bluuebunny/crossref_metadata_2025_split huggingface dataset:
Healthcare utilisation and costs associated with adherence to antipsychotics among people living with HIV/AIDS and schizophrenia: a population-based cohort study in British Columbia, Canada
Authors: Subedi Sony , Nanditha Ni Gusti Ayu , Tafessu Hiwot M , Nathani Hasan , St-Jean Martin , Elefante Julius , Patterson Thomas L , Honer William G , Montaner Julio S G , Lima Viviane D 
Published: April 2023

ObjectivesNon-adherence to antipsychotics is the greatest obstacle to treating schizophrenia. We assessed the economic and clinical impacts of adherence to antipsychotics among people living with HIV/AIDS (PLWH) and schizophrenia in British Columbia, Canada.Design and settingA population-based cohort study in British Columbia, Canada.MethodsEligible PLWH were enrolled in the Seek and Treat for Optimal Prevention HIV/AIDS population-based cohort during 2001–2016, diagnosed with schizophrenia, on antipsychotics for ≥1 day, and followed for ≥1 year from schizophrenia diagnosis date or 1 January 2001, whichever occurred last.Primary and secondary outcome measuresA two-part model assessed the marginal effect of adherence on healthcare costs (in 2016 Canadian dollar), while logistic regression examined the effect on virological failure, and generalised linear mixed models examined the effect on hospital readmissions within 30 days and length of hospital stay.ResultsAmong 726 PLWH with schizophrenia, ≥80% adherence to antipsychotics increased from 25% (50/198) in 2001 to 41% (225/554) in 2016. In most years, we observed no difference in adherence to antipsychotics among those who used only injectables, only non-injectables, and a combination of both, or among those who have ever consumed typical/first-generation antipsychotics and who consumed only atypical/second-generation antipsychotics. Overall healthcare costs were higher in the non-adherent group ($C2185), driven by the average annual hospitalisation costs ($C5517), particularly among women ($C8806) and people who ever injected drugs (PWID) ($C5985). Non-adherent individuals also experienced higher hospital readmissions (adjusted odds ratio (aOR) 1.48, 95% CI 1.23 to 1.77), and longer hospital stays (adjusted mean ratio 1.23, 95% CI 1.13 to 1.35) in comparison to adherent individuals. We found no difference in virological failure by adherence groups, except when we stratified by gender where the aOR for women was 2.48 (95% CI 1.06 to 5.82).ConclusionsOur results showed that implementing strategies and interventions to increase antipsychotic adherence, particularly among women and PWID, will be critical in addressing this public health challenge.
Prevalence and incidence of alcohol dependence: cross-sectional primary care analysis in Liverpool, UK
Authors: Montgomery Catharine , Schoetensack Christine , Saini Pooja , Owens Lynn , Van Ginneken Nadja , Rice Melissa , Young Ryan , Jones Andrew 
Published: April 2023

ObjectivesLiverpool has high prevalence of alcohol use disorders (AUDs) compared with the rest of the UK. Early identification and referral in primary care would improve treatment for people with AUD. This study aimed to identify changes in prevalence and incidence of AUD in primary care in Liverpool, to identify local need for specialist services.DesignCross-sectional retrospective analysis of electronic health records.SettingNational Health Service (NHS) Liverpool Clinical Commissioning Group (CCG) primary care. In total, 62 of the 86 general practitioner (GP) practices agreed to share their anonymised Egton Medical Information Systems (EMIS) data from 1 January 2017 to 31 December 2021.ParticipantsPatients aged over 18 years with a SNOMED code for alcohol dependence (AD) or hazardous drinking (N=4936). Patients were excluded if they had requested that their data was not to be shared, and practices were excluded if they opted out (N=2) or did not respond to the data sharing request (N=22).Primary and secondary outcomesPrevalence and incidence of AUD diagnoses in primary care over the 5-year period; demographic profile of patients (sex, age, ethnicity, occupation); GP postcode; alcohol-related medications; and psychiatric and physical comorbidities.ResultsThere were significant decreases in incidence of AD and hazardous drinking diagnoses over the 5 years (p<0.001 in all cases). Prevalence showed less change over time. Diagnoses were significantly higher in more deprived areas (Indices of Multiple Deprivation decile 1 vs 2–10). Overall pharmacotherapy prescriptions were lower than national estimates.ConclusionsThere are low levels of identification of AUDs in primary care in Liverpool, and this is decreasing year on year. There was weak evidence to suggest patients in the most deprived areas are less likely to receive pharmacotherapy once diagnosed. Future research should seek to investigate practitioner and patient perspectives on barriers and facilitators to management of AUDs in primary care.
Verbal autopsy analysis of maternal mortality in Bong County, Liberia: a retrospective mixed methods study
Authors: Lee Haeun , Perosky Joseph , Horton Madison , Reynolds Christopher , Nyanplu Aloysius , Lori Jody R 
Published: April 2023

