bluuebunny/crossref_metadata_2025_split huggingface dataset:
Internet-facilitated interventions for informal caregivers of patients with neurodegenerative disorders: Systematic review and meta-analysis
Authors: Boyt Neil , Ho Aileen K , Morris-Bankole Hannah , Sin Jacqueline 
Published: October 2022

Objective This systematic review explored the effectiveness of internet-delivered interventions in improving psychological outcomes of informal caregivers for neurodegenerative-disorder (ND) patients. Methods We searched seven databases for English-language papers published from 1999 to May 2021. Study-eligibility required that interventions used a minimum 50% internet-facilitation, targeting unpaid, adult informal caregivers of community-based ND-patients. We included randomised controlled trials (RCTs) and pre-post evaluative studies reporting outcomes for at least one-time point post-intervention. Independent quality checks on abstract and full-text screening were completed. Data extraction encompassed interventions’ features, approaches, theoretical bases and delivery-modes. The Integrated quality Criteria for the Review Of Multiple Study designs (ICROMS) framework assessed risk of bias. Alongside narrative synthesis, we calculated meta-analyses on post-intervention using outcome measures from at least two RCTs to assess effectiveness. Results Searches yielded 51 eligible studies with 3180 participants. In 48 studies, caregivers supported a dementia-diagnosed individual. Intervention-durations encompassed four weeks to 12 months, with usage-frequency either prescribed or participant-determined. The most frequently-used approach was education, followed by social support. We calculated meta-analyses using data from 16 RCTs. Internet-delivered interventions were superior in improving mastery (g  =  1.17 [95% CI; 0.1 to 2.24], p  =  0.03) and reducing anxiety (g = -1.29 [95% CI; −1.56 to −1.01], p < 0.01), compared to all controls. Findings were equivocal for caregivers’ quality of life, burden and other outcomes. High heterogeneity reflected the multifarious combinations of approaches and delivery-modes, precluding assessment of the most efficacious intervention features. Analyses using burden and self-efficacy outcomes’ follow-up data were also non-significant compared to all comparator-types. Although 32 studies met the ICROMS threshold scores, we rated most studies’ evidence quality as ‘very-low’. Conclusions This review demonstrated some evidence for the efficacy of internet-delivered interventions targeting informal ND-caregivers. However, more rigorous studies, with longer follow-ups across outcomes and involving NDs other than dementia, are imperative to enhance the knowledge-base.
Readability and Quality of Online Health Information Regarding Parathyroidectomy
Authors: Byrne Jim , Keogh Samuel , Cullinane Carolyn , Razzaq Zeeshan , Redmond Henry Paul 
Published: October 2022

ObjectiveAssessment of the readability and quality of online health information regarding parathyroidectomy.Study DesignCross‐sectional analysis.SettingWebsites providing patient‐oriented health information regarding parathyroidectomy obtained via the Google search engine.MethodsThe top 75 Google search results for “parathyroidectomy,”“parathyroid surgery,” and “parathyroid gland removal” were reviewed. Websites were categorized by website type and country of origin. Readability was assessed by Flesch‐Kincaid Grade Level and Simple Measure of Gobbledygook. Website quality was assessed per JAMA benchmark criteria and the DISCERN instrument.ResultsA total of 74 unique websites were evaluated. The mean readability of the assessed websites exceeded the recommended sixth‐grade reading level on the Flesch‐Kincaid Grade Level and Simple Measure of Gobbledygook (P <. 001). Readability did not vary significantly by website type. Websites originating from the United Kingdom were significantly more readable than those from the United States. The majority of assessed websites were of poor quality (n = 42, 56.8%) on assessment based on the DISCERN instrument. Quality varied significantly by website category on the JAMA benchmark criteria (P <. 001) and DISCERN score (P =. 049) with commercial websites receiving the highest scores. DISCERN score also varied significantly by country of origin (P =. 036) with UK sites receiving highest mean DISCERN scores.ConclusionOnline health information regarding parathyroidectomy is largely of poor quality and is poorly readable for many patients. Institutions utilizing well‐defined guidelines for development of patient educational resources may provide online health information of greater quality and readability.
An innovative approach based on real-world big data mining for calculating the sample size of the reference interval established using transformed parametric and non-parametric methods
Authors: Ma Chaochao , Hou Li’an , Zou Yutong , Ma Xiaoli , Wang Danchen , Hu Yingying , Song Ailing , Cheng Xinqi , Qiu Ling 
Published: October 2022

Abstract
Background
Currently, the direct method is the main approach for establishment of reference interval (RI). However, only a handful of studies have described the effects of sample size on establishment of RI and estimation of sample size. We describe a novel approach for estimation of the sample size when establishing RIs using the transformed parametric and non-parametric methods.

