bluuebunny/crossref_metadata_2025_split huggingface dataset:
Drivers of antibiotic use habits and animal disease incidence in smallholder livestock farms: evidence from a survey in Burkina Faso
Authors: Emes Eve , Kagambèga Assèta , Dione Michel 
Published: June 2023

AbstractReducing nontherapeutic antibiotic (ABU) use in livestock animals has been identified as an important way of curbing the growth of antimicrobial resistance (AMR). However, this ABU can be an important disease management tool, and farmers may not feel safe to reduce it without simultaneous interventions to safeguard animal health. It is therefore important to determine a) if nontherapeutic ABU is important for averting livestock animal disease, b) which factors can encourage farmers to improve antibiotic stewardship on their own terms, and c) which factors can be paired with ABU reduction in order to safeguard against any animal health risks.We investigated these questions using data from the AMUSE survey, which is designed to evaluate knowledge, attitudes and practices relating to AMR in smallholder livestock farms. Our sample covered 320 animal herds from 216 smallholder livestock farms in Burkina Faso, with species including poultry, small ruminants, and cattle. The determinants of the likelihood of animal disease and nontherapeutic ABU were investigated using logistic regression.We found that nontherapeutic ABU was positively associated with animal disease, although the potential endogeneity of this relationship should be investigated further. We also found that going primarily to a public veterinarian for animal health services was associated with a lower likelihood of nontherapeutic ABU. We also found some evidence that going to public veterinarians, and a higher level of formal education, were associated with a lower likelihood of animal disease.These findings support the expansion of public veterinary services as a way to encourage antibiotic stewardship, and to safeguard against any animal health risks associated with ABU reduction.
Neisseria gonorrhoeaeMtrCDE Efflux Pump DuringIn VivoExperimental Genital Tract Infection in Men and Mice Reveals the Presence of Within-Host Colonization Bottleneck
Authors: Waltmann Andreea , Balthazar Jacqueline T. , Begum Afrin A. , Hua Nancy , Jerse Ann E. , Shafer William M. ,   UNC-Global Clinical Trials Unit/DMID 09-0106 Study Team, Hobbs Marcia M. , Duncan Joseph A. 
Published: June 2023

AbstractThe MtrCDE efflux pump ofNeisseria gonorrhoeaeexports a wide range of antimicrobial compounds that the gonococcus encounters at mucosal surfaces during colonization and infection. Here, we evaluate the role of this efflux pump system in strain FA1090 in human male urethral infection with a Controlled Human Infection Model. Using the strategy of competitive multi-strain infection with wild-type FA1090 and an isogenic mutant strain that does not contain a functional MtrCDE pump, we found that the presence of the efflux pump during human experimental infection did not confer a competitive advantage. This finding is in contrast to previous findings in female mice, which demonstrated that gonococci of strain FA19 lacking a functional MtrCDE pump had a significantly reduced fitness compared to the wild type strain in the lower genital tract of female mice. We conducted competitive infections in female mice with FA19 and FA1090 strains, including mutants that do not assemble a functional Mtr efflux pump, demonstrating the fitness advantage provided byt the MtrCDE efflux pump during infection of mice is strain dependent. Our data indicate that new gonorrhea treatment strategies targeting the MtrCDE efflux pump functions may not be universally efficacious in naturally occurring infections. Owing to the equal fitness of FA1090 strains in men, our experiments unexpectedly demonstrated the likely presence of an early colonization bottleneck ofN. gonorrhoeaein the human male urethra.TRIAL REGISTRATIONClinicaltrials.govNCT03840811.
Growing inequities by immigration group among older adults: Population-based analysis of access to primary care and return to in-person visits during the COVID-19 pandemic in British Columbia, Canada
Authors: Sierra-Heredia Cecilia , Tayyar Elmira , Bozorgi Yasmin , Thakore Padmini , Hagos Selamawit , Carrillo Ruth , Machado Stefanie , Peterson Sandra , Goldenberg Shira , Wiedmeyer Mei-ling , Lavergne Ruth 
Published: June 2023