BackgroundWhile the medical contributors to maternal mortality are well known, the contextual contributors are less known and understudied. Liberia has one of the highest maternal mortality rates in sub-Saharan Africa, with recent increases in maternal deaths in rural Bong County. The purpose of this study was to better classify the contextual factors leading up to maternal deaths and to develop a list of recommendations to prevent future similar deaths.MethodsA retrospective mixed method study was conducted examining 35 maternal deaths in Bong County, Liberia using verbal autopsy reports from 2019. An interdisciplinary death audit team reviewed and analysed the maternal deaths to determine the contextual causes of the maternal death.FindingsThis study identified three contextual causes: limited resources (materials, transportation, facility, staff), inadequate skills and knowledge (staff, community, family, patient), and ineffective communication (between providers, between health facilities and hospitals, and between provider and patient/family). Of these, inadequate patient education (54.28%), inadequate staff education and training (51.42%), ineffective communication between health facilities and hospitals (31.42%), and inadequate materials (28.57%) were most frequently mentioned.ConclusionMaternal mortality remains an issue in Bong County, Liberia, due to addressable contextual causes. Interventions to ameliorate these preventable deaths include ensuring availability of resources and transportation through improved supply chain and health system accountability. Recurring training should be provided to healthcare workers which involves husbands, families and communities. Innovative means for providers and facilities to communicate clearly and consistently should also be prioritised to prevent future maternal deaths in Bong County, Liberia.
Limited caffeine consumption as first-line treatment in managing primary monosymptomatic enuresis in children: how effective is it? A randomised clinical trial
Authors: Rezakhaniha Sadra , Rezakhaniha Bijan , Siroosbakht Soheila 
Published: April 2023

ObjectiveEvidence about the negative caffeine effect on enuresis in children remains understudied or poorly understood. The study aimed to investigate the effect of caffeine restriction on the improvement and severity of primary monosymptomatic nocturnal enuresis (PMNE).DesignRandomised clinical trial.SettingTwo referral hospitals in Tehran, Iran, from 2021 to 2023.PatientsFive hundred and thirty-four PMNE children aged 6–15 years (each group 267).InterventionsAmount of caffeine consumption was recorded by the feed frequency questionnaire and was estimated by Nutrition 4 software. Caffeine consumption per day in the intervention group was <30 mg, and in the control group, 80–110 mg. All children were asked to return 1 month later to check the recorded data. The ordinal logistic regression analysis was used to assay the effects of caffeine restriction on PMNE by relative risk (RR) at a 95% CI.Main outcome measuresThe effect of limited caffeine consumption on the improvement and severity of PMNE.ResultsThe mean age of the intervention and control groups was 10.9±2.3 and 10.5±2.5 years, respectively. The mean number of bed-wetting before caffeine restriction in the intervention and control group was 3.5 (SD 1.7) times/week and 3.4 (SD 1.9) times/week (p=0.91) and 1 month after intervention were 2.3 (SD 1.8) times/week and 3.2 (SD 1.9) times/week, respectively (p=0.001). Caffeine restriction significantly reduced the severity of enuresis in the intervention group. Fifty-four children (20.2%) improved (dry at night) in caffeine restriction and 18 children (6.7%) in the control group with RR 0.615 at 95% CI 0.521 to 0.726, p=0.001. The caffeine restriction significantly reduced the enuresis in children with a number-needed-to-treat benefit 7.417. It means you must treat 7.417 PMNE children with caffeine limitation to improve one child with enuresis (become dry).ConclusionCaffeine restriction can be helpful in reducing PMNE or its severity. Constructive limitation of caffeine is suggested as one of the first-line treatments in the management of PMNE.Trial registration numberIRCT20180401039167N3.
Granulocyte activation markers in cerebrospinal fluid differentiate acute neuromyelitis spectrum disorder from multiple sclerosis
Authors: Leppert David , Watanabe Mitsuru , Schaedelin Sabine , Piehl Fredrik , Furlan Roberto , Gastaldi Matteo , Lambert Jeremy , Evertsson Björn , Fink Katharina , Matsushita Takuya , Masaki Katsuhisa , Isobe Noriko , Kira Jun-ichi , Benkert Pascal , Maceski Aleksandra , Willemse Eline , Oechtering Johanna , Orleth Annette , Meier Stephanie , Kuhle Jens 
Published: April 2023

