare contexts. This systematic review aims to synthesize opinions and texts on the best practices for collecting race-based data in healthcare contexts.Methods and AnalysesWe will use the Joanna Briggs Institute (JBI) method for synthesizing text and opinions. JBI is a global leader in evidence-based healthcare and provides guidelines for systematic reviews. The search strategy will locate both published and unpublished papers in English in CINAHL, Medline, PsycINFO, Scopus and Web of Science from 1 January 2013 to 1 January 2023, as well as unpublished studies and grey literature of relevant government and research websites using Google and ProQuest Dissertations and Theses. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement methodology for systematic reviews of text and opinion will be applied, including screening and appraisal of the evidence by two independent reviewers and data extraction using JBI’s Narrative, Opinion, Text, Assessment, Review Instrument. This JBI systematic review of opinion and text will address gaps in knowledge about the best ways to collect race-based data in healthcare. Improvements in race-based data collection, may be related to structural policies that address racism in healthcare. Community participation may also be used to increase knowledge about collecting race-based data.Ethics and disseminationThe systematic review does not involve human subjects. Findings will be disseminated through a peer-reviewed publication in JBI evidence synthesis, conferences and media.PROSPERO registration numberCRD42022368270.
Development and evaluation of a data-driven integrated management app for perioperative adverse events: protocol for a mixed-design study
Authors: Li Peiyi , Wang Ce , Zhou Ruihao , Tan Lingcan , Deng Xiaoqian , Zhu Tao , Chen Guo , Li Weimin , Hao Xuechao 
Published: May 2023

IntroductionA patient record review study conducted in 2006 in a random sample of 21 Dutch hospitals found that 51%–77% of adverse events are related to perioperative care, while Centers for Disease Control and Prevention data in USA in 2013 estimated that the medical error is the third-leading cause of mortality. To capitalise on the potential of apps to enhance perioperative medical quality, there is a need for interventions developed in consultation with real-world users designed to support integrated management for perioperative adverse events (PAEs). This study aims: (1) to access the knowledge, attitude and practices for PAEs among physicians, nurses and administrators, and to identify the needs of healthcare providers for a mobile-based PAEs tool; (2) to develop a data-driven app for integrated PAE management that meets those needs and (3) to test the usability, clinical efficacy and cost-effectiveness of the developed app.Methods and analysisWe will adopt an embedded mixed-methods research technique; qualitative data will be used to assess user needs and app adoption, while quantitative data will provide crucial insights to establish the demand for the app, and measure the app effects. Phase 1 will enrol surgery-related healthcare providers from the West China Hospital and identify their latent demand for mobile-based PAEs management using a self-designed questionnaire underpinned by the knowledge, attitude and practice model, as well as expert interviews. In phase 2, we will develop the app for integrated PAE management and test its effectiveness and sustainability. In phase 3, the effects on the total number and severity of reported PAEs will be evaluated using Poisson regression with interrupted time-series analysis over a 2-year period, while users’ engagement, adherence, process evaluation and cost-effectiveness will be evaluated using quarterly surveys and interviews.Ethics and disseminationThe West China Hospital of Sichuan University’s Institutional Review Board authorised this study after approving the study protocol, permission forms and questionnaires (number: 2022-1364). Participants will be provided with study information, and informed written consent will be obtained. Study findings will be disseminated through peer-reviewed publications and conference presentations.
Effects of ethical climate in association with tenure on work addiction, quality of care and staff retention: a cross-sectional study
Authors: Maisonneuve Francis , Groulx Patrick , Chênevert Denis , Grady Colleen , Coderre-Ball Angela 
Published: May 2023