Methods
A total of 3,697 healthy participants were enrolled in this study. We adopted a two-layer nested loop sample size estimation method to determine the effects of sample size on RI, using thyroid-related hormone as an example. The sample size was selected as the calculation result when the width of the confidence interval (CI) of the upper and lower limit of the RI were both stably < 0.2 times the width of RI. Then, we calculated the sample size for establishing RIs via transformed parametric and non-parametric methods for thyroid-related hormones.

Results
Sample sizes for thyroid stimulating hormone (TSH), as required by parametric and non-parametric methods to establish RIs were 239 and 850, respectively. Sample sizes required by the transformed parametric method for free triiodothyronine (FT3), free thyroxine (FT4), total triiodothyronine (TT3) and total thyroxine (TT4) were all less than 120, while those required by the non-parametric method were more than 120.

Conclusion
We describe a novel approach for estimating sample sizes for establishment of RI. A corresponding open-source code has been developed and is available for applications. The established method is suitable for most analytes, with evidence based on thyroid-related hormones indicating that different sample sizes are required to establish RIs using different methods for analytes with different variations.
Patient experience with non-invasive prenatal testing (NIPT) as a primary screen for aneuploidy in the Netherlands
Authors: Kristalijn Syanni A. , White Karen , Eerbeek Deanna , Kostenko Emilia , Grati Francesca Romana , Bilardo Caterina M. 
Published: October 2022

Abstract
Background
Non-invasive prenatal testing (NIPT) as a screening method for trisomy 21 and other chromosomal abnormalities has been adopted widely across the globe. However, while many clinical validation studies have been performed, less is known regarding the patient experience with NIPT. This study explored how individuals experience NIPT in a pre- and post-test setting, where NIPT is broadly available as a primary screening method with the option of reporting beyond common trisomies.

Methods
Participants were recruited using social media with a strategy designed to select individuals who had the option to have NIPT as part of the TRIDENT-2 study (In the Netherlands, NIPT is only available within the TRIDENT studies executed by the NIPT consortium. This research was done independently from the NIPT consortium.) in the Netherlands. The study used online questionnaires and semi-structured interviews. Both were developed around a patient experience framework consisting of seven themes: information, patient as active participant, responsiveness of services, lived experience, continuity of care and relationships, communication, and support.

Results
Overall, 4539 questionnaire responses were analyzed and 60% of the respondents had experienced NIPT. Of those, 1.7% received a high-risk result for trisomy or another chromosomal copy number variant (referred to as an “additional finding”). Overall, participants felt they had received sufficient information and had control over their decision regarding whether or not to choose NIPT. The vast majority of respondents who had NIPT were positive about their experience and would use it again. Those with results showing an increased probability for trisomy or additional findings were more likely to report negative feelings such as tension and anxiety, and less likely to feel that they had been sufficiently prepared for the implications of their results.

Conclusions
The patient experience with first-tier NIPT in the Netherlands was largely positive. Areas for improvement included counseling on the implications of screening and the different possible outcomes of NIPT, including additional findings that may be uncovered by expanding NIPT beyond the common trisomies. The experiences reported in this study may be useful for other countries intending to implement NIPT.
Mortality from diseases of the circulatory system in Brazil and its relationship with social determinants focusing on vulnerability: an ecological study
Authors: Bastos Luiz A. V. M. , Bichara Jose L. P. , Nascimento Gabriela S. , Villela Paolo B. , de Oliveira Glaucia M. M. 
Published: October 2022

Abstract
Background
Deaths from diseases of the circulatory system and ischemic heart diseases are declining, but slowly in developing countries, emphasizing its probable relationship with determinants of social vulnerability.