BackgroundGranulocyte invasion into the brain is a pathoanatomical feature differentiating neuromyelitis optica spectrum disorder (NMOSD) from multiple sclerosis (MS). We aimed to determine whether granulocyte activation markers (GAM) in cerebrospinal fluid (CSF) can be used as a biomarker to distinguish NMOSD from MS, and whether levels associate with neurological impairment.MethodsWe quantified CSF levels of five GAM (neutrophil elastase, myeloperoxidase, neutrophil gelatinase-associated lipocalin, matrixmetalloproteinase-8, tissue inhibitor of metalloproteinase-1), as well as a set of inflammatory and tissue-destruction markers, known to be upregulated in NMOSD and MS (neurofilament light chain, glial fibrillary acidic protein, S100B, matrix metalloproteinase-9, intercellular adhesion molecule-1, vascular cellular adhesion molecule-1), in two cohorts of patients with mixed NMOSD and relapsing-remitting multiple sclerosis (RRMS).ResultsIn acute NMOSD, GAM and adhesion molecules, but not the other markers, were higher than in RRMS and correlated with actual clinical disability scores. Peak GAM levels occurred at the onset of NMOSD attacks, while they were stably low in MS, allowing to differentiate the two diseases for ≤21 days from onset of clinical exacerbation. Composites of GAM provided area under the curve values of 0.90–0.98 (specificity of 0.76–1.0, sensitivity of 0.87–1.0) to differentiate NMOSD from MS, including all anti-aquaporin-4 protein (aAQP4)-antibody-negative patients who were untreated.ConclusionsGAM composites represent a novel biomarker to reliably differentiate NMOSD from MS, including in aAQP4−NMOSD. The association of GAM with the degree of concurrent neurological impairment provides evidence for their pathogenic role, in turn suggesting them as potential drug targets in acute NMOSD.
Dexmedetomidine and clonidine in palliative medicine: multicentric qualitative evaluation
Authors: Prod'homme Chloé , Werbrouck Xavier , Pierrat Magali , Chevalier Luc , Lesaffre Helene , Pasqualini Claire , Touzet Licia 
Published: April 2023

ObjectivesAlpha-2 agonists have analgesic and sedative properties that can prove interesting in palliative care. The main objective of this study was to describe the use of clonidine and dexmedetomidine in palliative care units (PCU). The secondary objective was to identify physicians’ perspectives and attitudes toward alpha-2-agonists.MethodsInternational multicentric qualitative survey of prescribing characteristics and attitudes towards alpha-2 agonist. All 159 PCUs in France, Belgium and French-speaking Switzerland were contacted, and 142 physicians answered the questionnaire (31% participation).Results20% of the practitioners surveyed prescribe these molecules are mainly for analgesic and sedative indications. There was considerable heterogeneity in the modalities and dosages of administration. The use of clonidine is more frequent and common in Belgium, while dexmedetomidine is only used in France. There is a high level of satisfaction among practitioners who use these molecules, with the desire of the majority of respondents to obtain additional studies and information on alpha-2-agonists.ConclusionAlpha-2 agonists are little known and little prescribed by French-speaking palliative care physicians but are of interest because of their potential in this field. Phase 3 studies could justify the use of these molecules in palliative situations and would contribute to harmonising professional practices.
Group 2 innate lymphoid cells resolve neuroinflammation following cerebral ischaemia
Authors: Zheng Pei , Xiu Yuwhen , Chen Zhili , Yuan Meng , Li Yan , Wang Ningning , Zhang Bohao , Zhao Xin , Li Minshu , Liu Qiang , Shi Fu-Dong , Jin Wei-Na 
Published: April 2023