AbstractBackgroundThe onset of the COVID-19 pandemic drove a rapid and widespread shift to virtual care, followed by a gradual return to in-person visits. Virtual visits may offer more convenient access to care for some, but others may experience challenges accessing care virtually, and some medical needs must be met in-person. Experiences of the shift to virtual care and benefits of in-person care may vary by immigration experience (immigration status and duration), official language level, and age. We examined use of virtual care and return to in-person visits in the Canadian province of British Columbia (BC), comparing patterns by age and across immigration groups, including length of time in Canada and language level (English) at time of arrival.MethodsWe used linked administrative health and immigration data to examine total primary care visits (virtual or in-person) and return to in-person visits during the COVID-19 pandemic (2019/20-2021/2) in BC. We examined the proportion of people with any primary care visits and with any in-person visit within each year as measures of access to primary care. We estimated the odds of any primary care visit and any in-person visit by immigration group and official language level assessed prior to arrival: non-immigrants, long-term immigrants, recent immigrants (<5 years) with high assessed English level and recent immigrants (<5 years) with low assessed English level, stratified by age.ResultsIn general, changes in access to primary care (odds of any visit and odds of any in-person visit) were similar across immigration groups over the study period. However, we observed substantial disparities in access to primary care by immigration group among people aged 60+, particularly in recent immigrants with low official language level (0.42, 0.40-0.45). These disparities grew wider over the course of the pandemic.ConclusionThough among younger adults changes in access to primary care between 2019-2021 were similar across immigration groups, we observed significant and growing inequities among older adults, with particularly limited access among adults who immigrated recently and with low assessed English level. Targeted interventions to ensure acceptable, accessible care for older immigrants are needed.
Use of antimicrobials during the COVID-19 pandemic: a qualitative study among stakeholders in Nepal
Authors: Dhungel Binod , Shrestha Upendra Thapa , Adhikari Sanjib , Adhikari Nabaraj , Bhattarai Alisha , Pokharel Sunil , Karkey Abhilasha , Limmathurotsakul Direk , Ghimire Prakash , Rijal Komal Raj , Cheah Phaik Yeong , Pell Christopher , Adhikari Bipin 
Published: June 2023

AbstractIntroductionThe COVID-19 pandemic was a major public health threat and posed tremendous pressure to develop a cure for it. Apart from ongoing efforts in developing vaccines, a lot of empirical treatments were recommended, that may have expedited the use of antimicrobials. The main objective of this study was to explore if and how the pandemic posed pressure on antimicrobials in Nepal using semi-structured interviews (SSIs) among patients, clinicians and drug dispensers.MethodsA total of 30 stakeholders (10 each among clinicians, dispensers and COVID-19 patients) were identified purposively and were approached for SSIs. Clinicians and dispensers working in three tertiary hospitals in Kathmandu were first approached and were asked for their support to reach out to COVID-19 patients who were on follow-up at their out-patient department. SSIs were audio recorded, translated and transcribed into English, and were analyzed for thematic synthesis.ResultsOver-the-counter (OTC) uses of antibiotics were widespread during the pandemic, and were mostly rooted to patients’ attempts to halt the potential severity due to respiratory like illnesses, and the fear of being identified as a COVID-19 patients. Being identified as a COVID-19 patient was feared because of the stigmatization and social isolation. Patients who visited the drug shops and physicians were reported to make demands on specific medicines including antibiotics that may have added pressure among physicians and dispensers. Clinicians reported a degree of uncertainty related to treatment and that may have added pressure to prescribe antimicrobials. All stakeholders, although mostly patients and dispensers with limited understanding of what constitutes antimicrobials and the mechanisms underpinning it reported that the pressure during the pandemic may have added to the adversities such as antimicrobials resistance.ConclusionsCOVID-19 added a pressure to prescribe, dispense and overuse antimicrobials and may have accentuated the pre-existing OTC use of antimicrobials. Future pandemics including infectious disease outbreaks are major public health incidents that warrant a special caution on inappropriate pressure on antimicrobials. Strict policies related to the use of antimicrobials are urgent to redress their use during normal and pandemic situations.
Clubfoot Twin Study with Wearable GaitUp Sensors and Footscan V9
Authors: Ursula Issler-Wüthrich , Christian Issler , Ulrich Exner G. , Peter Joller 
Published: June 2023