ObjectivesWork addiction is not contingent on personality alone; it is also impacted by social contextual factors. Work addiction influences the perceived quality of care and intention to remain in healthcare sector. The current study seeks to understand the role of ethical climate as a potential organisational lever to reduce such addiction, especially among newcomers.DesignWe contacted a sample of Canadian healthcare organisations to collect quantitative data using an online questionnaire from November 2021 to February 2022. All constructs (ethical climate, work addiction, perceived quality of care, intention to quit the profession) were measured using validated psychometric scales. 860 respondents provided complete questionnaires. We analysed the data using structural equation modelling and regression analysis.ResultsWork addiction mediated the indirect relationship between ethical climate and the intention to quit the profession (β=−0.053; 95% CI (−0.083 to –0.029); p<0.001) and with quality of care (β=0.049; 95% CI (0.028, 0.077); p<0.001). For each increase of 1 SD of ethical climate, the total effects regarding the variations in the outcomes were more important at low rather than high levels of tenure for work addiction (−11%, −2%), perceived quality of care (23%, 11%) and intention to quit the profession (−30%, −23%), respectively.ConclusionEthical climate in healthcare organisations has a significant and beneficial relationship with healthcare workers’ (HCWs) work addiction behaviours. In turn, this relationship is related to greater perceived quality of care and higher intention to remain, especially for HCWs with lower tenure.
Prevalence, severity and risk factors for asthma in school-going adolescents in KwaZulu Natal, South Africa
Authors: Mphahlele Reratilwe , Lesosky Maia , Masekela Refiloe 
Published: May 2023

BackgroundAsthma remains highly prevalent, with more severe symptoms in low-income to middle-income countries (LMICs) compared with high-income countries. Identifying risk factors for severe asthma symptoms can assist with improving outcomes. We aimed to determine the prevalence, severity and risk factors for asthma in adolescents in an LMIC.MethodsA cross-sectional survey using the Global Asthma Network written and video questionnaires was conducted in adolescents aged 13 and 14 from randomly selected schools in Durban, South Africa, between May 2019 and June 2021.ResultsA total of 3957 adolescents (51.9% female) were included. The prevalence of lifetime, current and severe asthma was 24.6%, 13.7% and 9.1%, respectively. Of those with current and severe asthma symptoms; 38.9% (n=211/543) and 40.7% (n=147/361) had doctor-diagnosed asthma; of these, 72.0% (n=152/211) and 70.7% (n=104/147), respectively, reported using inhaled medication in the last 12 months. Short-acting beta agonists (80.4%) were more commonly used than inhaled corticosteroids (13.7%). Severe asthma was associated with: fee-paying school quintile (adjusted OR (CI)): 1.78 (1.27 to 2.48), overweight (1.60 (1.15 to 2.22)), exposure to traffic pollution (1.42 (1.11 to 1.82)), tobacco smoking (2.06 (1.15 to 3.68)), rhinoconjunctivitis (3.62 (2.80 to 4.67)) and eczema (2.24 (1.59 to 3.14)), all p<0.01.ConclusionAsthma prevalence in this population (13.7%) is higher than the global average (10.4%). Although common, severe asthma symptoms are underdiagnosed and associated with atopy, environmental and lifestyle factors. Equitable access to affordable essential controller inhaled medicines addressing the disproportionate burden of asthma is needed in this setting.
WEB shape modifications: angiography–histopathology correlations in rabbits
Authors: Janot Kevin , Boulouis Grégoire , Forestier Géraud , Bala Fouzi , Cortese Jonathan , Szatmáry Zoltán , Bardet Sylvia M. , Baudouin Maxime , Perrin Marie-Laure , Mounier Jérémy , Couquet Claude , Yardin Catherine , Segonds Guillaume , Dubois Nicolas , Martinez Alexandra , Lesage Pierre-Louis , Ding Yong-Hong , Kadirvel Ramanathan , Dai Daying , Mounayer Charbel , Terro Faraj , Rouchaud Aymeric 
Published: May 2023

Background
WEB Shape Modification (WSM) over time is frequent after aneurysm treatment. In this study, we explored the relationship between histopathological changes and angiographic evolution over time in experimental aneurysms in rabbits treated with the Woven EndoBridge (WEB) procedure.

Methods
Quantitative WSM was assessed using flat-panel computed tomography (FPCT) during follow-up by calculating height and width ratio (HR, WR), defined as the ratio between either measurement at an index time point and the measurement immediately after WEB implantation. The index time point varied from 1 day to 6 months. HR and WR were evaluated with angiographic and histopathological assessments of aneurysm healing.