BackgroundAcute brain ischaemia elicits pronounced inflammation, which aggravates neural injury. However, the mechanisms governing the resolution of acute neuroinflammation remain poorly understood. In contrast to regulatory T and B cells, group 2 innate lymphoid cells (ILC2s) are immunoregulatory cells that can be swiftly mobilised without antigen presentation; whether and how these ILC2s participate in central nervous system inflammation following brain ischaemia is still unknown.MethodsLeveraging brain tissues from patients who had an ischaemic stroke and a mouse model of focal ischaemia, we characterised the presence and cytokine release of brain-infiltrating ILC2s. The impact of ILC2s on neural injury was evaluated through antibody depletion and ILC2 adoptive transfer experiments. Using Rag2−/−γc−/−mice receiving passive transfer of IL-4−/−ILC2s, we further assessed the contribution of interleukin (IL)-4, produced by ILC2s, in ischaemic brain injury.ResultsWe demonstrate that ILC2s accumulate in the areas surrounding the infarct in brain tissues of patients with cerebral ischaemia, as well as in mice subjected to focal cerebral ischaemia. Oligodendrocytes were a major source of IL-33, which contributed to ILC2s mobilisation. Adoptive transfer and expansion of ILC2s reduced brain infarction. Importantly, brain-infiltrating ILC2s reduced the magnitude of stroke injury severity through the production of IL-4.ConclusionsOur findings revealed that brain ischaemia mobilises ILC2s to curb neuroinflammation and brain injury, expanding the current understanding of inflammatory networks following stroke.
SomaticGJA4mutation in intracranial extra-axial cavernous hemangiomas
Authors: Huo Ran , Yang Yingxi , Xu Hongyuan , Zhao Shaozhi , Song Dong , Weng Jiancong , Ma Ruochen , Sun Yingfan , Wang Jie , Jiao Yuming , Zhang Junze , He Qiheng , Wu Ruolei , Wang Shuo , Zhao Ji-Zong , Zhang Junting , Wang Jiguang , Cao Yong 
Published: April 2023

ObjectiveExtra-axial cavernous hemangiomas (ECHs) are sporadic and rare intracranial occupational lesions that usually occur within the cavernous sinus. The aetiology of ECHs remains unknown.MethodsWhole-exome sequencing was performed on ECH lesions from 12 patients (discovery cohort) and droplet digital polymerase-chain-reaction (ddPCR) was used to confirm the identified mutation in 46 additional cases (validation cohort). Laser capture microdissection (LCM) was carried out to capture and characterise subgroups of tissue cells. Mechanistic and functional investigations were carried out in human umbilical vein endothelial cells and a newly established mouse model.ResultsWe detected somaticGJA4mutation (c.121G>T, p.G41C) in 5/12 patients with ECH in the discovery cohort and confirmed the finding in the validation cohort (16/46). LCM followed by ddPCR revealed that the mutation was enriched in lesional endothelium. In vitro experiments in endothelial cells demonstrated that theGJA4mutation activated SGK-1 signalling that in turn upregulated key genes involved in cell hyperproliferation and the loss of arterial specification. Compared with wild-type littermates, mice overexpressing theGJA4mutation developed ECH-like pathological morphological characteristics (dilated venous lumen and elevated vascular density) in the retinal superficial vascular plexus at the postnatal 3 weeks, which were reversed by an SGK1 inhibitor, EMD638683.ConclusionsWe identified a somaticGJA4mutation that presents in over one-third of ECH lesions and proposed that ECHs are vascular malformations due toGJA4-induced activation of the SGK1 signalling pathway in brain endothelial cells.
Effect of Olive Pomace Fiber on the Baking Properties of Wheat Flour and Flat Bread (Barbari Bread) Quality
Authors: Azadfar Elham , Elhami Rad Amir Hossein , Sharifi Akram , Armin Mohammad 
Published: April 2023

The current study is aimed at fortifying Barbari bread with different levels (

T

Co

: 0,

T

5
%

: 5%,

T

10
%

: 10%, and

T

15
%

: 15) of olive pomace dietary fiber (ODF) and investigating the quality properties of enriched bread. The fiber of the defatted olive pomace powder was extracted by an enzymatic process as a green extraction method (α-amylase, protease, amyloglucosidase, and cellulase; incubation time: 4.5 h, 40°C). The effect of ODF addition on the thermal (based on differential scanning calorimetry (DSC)), rheological, physical, textural, and sensory properties of samples was investigated. The DSC curves of samples were a broad endothermic transition peak (