ABSTRACTPurposeTo control the therapeutic results in manual-dynamic physiotherapy for clubfeet we analyzed the gait pattern in children with clubfeet and their healthy twin siblings, aged between 3 and 13 years for GaitUp and 4 to 14 years for the footplate V9.MethodsWith the inertial GaitUp sensors and the footscan V9 pedobarographic plate the 11 twin-pairs were tested and statistically assessed. For the GaitUp sensors 22 parameters were considered and 10 parameters for the footplate V9. We analyzed the gait pattern for each child separately for both feet and in a second evaluation compared the affected feet with the ipsilateral feet of the healthy twins. The statistical comparisons were made with nonparametric methods. An additional twin girl treated with various therapies and her sister are included as a contrast.ResultsEspecially in younger children, the gait pattern is not stabilized yet. Therefore, sometimes the healthy twins have inferior values in gait patterns than the affected siblings. Over the whole study there are only minor statistical differences between the affected group and the healthy group suggesting that with the manual-dynamic therapy the clubfeet children show a gait pattern statistically similar to the healthy group. Noteworthy are the less convincing results of the contrast twin.ConclusionManual-dynamic physiotherapy can lead to a gait pattern equal to the one of unaffected children the same age. Our results do not support the statement that in one-sided clubfoot the other foot cannot be considered normal.IMPLICATIONS FOR REHABILITATIONClubfeet are a disabling birth defect affecting 1 to 3 babies per 1000 births.The manual-dynamic physiotherapy for clubfeet starting at birth leads to a normal gait pattern.
Factors Influencing Job Satisfaction among Healthcare Providers in a Specialty Department: a cross-sectional study
Authors: Haider Tanvir , Efa Syeda Sumaiya , Hossain Md. Emam , Ara Shampa Shamima Gulshan , Mahdee Syed Nafi , Reza Rafsan , Al Fidah Md. Fuad 
Published: June 2023

AbstractBackgroundJob satisfaction of professionals affects health, advancement, performance, and development, as well as the institution, employer, or organization. Healthcare professionals who are satisfied with their job have a higher probability of delivering excellent healthcare. In Bangladesh, the challenges of public health highlight the importance of having a competent healthcare workforce to provide an improved quality healthcare service.ObjectivesThe objective of this study was to evaluate the degree of job satisfaction and identify the factors that contribute to it among healthcare providers employed in the BMT unit of DMCH.MethodsThis cross-sectional study was conducted for the period of six months, from July to December 2014. The study population was all the healthcare professionals at the BMT unit of DMCH, Bangladesh. and consisted of doctors (n=20), nurses (n=15), and laboratory technicians (n=5). A semi structured self-administered questionnaire was used to collect the preliminary data. All ethical issues were maintained strictly.ResultsMost (95.0%) of the study respondents were at or below the age of 40 years with a mean (±SD) of 30.1 (±7.92) years. Most of them were female (52.5%), and lab technician, nurse and doctors had a frequency of 12.5%, 37.5%, and 50.0% respectively. Among the study participants, 65.0% were satisfied with their jobs, 35% were dissatisfied. Statistically significant association was found between sex (p=0.011) and profession (p < 0.001) with level of job satisfaction among respondents.ConclusionJob satisfaction is important for healthcare professionals, patients, and institutions. Satisfied professionals provide better care, while low job satisfaction leads to turnover and decreased access to care. Individual, job-related, and workplace factors influence job satisfaction. This study evaluated job satisfaction among healthcare providers in Bangladesh and identified contributing factors to inform interventions.
A novel longitudinal rank-sum test for multiple primary endpoints in clinical trials: Applications to neurodegenerative disorders
Authors: Xu Xiaoming , Ghosh Dhrubajyoti , Luo Sheng 
Published: June 2023

AbstractNeurodegenerative disorders such as Alzheimer’s disease (AD) present a significant global health challenge, characterized by cognitive decline, functional impairment, and other debilitating effects. Current AD clinical trials often assess multiple longitudinal primary endpoints to comprehensively evaluate treatment efficacy. Traditional methods, however, may fail to capture global treatment effects, require larger sample sizes due to multiplicity adjustments, and may not fully exploit multivariate longitudinal data. To address these limitations, we introduce the Longitudinal Rank Sum Test (LRST), a novel nonparametric rank-based omnibus test statistic. The LRST enables a comprehensive assessment of treatment efficacy across multiple endpoints and time points without multiplicity adjustments, effectively controlling Type I error while enhancing statistical power. It offers flexibility against various data distributions encountered in AD research and maximizes the utilization of longitudinal data. Extensive simulations and real-data applications demonstrate the LRST’s performance, underscoring its potential as a valuable tool in AD clinical trials. Nonparametrics, Global test, rank-sum-type test, U-Statistics.
Putting Bicarbonate on the spot. Implication for theratyping in Cystic Fibrosis
Authors: Zajac Miroslaw , Lepissier Agathe , Dréano Elise , Chevalier Benoit , Hatton Aurélie , Kelly Mairead , Guidone Daniela , Planelles Gabrielle , Edelman Aleksander , Girodon Emmanuelle , Hinzpeter Alexandre , Crambert Gilles , Pranke Iwona , Galietta Luis J.V. , Sermet-Gaudelus Isabelle 
Published: June 2023

