bluuebunny/crossref_metadata_2025_split huggingface dataset:
Can HIV/AIDS be fought by targeting youths in Zambia? Analysis of the Knowledge, Attitudes and Sexual Behaviour among youths aged 15 – 24 years.
Authors: Bwalya Bupe Bwalya , Banda Andrew , Jere Stanley , Amanzi Patrick , Funsani Peter 
Published: April 2023

Background: Although people of any age are susceptible to HIV, youths aged 15 – 24 face disproportionate risk of contracting it because of challenges that they face with regard to correct HIV and AIDS related knowledge, attitudes and practices. This study was aimed at determining whether HIV and AIDS can be fought by targeting interventions at youths aged 15 – 24 years by assessing their current knowledge, attitudes and sexual behaviours in Zambia.
Methods: The study utilised secondary data from a self-weighting nationally representative sample of the 2009 Zambia Sexual Behaviour Survey.
Results: Generally correct comprehensive knowledge is very low among youths (43 percent). This is in spite having good command of general and full general knowledge and the ABCs of HIV and AIDS prevention. Attitudes towards PLHIV, Condom use and HIV counselling and testing were negative. About one third (58 percent) of youths in Zambia have a history of early sexual debut (sex before age 15) with more females (64 percent) than males (51 percent) having hard sex. Male youths were more likely to have used a condom with most recent sexual partner as compared to females (AOR=0.265, 95%CI: 0.160, 0.438; p<0.001). Youths in rural areas had reduced odds of using a condom during their first sexual intercourse compared with those in urban areas (AOR=0.530, 95%CI: 0.387, 0.726; p<0.001).
Conclusions: Therefore, it can be seen lack of comprehensive correct knowledge, gender disparities, poor educational levels, youth’s age and place of residence are some of the contributing factors that may hinder the fight against HIV/AIDS among youths in Zambia.
Distance learning training in genetics and genomics testing for Italian health professionals: results of a pre and post-test evaluation
Authors: Michelazzo Maria Benedetta , Pastorino Roberta , Mazzucco Walter , Boccia Stefania 
Published: April 2023

Background
Progressive advances in technologies for DNA sequencing and decreasing costs are allowing an easier diffusion of genetic and genomic tests. Physicians’ knowledge and confidence on the topic is often low and not suitable for manage this challenge. Tailored educational programs are required to reach a more and more appropriate use of genetic technologies.
Methods
A distance learning course has been created by experts from different Italian medical associations with the support of the Italian Ministry of Health. The course was directed to professional figures involved in prescription and interpretation of genetic tests. A pretest-post-test study design was used to assess knowledge improvement. We analyzed the proportion of correct answers for each question pre and post-test, as well as the mean score difference stratified by gender, age, professional status and medical specialty.
Results
We reported an improvement in the proportion of correct answers for 12 over 15 questions of the test. The overall mean score to the questions significantly increased in the post-test, from 9.44 to 12.49 (p-value < 0.0001). In the stratified analysis we reported an improvement in the knowledge of all the groups except for geneticists; the pre-course mean score of this group was already very high and did not improve significantly.
Conclusion
Distance learning is effective in improving the level of genetic knowledge. In the future, it will be useful to analyze which specialists have more advantage from genetic education, in order to plan more tailored education for medical professionals.
The Prevalence of anemia among informal primary school children: a community based study in Rural Upper Egypt
Authors: Salama Rasha A , Labib Meray R 
Published: April 2023

Background: Anemia has been recognized as a major public health problem in developing countries. The magnitude of anemia among school children has received less attention compared with that in preschoolers and pregnant women. This study aimed to estimate the prevalence of anemia and to assess its associated factors among informal school children in rural Upper Egypt.
Methods: A cross sectional descriptive study was conducted in a randomly selected Girls Education initiative schools in three Egyptian governorates for duration of 11 months. A structured questionnaire was used to collect sociodemographic data from 2826 children aged 6-19 years. Hemoglobin concentration and anthropometric indicators were assessed using the World Health Organization guidelines. Stool samples were examined for parasitic infestations, using the Kato Katz technique. The objective of the study was adequately explained to participants’ guardian and their consensus was obtained with assured confidentiality.
Results: the prevalence of anemia among these children was 59.3%, out of which, 82.5% had mild anemia and 17.4% of them had moderate anemia. It was significantly higher among 64% of children in age group 6-9years and 61.3% of females. The majority of underweight children (75.8%) and 66.4% of children with parasitic infestation were anemic.
Conclusions: Anemia remains a common problem among GEI School particularly the young children and girls of low income household. School children should be screened periodically and appropriate measures should be taken in order to promote health and guide effective education sector reform initiatives.
Colorectal Cancer, Socioeconomic Distribution and Behavior: A Comparative Analysis of Urban and Rural Counties in the USA
Authors: Nuhu Kaamel M , McDaniel Justin T , Ruiz Juan I 
Published: April 2023