Objectives
To analyze the temporal progression of mortality rates of diseases of the circulatory system and ischemic heart diseases from 1980 to 2019 and the association of the rates with the Municipal Human Development Index and Social Vulnerability Index in Brazil.

Methods
We estimated the crude and standardized mortality rates of diseases of the circulatory system and ischemic heart diseases and analyzed the relationship between the obtained data and the Municipal Human Development Index and Social Vulnerability Index. Data on deaths and population were obtained from the DATASUS. The Municipal Human Development Index and the Social Vulnerability Index of each federative unit were extracted from the websites Atlas Brazil and Atlas of Social Vulnerability, respectively.

Results
The age-standardized mortality rates of diseases of the circulatory system and ischemic heart diseases showed a downward trend nationwide, which was unequal across the federative units. There was an inversely proportional relationship between the standardized mortality rates of diseases of the circulatory system and ischemic heart diseases and the Municipal Human Development Index. The downward mortality trend was observed when the indices were greater than 0.70 and 0.75, respectively. The Social Vulnerability Index was directly proportional to the standardized mortality rates of diseases of the circulatory system and ischemic heart diseases. An upward mortality trend was observed with a Social Vulnerability Index greater than 0.35.

Conclusions
Social determinants represented by the Municipal Human Development Index and the Social Vulnerability Index were related to mortality from diseases of the circulatory system and ischemic heart diseases across the Brazilian federative units. The units with most development and least social inequalities had the lowest mortality from these causes. The most vulnerable die the most.
Innovative approach to monitor performance of integrated disease surveillance and response after the Ebola outbreak in Sierra Leone: lessons from the field
Authors: Njuguna Charles , Vandi Mohamed , Squire James Sylvester , Kanu Joseph Sam , Gachari Wilson , Liyosi Evans , Githuku Jane , Chimbaru Alexander , Njeru Ian , Caulker Victor , Mugagga Malimbo , Sesay Stephen , Yahaya Ali Ahmed , Talisuna Ambrose , Yoti Zabulon , Fall Ibrahima Socé 
Published: October 2022

Abstract
Background
Supervision of healthcare workers improves performance if done in a supportive and objective manner. Regular supervision is a support function of Integrated Disease Surveillance and Response (IDSR) strategy and allows systematic monitoring of IDSR implementation. Starting 2015, WHO and other development partners supported the Ministry of Health and Sanitation (MoHS) to revitalize IDSR in Sierra Leone and to monitor progress through supportive supervision assessments. We report on the findings of these assessments.

Methods
This was a cross-sectional study where six longitudinal assessments were conducted in randomly selected health facilities. Health facilities assessed were 71 in February 2016, 99 in July 2016, 101 in May 2017, 126 in August 2018, 139 in February 2019 and 156 in August 2021. An electronic checklist based on selected core functions of IDSR was developed and uploaded onto tablets using the Open Data Kit (ODK) platform. Supervision teams interviewed health care workers, reviewed documents and made observations in health facilities. Supervision books were used to record feedback and corrective actions. Data from the supervisory visits was downloaded from ODK platform, cleaned and analysed. Categorical data was summarized using frequencies and proportions while means and medians were used for continuous variables. Z test was used to test for differences in proportions.

Results
Completeness of IDSR reporting improved from 84.5% in 2016 to 96% in 2021 (11.5% points; 95% CI 3.6, 21.9; P-value 0.003). Timeliness of IDSR reports improved from 80.3 to 92% (11.7% points; 95% CI 2.4, 22.9; P-value 0.01). There was significant improvement in health worker knowledge of IDSR concepts and tools, in availability of IDSR standard case definition posters and reporting tools and in data analysis practices. Availability of vaccines and temperature monitoring tools in health facilities also improved significantly but some indicators dropped such as availability of IDSR technical guidelines and malaria testing kits and drugs.