AbstractCystic fibrosis (CF) is caused by defective Cystic Fibrosis Transmembrane Conductance Regulator (CFTR) protein. CFTR controls chloride (Cl-) and bicarbonate (HCO3-) transport into the Airway Surface Liquid (ASL).We investigated the impact of F508del-CFTR correction on HCO3-secretion by studying transepithelial HCO3-fluxes.HCO3-secretion was measured by pH-stat techniquein primary human respiratory epithelial cells from healthy subjects (WT) and people with CF (pwCF)carrying at least oneF508del variant.Its changes after CFTR modulation by the triple combination VX445/661/770 and in the context of TNF-α+IL-17 induced inflammation were related to ASL pH and transcriptionnal levels of CFTRand other HCO3-transporters ofairway epithelia such asSLC26A4 (Pendrin), SLC26A9 and NBCe1.CFTR-mediated HCO3-secretion was not detected in F508del primary human respiratory epithelial cells. It was rescued up to ∼ 80% of the WT levelby VX-445/661/770. In contrast,TNF-α+IL-17 normalized transepithelial HCO3-transportand ASL acidic pH. This was related to anincrease in SLC26A4 and CFTR transcript levels.VX-445/661/770 induced an increase in pH only in the context of inflammation.Effects on HCO3-transport werenot differentbetween F508del homozygous and F508del heterozygous CF airway epithelia.Our studies show that correction of F508del-CFTRHCO3-is not sufficient to buffer acidic ASL and that inflammation is a key regulator of HCO3-secretion in CF airways. Prediction of the response to CFTR modulators by theratyping should take into account airway inflammation.
Kidney Shape Statistical Analysis: Associations with Disease and Anthropometric Factors
Authors: Thanaj Marjola , Basty Nicolas , Cule Madeleine , Sorokin Elena P , Whitcher Brandon , Srinivasan Ramprakash , Lennon Rachel , Bell Jimmy D , Thomas E Louise 
Published: June 2023

AbstractBackgroundOrgan measurements derived from magnetic resonance imaging (MRI) have the potential to enhance our understanding of the precise phenotypic variations underlying many clinical conditions.MethodsWe applied morphometric methods to study the kidneys by constructing surface meshes from kidney segmentations from abdominal MRI data in 38,868 participants in the UK Biobank. Using mesh-based analysis techniques based on statistical parametric maps (SPMs), we were able to detect variations in specific regions of the kidney and associate those with anthropometric traits as well as disease states including chronic kidney disease (CKD), type-2 diabetes (T2D), and hypertension. Statistical shape analysis (SSA) based on principal component analysis was also used within the disease population and the principal component scores were used to assess the risk of disease events.ResultsWe show that CKD, T2D and hypertension were associated with kidney shape. Age was associated with kidney shape consistently across disease groups. Body mass index (BMI) and waist-to-hip ratio (WHR) were also associated with kidney shape for the participants with T2D. Using SSA, we were able to capture kidney shape variations, relative to size, angle, straightness, width, length, and thickness of the kidneys, within disease populations. We identified significant associations between both left and right kidney length and width and incidence of CKD (hazard ratio (HR): 0.74, 95% CI: 0.61-0.90, p<0.05, in the left kidney; HR: 0.76, 95% CI: 0.63-0.92, p<0.05, in the right kidney) and hypertension (HR: 1.16, 95% CI: 1.03-1.29, p<0.05, in the left kidney; HR: 0.87, 95% CI: 0.79-0.96, p<0.05, in the right kidney).ConclusionsThe results suggest that shape-based analysis of the kidneys can augment studies aiming at the better categorisation of pathologies associated with acute and chronic kidney conditions.
A NOVEL ELECTROCARDIOGRAPHIC PREDICTION MODEL FOR DIAGNOSING CONCEALED BRUGADA SYNDROME: RESULTS FROM A CLINICAL TRIAL OF AJMALINE PROVOCATION IN HEALTHY SUBJECTS
Authors: Ensam Bode , Scrocco Chiara , Johnson David , Wijeyeratne Yanushi D. , Bastiaenen Rachel , Gray Belinda , Miles Chris , Ben-Haim Yael , Papatheodorou Stathis , Sharma Sanjay , Papadakis Michael , Devine Brian , Macfarlane Peter W. , Behr Elijah R. 
Published: June 2023