Background: Colorectal cancer (CRC) ranks second for all cancer related deaths among men and women together and third for either sex when considered separately. Disparities exist in CRC incidence and mortality between rural and urban counties in the USA. This study sought to explore socioeconomic and behavioral factors that may partly explain these observed differences.
Methods: Using educational and income levels as measures of socioeconomic status (SES), and average alcohol consumption and smoking frequency as behavioral factors, data from the Behavioral Risk Factor Surveillance System (BRFSS) and the Surveillance, Epidemiology, and End Results (SEER) program for analysis were coupled.
Results: Results showed statistically significant inequalities for CRC incidence (t = 2.678, p = 0.010) and mortality (t = 2.567, p = 0.013), as well as socioeconomic (i.e., poverty; t = 5.644, p < 0.001) and behavioral (i.e., smoking; t = 2.885, p = 0.006) factors between selected rural and urban counties. Regression analysis for colorectal cancer incidence and mortality rates at the rural, urban, and national levels yielded relative impacts of smoking frequency, alcohol consumption, and educational level.
Conclusions: Health policies aimed at reducing disparities between rural and urban populations in the USA must therefore adequately address SES and behavioral factors.
Key words: colorectal cancer, rural health, social determinants of health, health behavior
General health status and its related socio-demographic factors: a population based cross-sectional study
Authors: Armanmehr Vajihe , Shahghasemi Zohreh , Alami Ali , Moradi Noorallah , Rezaeian Shahab 
Published: April 2023

Background: There is still little information on health status in small communities and also according to the different cultural characteristics of people in different societies, the present study aimed to determine the rate of general health and its related socio-demographic factors in general population.
Methods: A population-based cross-sectional study was conducted in Gonabad city, the North-East of Iran, in 2013. We used the 28-item General Health Questionnaire (GHQ-28) to examine general health status with the cutoff point of 23. The association between general health and socio-demographic factors were reported in crude and adjusted odds ratios with 95% confidence interval.
Results: A total of 800 subjects were interviewed (Response rate=98%). The mean age was 35.5 (SD ± 10.6) years, 49.6% were female, 41.8% were aged 30 years or younger, and 65.9% did not have academic education. According to the GHQ-28, 24.7% of the participants were categorized as not healthy people. General health status was associated with age, sex, education level, family size, residency duration in neighborhood, and SES status.
Conclusion: General health status varied according to both the individual and socio-economic factors. Socio-economic status seems to play an important role in enhancing individual’s health and then lead to improve the health of community. These findings also suggest that mental health programs should be targeted in women and elderly population by the newly established family physician plan.
Environmental and Personal Factors Related to Asthma Severity among Children: Hospital Based Study, Egypt
Authors: Abo Elkheir Omaima Ibrahim , Hafez Manal Refaat , Mohamed Soheir Ibrahim 
Published: April 2023

Background: Childhood asthma is a complex disorder in which many environmental and personal factors play a role. However, the contribution of these factors to asthma severity is poorly understood. This study aims to determine the relationship between environmental exposures, personal factors and asthma severity among asthmatic children.
Methods: This cross-sectional hospital based study was conducted on 180 asthmatic children; they were divided into mild, moderate and severe asthma according to forced expiratory volume in first second. Environmental factors (indoor and outdoor), food allergy, history of other allergic diseases, family history of allergic disorders, time trend of attacks as well as asthma outcome were reported.
Results: Children with severe asthma were younger than those with mild or moderate asthma. Severe asthma was significantly linked to family history of allergy, presence of co-morbid allergic diseases, fish, egg and milk allergy, as well as exposure to passive smoking (73.7%) and poor housing conditions. Also, it was significantly linked to presence of unauthorized factories in residential area (31.6 %, p=0.001). As well as, contact with pets (42.1%). Children with severe asthma had more limitations of physical activities (73.7%), missed school days (81.5%), with poor school performance (p=0.04) than those with mild moderate or asthma.
Conclusion: Severe asthma was linked to female gender and younger age, co-morbid allergic diseases, family history of atopy and food allergy. It was higher among children residing in places with unauthorized factories and living in substandard housing condition. Children with severe asthma had poor asthma outcome.
Prevalence of Dyslipidemia among Healthy University Students: Fayoum Governorate, Egypt.
Authors: Abdel Wahed Wafaa Y Y , El-Khashab Khalid , Hassan Safaa Khamis 
Published: April 2023