T

onset

~
43

°C and

T

peak

=
123.58
−
125.74

°C). By increasing the ODF level, the water absorption rate of the dough increased while softening degree reduced. There was a negative significant correlation between baking loss and crumb moisture (

R
>
−
0.94

) and aw (

R
=
−
0.769

). By increasing ODF, sample porosity and specific volume decreased. There was a significant difference between hardness and springiness of

T

15
%

and

T

Co

. Replacement of wheat flour with 10% ODF had no significant effect on the sensory parameters of Barbari bread.
Hydrogeochemical Characterization and Appraisal of Groundwater Quality in Yisr River Catchment, Blue Nile River Basin, Ethiopia, by Using the GIS, WQI, and Statistical Techniques
Authors: Demelash Abebaw , Atlabachew Abunu , Jothimani Muralitharan , Abebe Abel 
Published: April 2023

Groundwater is a primary drinking, agricultural, domestic, and nondomestic water source in Ethiopia’s Yisr River watershed of the Blue Nile River basin. There has been no systematic investigation of the hydrogeochemical properties of groundwater in the research area. The study investigated the hydrogeochemical parameters of groundwater in the catchment to find out if it is fit for drinking and irrigation. A total of 26 samples of groundwater were collected and analyzed for seventeen parameters, including pH, temperature, EC, TDS, TH, K+, Na+, Ca2+, Mg2+, Fe2+, Cl−,

HCO

3

−

,

CO

3

2
−

,

SO

4

2
−

, F−,

PO

4

2
−

, and

NO

3

−

. The data were processed and evaluated using integrated hydrogeochemical techniques, including individual ionic signatures, interionic ratios, and multivariate statistical methods, such as multiple correlation analysis, principal component analysis, and hierarchical cluster analysis. The water quality index (WQI) and Na%, PI, RSC, SAR, EC, TDS, and MH were used to judge the quality of water for drinking and irrigation, respectively. The box plot diagram shows the dominant ions in descending order of Ca2+ > Mg2+ > Na+ > K+ and

HCO

3

2
−

> Cl- >

SO

4

2
−

>

NO

3

−

> F− for cations and anions, respectively. The chemical composition of shallow wells and springs indicates freshwater. At the same time, the deep groundwater wells are brackish. The two-factor loadings (principal component analysis) were used to explain the existence of anthropogenic and geogenic sources. Three clusters are identified in the dendrogram. The third cluster has the most significant linkage distance among all the clusters. This means that the groundwater sample in this cluster is geochemically different from the other two clusters, and that this cluster is made up of only deep wells. Water quality indices showed that water quality ranged from excellent to very poor, with the majority (53.85%) being excellent and 26.9% being good. The results of the calculated indices for agricultural water quality indicated that the water quality in most collected samples was in the good and excellent categories; however, the EC, RSC, MH, and TDS indices in deep groundwater wells were found to be hazardous. The findings of this study are useful for understanding groundwater sustainability for various reasons. However, they are also helpful in supporting water management and protection in the future.
Los desafíos de la dirección educativa en el fomento de habilidades científicas
Authors: Hernández-Gil Cristian , Cardozo-Jiménez Carol Jennifer , Perdomo-Rojas Laddy Tatiana 
Published: April 2023

(analítico)El objetivo de esta investigación es entender la incidencia del papel de los directivos docentes en el fomento de la investigación científica en los niños, niñas y adolescentes de las instituciones educativas públicas de una región colombiana. Se realizó un estudio no experimental transversal y descriptivo, con 73 rectores de planteles urbanos y rurales, usando como estrategia de análisis el enfoque cualitativo con una orientación hacia la sistematización del fenómeno, primero desde la experiencia administrativa y, segundo, desde las capacidades para promover una educación científica. Los resultados consideran tres retos de la gestión del administrador de la educación: las relaciones con los integrantes de la comunidad educativa, la capacidad para gestionar los recursos y la articulación entre los fines pedagógicos institucionales y la gestión humana con los docentes.
Palabras clave: Educación básica; gestión escolar; habilidad investigativa; investigación científica; niñez.