Results
Final HR of devices varied from 0.30 to 1.02 and final WR varied from 0.62 to 1.59. Altogether, at least 5% of HR and WR variations were observed in 37/40 (92.5%) and 28/40 (70%) WEB devices, respectively, at the time of final assessment. There was no significant correlation between complete or incomplete occlusion groups and HR or WR (p=0.15 and p=0.43). Histopathological analysis revealed a significant association between WR and aneurysm healing and fibrosis 1 month following aneurysm treatment (both p<0.05).

Conclusion
Using longitudinal FPCT assessment, we observed that WSM affects both the height and width of the WEB device. No significant association was found between WSM and aneurysm occlusion status. Although presumably a multifactorial phenomenon, the histopathological analysis highlighted a significant association between width variations, aneurysm healing and fibrosis in the first month following aneurysm treatment.
Nongrowing season soil nitrous oxide emissions as influenced by cover crops and fall tillage termination
Authors: Gao Yuanpei , Borden Kira A. , Brown Shannon E. , Wagner-Riddle Claudia 
Published: May 2023

Cropland soil is a major driver of global nitrous oxide (N2O) emissions. In cold climates, nongrowing season (NGS) emissions can be significant due to high fluxes during freeze–thaw (FT) cycles. Cover crops can alter key soil conditions that govern N2O-producing microbial processes, with multiple potential pathways to either increase or decrease N2O production during FT cycles. Cultivating cover crops in the fall to terminate may further disrupt these processes and the overall impact of cover crops on N2O emissions. Yet, few studies have touched on how termination practices of cover crops impact FT emissions over the NGS. Using the flux gradient method to continuously measure N2O emissions from a conventional corn–soybean rotation, we investigated the effects of summer-established cover crops (perennial ryegrass and crimson clover) (with cover crops, +CC; without cover crops, −CC) when terminated by fall cultivation (with fall cultivation, +FC; without fall cultivation, −FC) over a six-month NGS that was characterized by several freezing and thawing periods. Crimson clover cover crop was completely winterkilled, while the ryegrass survived on the +CC−FC field. Total NGS (Nov–Apr) emissions varied nearly 2.5-fold among treatments from 395.1 (−CC−FC) to 978.1 (+CC+FC) g N2O-N ha−1. Compared with the control treatment (−CC−FC), fall cultivation alone (−CC+FC) and cover crops alone (+CC−FC) increased total NGS N2O emissions, and fall cultivation with cover crops (+CC+FC) increased N2O fluxes even more. Careful CC species selection and management are important to avoid elevated NGS emissions.
Frugal Exoscope: A Minimal Cost Option for Microsurgery and Training Program in Male Infertility
Authors: Khoa Le Dang , Hoang Le , Thang Le Duc , Vy Ngo Dinh Trieu , Dung Mai Ba Tien , Huy Duong Quang , Nhu Giang Huynh , Handelsman David 
Published: May 2023

Background: Conventional microscopes and exoscopes currently play pivotal roles in the microsurgery or training for male infertility. However, they are expensive and unaffordable in low-resource settings, which limits training or application of advanced methods. Objectives: To introduce a new, low-cost exoscope system and to determine whether it is an effective frugal innovation. Methods: Using animal models, we evaluated a new frugal exoscope system named DKTA in experimental microsurgery of vas deferens repair. Five experts in male infertility surgery undertook an anonymous survey to elucidate their experience with DKTA system use. Three crucial criteria (i.e., substantial cost reduction, concentration on core functionalities, and optimized performance level) were evaluated to determine whether the DKTA is effective as frugal innovation. The survey used a 5-point Likert scale of responses to eight statements investigating surgical, ergonomic, and educational aspects. Results: The DKTA system, including an optical microscope and ultra-high-definition (UHD) camera (4K), was an exoscope placed between 20 and 40 cm from the surgical field. It was held in position with a camera support arm on casters and connected to a 65-in. smart TV. DKTA system met the three crucial criteria of frugal innovation. Five male infertility microsurgeons reported positive evaluations based on modal scores of the DKTA system when performing experimental vasovasostomy. Conclusions: DKTA system, a frugal innovation, has a valuable contribution to the training program and performance of male infertility microsurgery in low-resource settings.