Introduction:. Dyslipidemia is a well known and major modifiable risk factor for coronary heart disease (CHD). Increased prevalence of these abnormalities in young adulthood, increase the prevalence of CHD later on life.
Objectives: to estimate the prevalence and patterns of serum lipid profiles and associated factors among university students in Fayoum University students.
Methods: A descriptive cross-sectional study was conducted on a group of 384 Fayoum university students. Fasting blood samples were collected from all participants and assayed for fasting total cholesterol (TC), triglyceride (TG), high density lipoprotein (HDL), and low density lipoprotein (LDL).
Results: According to the National Cholesterol Education Program-Adult Treatment Panel III criteria, the overall prevalence of dyslipidemia was 44.3% , hypercholesterolemia prevalence was 38.8%, hypertrigyceridemia 29.7% low HDL-C 27.1% and high LDL-C 33.1% Significant associated factors of dyslipidemia among study participants were urban residence, increasing age, physical inactivity ,overweight&obesity, abdominal obesity frequent fast food consumption and Low fruit and vegetables consumption
Conclusion: The prevalence of dyslipidemia is high among Fayoum university students, important associated factors are obesity and overweight, physical inactivity , unhealthy dietary habits that need to be tackled through intervention programs.
Comparison among single-phase test, automated screening method and GC/MS for the traceability of ketamine in urine
Authors: Lagravinese Giovanni M. , De Vita Miriam , Visione Alice , Capomassi Angelica , Visconti Sara , Guglielmelli Emanuele 
Published: April 2023

BACKGROUND
The use of ketamine, for non-medical purpose, results widespread also in Italy. This drug is not searched by institutional centers, charged of the responsibility to realize the execution of toxicological analysis based on the article 187 of The New Italian Highway Code. We evaluated the reliability of the single-phase test comparing it with an automated screening method and a gas chromatography-mass spectrometry to search the presence of ketamine on casualty patients involved in car accidents in Rome.METHODS The screening analysis were performed by a single-phase test (with a cut-off settled at 1000 ng/ml), and an automated immunoenzymatic assay (cut-off settled at 330 ng/ml). The confirmation tests have been realized by gas chromatography-mass spectrometry.RESULTSThe single-phase test highlighted ten positive samples out of 294. The automated instrument confirmed only six out of ten previous positive samples, meanwhile the instrument found further four positive samples, considered negative by the single-phase test. The presence of ketamine is confirmed by gas chromatography-mass spectrometry only in seven samples out of fourteen resulted positives from both screening analysis. Three samples out of seven confirmed by gas chromatography-mass spectrometry were positive only to ketamine.CONCLUSION Following the law indications, ketamine is not searched: this limit does not make the authorities able to apply the penalties expected for road laws violations. The automation is essential to guarantee the reliability of toxicological screening tests, especially to medico-legal significance. This results highlight the absolutely necessity of the execution of the confirmation test, successively to screening analysis.
Detecting Rates, Trends and Determinants of Cesarean Section Deliveries in Iran Using Generalized Additive Mixed Models
Authors: Mahmoodi Marzieh , Moghimbeigi Abbas , Faradmal Javad , Ghahramani Masoome 
Published: April 2023

Background: The present study aimed to investigate the trend of cesarean section and its related factors through the recent years.
Methods: The study data containing delivery information from Hamadan hospitals and are recorded from 2001 to 2014. The data were analyzed through the generalized additive mixed models using R software (v. 3.2.2).
Results: cesarean rate in this study was about 42%. According to the results, the trend of cesarean deliveries almost increased in the recent years. A significant relationship was found between the average age and elective cesarean rate, but, the pregnancy rate didn’t have a significant effect on the elective cesarean rate.
Conclusion: Cesarean section rate was more than the allowed limit by world health organization (WHO) that is 15%. Although cesarean delivery is preferred to natural vaginal delivery in the case the mother’s or infant’s life is in danger, it should not replace natural delivery for any reason. Natural vaginal delivery can be promoted by providing the society with the knowledge about the advantages of natural delivery and complications of cesarean section.
Is vaccination good value for money? A review of cost-utility analyses of vaccination strategies in eight European countries
Authors: Barbieri Marco , Capri Stefano 
Published: April 2023