Conclusion
Supervision using electronic tool contributed to health systems strengthening through longitudinal tracking of core IDSR indicators and other program indicators such as essential malaria commodities and availability and status of routine vaccines. Supervision using electronic tools should be extended to other programs.
Global burden and trends of rotavirus infection-associated deaths from 1990 to 2019: an observational trend study
Authors: Du Yuxia , Chen Can , Zhang Xiaobao , Yan Danying , Jiang Daixi , Liu Xiaoxiao , Yang Mengya , Ding Cheng , Lan Lei , Hecht Robert , Zhu Changtai , Yang Shigui 
Published: October 2022

Abstract
Background
Rotavirus is the leading global pathogen of diarrhea-associated mortality and poses a great threat to public health in all age groups. This study aimed to explore the global burden and 30-year change patterns of rotavirus infection-associated deaths.

Methods
Based on the Global Burden of Disease 2019 Study (GBD 2019), we analyzed the age-standardized death rate (ASDR) of rotavirus infection by sex, geographical region, and sociodemographic index (SDI) from 1990 to 2019. A Joinpoint regression model was used to analyze the global trends in rotavirus infection over the 30 years, SaTScan software was used to detect the spatial and temporal aggregations, and a generalized linear model to explore the relationship between sociodemographic factors and death rates of rotavirus infection.

Results
Globally, rotavirus infection was the leading cause of diarrheal deaths, accounting for 19.11% of deaths from diarrhea in 2019. Rotavirus caused a higher death burden in African, Oceanian, and South Asian countries in the past three decades. The ASDR of rotavirus declined from 11.39 (95% uncertainty interval [95% UI] 5.46–19.48) per 100,000 people in 1990 to 3.41 (95% UI 1.60–6.01) per 100,000 people in 2019, with an average annual percentage change (AAPC) (− 4.07%, P < 0.05). However, a significant uptrend was found in high-income North America (AAPC = 1.79%, P < 0.05). The death rate was the highest among children under 5 years worldwide. However, the death rates of elderly individuals over 70 years were higher than those of children under 5 years in 2019 among high, high-middle, middle, and low-middle SDI regions. Current health expenditure, gross domestic product per capita, and the number of physicians per 1000 people were significantly negatively correlated with death rates of rotavirus.

Conclusions
Although the global trends in the rotavirus burden have decreased substantially over the past three decades, the burden of rotavirus remained high in Africa, Oceania, and South Asia. Children under 5 years and elderly individuals over 70 years were the populations most at risk for rotavirus infection-associated deaths, especially elderly individuals over 70 years in relatively high SDI regions. More attention should be paid to these areas and populations, and effective public health policies should be implemented in the future.
Simultaneous femoral head reduction osteotomy (FHRO) combined with periacetabular osteotomy (PAO) for the treatment of severe femoral head asphericity in Perthes disease
Authors: Gharanizadeh Kaveh , Ravanbod Hadi , Aminian Amir , Mirghaderi Seyed Peyman 
Published: October 2022

Abstract
Background
The purpose of this study is to describe the midterm clinical and radiologic outcomes of concurrent femoral head reduction osteotomy (FHRO) and periacetabular osteotomy (PAO) in Legg–Calvé–Perthes disease (LCPD) patients with major aspherical femoral head deformities.

Methods
The study included four Perthes patients in Stage IV of Waldenstrom’s classification with a mean age of 10.5 and severe femoral head asphericity. They were treated with a combination of FHRO + PAO and followed for at least 2 years. An evaluation of the radiological outcome of the surgery was carried out based on the lateral center to edge angle (LCEA), the anterior center to edge angle (ACEA), the Tönnis angle, the head sphericity index, the Stulberg classification, the extrusion index, and Shenton’s line integrity. An evaluation of the clinical outcome was made by evaluating hip range of motion (ROM), Harris hip score (HHS), and Merle d’Aubigne´-Postel score.

Results
All radiographic measures improved; three patients were classified as Stulberg class II and one as class III. The LCEA, ACEA, and Tönnis angle improved by 29° (from 3° to 32°), 16° (from 14° to 30°), and − 10° (from 18° to 8°), respectively. The mean femoral head sphericity index and extrusion index improved by 12% (from 83 to 95%) and − 33% (from 40 to 7%). No disruption was observed in the postoperative Shenton’s line. According to HHS, all patients have shown excellent hip function, which improved by 27 points (from 69 to 96). Moreover, the hip ROM was increased from 222° to 267°. The follow-up period did not reveal any serious postoperative complications, such as osteonecrosis or conversion to arthroplasty.