BackgroundClinical, electrocardiographic, and genomic factors have been associated with the drug-induced type 1 Brugada pattern (DI-T1BP), in response to sodium channel blocker provocation (SCBP). However, prior analyses have been concerned with prediction of the DI-T1BP rather than the validity of the diagnosis of concealed Brugada syndrome (BrS). We sought to analyse and compare the ECG response to SCBP with ajmaline in a cohort of healthy controls (HC) and a definite BrS group (Def-BrS) to develop a diagnostic score.MethodsHealthy controls (HC) were systematically recruited as part of a clinical trial. Following comprehensive cardiovascular screening, eligible subjects underwent SCBP with ajmaline. We identified a Def-BrS cohort, defined as a DI-T1BP and a Shanghai Score (SS)>3.5, from consecutive patients with suspected BrS undergoing SCBP with ajmaline using the identical protocol. Def-BrS and HC were divided equally into discovery and validation cohorts. Digital ECG acquisition facilitated automated measurement of ECG parameters. A multivariable analysis compared ECG parameters between the HC and Def-BrS cohorts. A logistic regression analysis identified ECG characteristics that accurately predicted the diagnosis of Def-BrS. This model was then assessed in the validation cohort.ResultsTwo-hundred-and-forty-eight volunteers completed an online questionnaire, 103 accepted an invitation to undergo further screening and 100 were recruited into the HC group. Three HCs developed a DI-T1BP. From 1241 patients undergoing SCBP, 166 were Def-BrS. There were no demographic differences between the HC discovery and validation groups or between the Def-BrS discovery and validation groups. Following multivariable logistic regression analysis, QRS duration, mean anterior lead ST segment amplitude at baseline, maximum change in QRS duration, anterior ST segment amplitude and QRS area after SCBP, were independently associated with Def-BrS. The combined model was an excellent discriminator for Def-BrS, with an area under the curve of 0.95 [95% confidence interval (CI) = 0.912 – 0.989], P<0.001 in the discovery groups and 0.97 [95% CI = 0.948 – 0.998], P<0.001 in the validation groups.ConclusionThe yield of the DI-T1BP in HCs is 3%. However, there are distinct ECG parameters at baseline and in response to SCBP that favour a definite diagnosis of BrS. These observations permit the quantifiable refinement of the ECG diagnosis of concealed BrS, avoiding the pitfalls of relying upon the DI-T1BP alone.
Major bleeding increases the risk of subsequent cardiovascular events in patients with atrial fibrillation: Insights from the SAKURA AF registry and RAFFINE registry
Authors: Wada Hideki , Miyauchi Katsumi , Suwa Satoru , Miyazaki Sakiko , Hayashi Hidemori , Nishizaki Yuji , Yanagisawa Naotake , Yokoyama Katsuaki , Murata Nobuhiro , Saito Yuki , Nagashima Koichi , Matsumoto Naoya , Okumura Yasuo , Minamino Tohru , Daida Hiroyuki 
Published: June 2023

AbstractBackgroundBleeding events are one of the major concerns in patients using oral anticoagulants (OACs). We aimed to evaluate the association between major bleeding and long-term clinical outcomes in atrial fibrillation (AF) patients taking OACs.MethodsWe analyzed a database comprising two large-scale prospective registries of patients with documented AF: the RAFFINE and SAKURA registries. The primary outcome was major adverse cardiac and cerebrovascular events (MACCE), defined as the composite of all-cause death, ischemic stroke, and myocardial infarction. Major bleeding was defined in accordance with the criteria of the International Society on Thrombosis and Haemostasis. Cox multivariate analysis was used to determine the impact of major bleeding on the incidence of MACCE.ResultsThe median follow-up period was 39.7 months. Among 6,633 patients with AF who were taking OAC, 298 (4.5%) had major bleeding and 737 (11.1%) had MACCE. The incidence of MACCE was higher in patients with bleeding than in those without (18.33 and 3.22, respectively, per 100 patient-years; log-rank p <0.0001). Multivariate logistic regression analysis revealed older age, vitamin K antagonist use, and antiplatelet drug use as independent predictors of major bleeding. Multivariate Cox hazard regression analysis showed that the risk of MACCE was significantly higher in patients with major bleeding compared to those without (hazard risk, 4.64; 95% confidence interval, 3.62–5.94; p <0.0001).ConclusionsMajor bleeding was associated with long-term adverse cardiovascular events among AF patients taking OAC. Therefore, reducing the risk of bleeding is important for improving clinical outcomes in patients with AF.