Objective: The objective of this study is to review published cost-utility analyses of vaccination strategies in eight European countries and to assess whether there are differences in cost-effectiveness terms among countries and vaccinations.
Methods: A systematic search of the literature was conducted using the National Health Service Economic Evaluation Database and the PubMed database. Cost-utility analyses of any type of vaccination that used quality-adjusted life years (QALYs) as measure of benefit and conducted in Belgium, France, Germany, Italy, Spain, Sweden, the Netherlands or the UK were included.
Results: A total of 94 studies were identified. As a result of our search methodology, the vast majority of studies were conducted in the Netherlands or UK (33 and 30 studies, respectively). The most frequent vaccination types were against Human papillomavirus (HPV) with 23 studies, followed by vaccination against pneumococcal infections (19 studies). The analysed vaccinations were generally cost-effective but with high variability. Considering an incremental cost effectiveness ratio (ICER) of 40,000€/QALY, we noticed that the following vaccinations studies are below this threshold, i.e. all varicella and influenza (with one outlier) studies, 90% of the studies for HPV and 75% of the studies for pneumococcal vaccinations. Rotavirus vaccination was considered as not cost-effective, with only 30% of studies below the threshold of 40,000€/QALY. There was no clear trend for vaccinations being more cost-effective in some countries.
Conclusions: The published literature has shown that vaccination strategies are generally cost-effective in European countries. High heterogeneity in the results among studies and countries was found.
Inferential misconceptions and replication crisis
Authors: Hirschauer Norbert , Musshoff Oliver , Gruener Sven , Frey Ulrich , Theesfeld Insa , Wagner Peter 
Published: April 2023

Misinterpretations of the p value and the introduction of bias through arbitrary analytical choices have been discussed in the literature for decades. Nonetheless, they seem to have persisted in empirical research, and criticisms of p value misuses have increased in the recent past due to the non-replicability of many studies. Unfortunately, the critical concerns that have been raised in the literature are scattered over many disciplines, often linguistically confusing, and differing in their main reasons for criticisms. Misuses and misinterpretations of the p value are currently being discussed intensely under the label “replication crisis” in many academic disciplines and journals, ranging from specialized scientific journals to Nature and Science. In a drastic response to the crisis, the editors of the journal Basic and Applied Social Psychology even decided to ban the use of p values from future publications at the beginning of 2015, a fact that has certainly added fuel to the discussions in the relevant scientific forums. Finally, in early March, the American Statistical Association released a brief formal statement on p values that explicitly addresses misuses and misinterpretations. In this context, we systematize the most serious flaws related to the p value and discuss suggestions of how to prevent them and reduce the rate of false discoveries in the future.
Statistical modeling of complex health outcomes and air pollution data: Application of air quality health indexing for asthma risk assessment
Authors: Weerasinghe Swarna 
Published: April 2023

Background: Statistical models for complex health outcome data analyses with; zero inflation, autocorrelation, confounding, seasonality and delayed exposures, play an important role in accurately assessing air pollution risk, especially in public health warning using national air quality health indices (NAQHI). NAQHI assessment generalizes model estimates across all geographies and seasons and neglects area and season specific variations. The aim is to develop complex statistical models, specific to the complex data structures and to demonstrate effectiveness of the model estimates in public health massage delivery.
Methods: A time series model was fitted to asthma hospital admissions and ambient air pollution data from two sites, Halifax, an urban, traffic and industry polluted site and Sydney, a rural waste disposal polluted site, in the province of Nova Scotia, Canada. I fitted zero inflated, auto regressive, Poisson and Negative Binomial models with lagged effects for sparse asthma admissions and air pollution data and compared the model risk estimates with that of the NAQHI.
Results: NAQHI used three pollutants, Nitrogen Dioxide, Ozone and particulate matter. I found Carbon monoxide in the urban site and lead in the waste disposal site as prominent pollutants and there were seasonal differences. The findings demonstrated severe under-assessment of asthma relative risk by NAQHI, when prominent pollutants are neglected and also when auto correlation and zero inflation are ignored.
Conclusion: This study demonstrated the importance of complex statistical model use and the consequences of lack of such modelling that accounted for data structures in public health risk assessments.
Considering time-interaction terms using parametric survival models for interval-censoring data
Authors: Ghasemi Erfan , Baghban Alireza Akbarzadeh , Baghestani Ahmadreza , Asgary Saeed 
Published: April 2023

Background: Many of the variables which are investigated in survival research are time-invariant, i.e. their values do not change over time. But their effects, may yet vary over time. Thus, the change in behavior that occurs over time needs to be included in the analysis. This can be done by adding time-interaction terms to the model.
Method: In this research, a parametric survival model, which is capable of evaluating the effects of time-dependent variables, was applied for interval-censored data such that the time to invariant variables interaction terms were considered as time-dependent variables.
Results: Using a practical example, the results of the study show that this model can alter the interpretations regarding the effects of exploratory variables.
Conclusion: when dealing with fixed variables whose effects change over time, the researcher can incorporate their interaction effect with time, and treat them as time-dependent variables and obtain appropriate inferences.