Conclusions
Combined FHRO with PAO may improve the hip joint’s morphology and function in patients with residual femoral head deformity and acetabular dysplasia due to LCPD. Despite being considered a complex and demanding hip surgery, these results suggest a more widespread implication of the salvage procedure.
Using genetically encoded fluorescent biosensors to interrogate ovarian cancer metabolism
Authors: Bose Shree , Yao Haipei , Huang Qiang , Whitaker Regina , Kontos Christopher D. , Previs Rebecca A. , Shen Xiling 
Published: October 2022

Abstract
Background
Epithelial ovarian cancer (OC) is the most lethal gynecological malignancy and patients present with significant metastatic burden, particularly to the adipose-rich microenvironment of the omentum. Recent evidence has highlighted the importance of metabolic adaptations in enabling this metastasis, leading to significant interest in evolving the arsenal of tools used to study OC metabolism. In this study, we demonstrate the capability of genetically encoded fluorescent biosensors to study OC, with a focus on 3D organoid models that better recapitulate in vivo tumor microenvironments.

Materials and methods
Plasmids encoding the metabolic biosensors HyPer, iNap, Peredox, and Perceval were transfected into 15 ovarian cancer cell lines to assay oxidative stress, NADPH/NADP+, NADH/NAD+, and ATP/ADP, respectively. Fluorescence readings were used to assay dynamic metabolic responses to omental conditioned media (OCM) and 100 μM carboplatin treatment. SKOV3 cells expressing HyPer were imaged as 2D monolayers, 3D organoids, and as in vivo metastases via an intravital omental window. We further established organoids from ascites collected from Stage III/IV OC patients with carboplatin-resistant or carboplatin-sensitive tumors (n = 8 total). These patient-derived organoids (PDOs) were engineered to express HyPer, and metabolic readings of oxidative stress were performed during treatment with 100 μM carboplatin.

Results
Exposure to OCM or carboplatin induced heterogenous metabolic changes in 15 OC cell lines, as measured using metabolic sensors. Oxidative stress of in vivo omental metastases, measured via intravital imaging of metastasizing SKOV3-HyPer cells, was more closely recapitulated by SKOV3-HyPer organoids than by 2D monolayers. Finally, carboplatin treatment of HyPer-expressing PDOs induced higher oxidative stress in organoids derived from carboplatin-resistant patients than from those derived from carboplatin-sensitive patients.

Conclusions
Our study showed that biosensors provide a useful method of studying dynamic metabolic changes in preclinical models of OC, including 3D organoids and intravital imaging. As 3D models of OC continue to evolve, the repertoire of biosensors will likely serve as valuable tools to probe the metabolic changes of clinical importance in OC.
Male partners involvement in human immune deficiency virus testing and counseling during prenatal care visits in Bichena town Westcentral Ethiopia: a cross-sectional study
Authors: Gessesse Nigusu Ayalew , Gela Getahun Belay , Aweke Amlaku Mulat , Balcha Wondu Feyisa 
Published: October 2022

Abstract
Objective
Transmission of the Human immune deficiency virus (HIV) from mother to child remains a significant problem in developing countries. Male partners’ involvement in HIV testing and counseling is a major entry point for the prevention of mother-to-child transmission (PMTCT) of HIV. This study aimed to assess male partners’ involvement in HIV testing and counseling during prenatal care visits in Bichena town, Westcentral Ethiopia.

Results
A community-based cross-sectional study design was conducted from October 1/2018 to June 15/2019 among 406 male partners. Less than half (41.38%) [95% CI: 36.20–46.10%] of the male partners were involved in HIV testing and counseling. In multivariable analysis male partners who are found in the age group of 20–29 years, secondary, and diploma and above educational level, good knowledge of the services provided in the prenatal care visits, male partners whose wife had ≥ 4 prenatal care visits, good knowledge of mother to child transmission (MTCT) and PMTCT of HIV, entering the prenatal care room together with his wife, discussing maternal health issue with health care providers, and travel < 15 min to reach a nearby health facility were associated with male partners involvement in HIV testing and counseling.