bluuebunny/crossref_metadata_2025_split huggingface dataset:
Exploration of inter-jurisdictional TB programming and mobility in a Canadian First Nation community
Authors: Heendeniya Vidanaral Apeksha , Long Richard , Heffernan Courtney , Abonyi Sylvia , Clarke Sherry , Hackett Paul 
Published: December 2022

Abstract
Background
Colonially imposed jurisdictional boundaries that have little meaning to Indigenous peoples in Canada may confound tuberculosis (TB) prevention and care activities. This study explores how inter-jurisdictional mobility and the current accommodation of mobility through policies and programming sustain a regional TB epidemic in northwestern Saskatchewan, and northeastern Alberta.

Methods
A qualitative instrumental case study was performed using a community based participatory approach. Semi-structured interviews were conducted with First Nations peoples from a high-incidence community in Canada including community-based healthcare workers. These interview data are presented in the context of a multi-level document analysis of TB program guidelines.

Results
The location of the community, and related lack of access to employment, services and care, necessitates mobility across jurisdictional boundaries. There are currently no formal federal or provincial guidelines in place to accommodate highly mobile patients and clients within and across provincial TB prevention and care programs. As a result, locally developed community-based protocols, and related ad-hoc strategies ensure continuity of care.

Conclusion
Indigenous peoples living in remote communities face unique push/pull factors that motivate mobility. When these motivations exist in communities with increased risk of contagion by communicable infectious diseases such as TB, public health risks extend into increasingly large areas with competing jurisdictional authority. Such mobility poses several threats to TB elimination. We have identified a gap in TB services to systematically accommodate mobility, with specific implications for Indigenous peoples and reconciliation. We recommend clearly defined communication paths and inter-jurisdictional coordination to ensure maintenance of care for mobile populations.
Inequality in prevalence, awareness, treatment, and control of hypertension in Iran: the analysis of national households’ data
Authors: Mahdavi Mahdi , Parsaeian Mahboubeh , Farzadfar Farshad , Mohamadi Efat , Olyaeemanesh Alireza , Takian Amirhossein 
Published: December 2022

Abstract
Background
Providing an equitable Universal Health Coverage (UHC) is key for progressing towards the sustainable development goals in the health systems. To help policymakers make hypertension services more equitable with existing (limited) resources in Iran, we examined the inequality of the prevalence, awareness, treatment, and control (PATC) of hypertension as the four indicators of hypertension UHC in Iran.

Methods
This research was a cross-sectional study of inequality of PATC of hypertension using a representative sample of Iranians aged ≥ 25 years from the Iran 2016 STEP wise approach to Surveillance study (STEPS). Outcome variables consisted of PATC of hypertension. Covariates were demographic (age, sex, and marital status) and living standard (area of residence, wealth status, education, and health insurance) indicators. We drew concentration curves (CC) and estimated concentration indices (C). We also conducted normalized Erreygers decomposition analysis for binary outcomes to identify covariates that explain the wealth-related inequality in the outcomes. Analysis was conducted in STATA 14.1.

Results
The normalized concentration index of hypertension prevalence and control was -0.066 (p < .001) and 0.082 (p < .001), respectively. The C of awareness and treatment showed nonsignificant difference between the richest and poorest. Inequality in the hypertension prevalence of females was significantly higher than males (C = -0.103 vs. male C = -0.023, p < .001). Our analyses explained 33% of variation in the C of hypertension prevalence and 99.7% of variation in the C of control. Education, wealth index, and complementary insurance explained most inequality in the prevalence. Area of residence, education, wealth status, and complementary insurance had the largest contribution to C of control by 30%, 28%, 26%, and 21%, respectively.

Conclusions
This study showed a pro-rich inequality in the prevalence and control of hypertension in Iran. We call for expanding the coverage of complementary insurance to reduce inequality of hypertension prevalence and control as compared with other factors it can be manipulated in short run. We furthermore advocate for interventions to reduce the inequality of hypertension control between rural and urban areas.
Multilevel analysis of individual- and community-level determinants of birth certification of children under-5 years in Nigeria: evidence from a household survey
Authors: Anaduaka Uchechi Shirley 
Published: December 2022

AbstractPromoting birth certification is central to achieving legal identity for all - target 16.9 of the 2030 Sustainable Development Goals. Nigeria is not on track to achieve this goal with its low coverage of birth certification (BC). This study is aimed at identifying patterns of BC and its associated individual- and community-level factors, using pooled cross-sectional data from three rounds (2008, 2013, and 2018) of the nationally representative Nigerian Demographic and Health Survey. A weighted sample of 66,630 children aged 0–4 years was included, and a two-level multilevel logistic model which accommodates the hierarchical nature of the data was employed. Of the total sample, 17.1% [95% CI: 16.3–17.9] were reported to be certified. Zamfara state (2.3, 95% CI: 0.93–3.73) and the Federal Capital Territory (36.24, 95% CI: 31.16–41.31) reported the lowest and the highest BC rates. Children with an SBA [AOR = 1.283, 95% CI: 1.164–1.413] and with at least one vaccination [AOR = 1.494, 95% CI: 1.328–1.681] had higher odds of BC. The AOR for mothers with at least one prenatal visit was 1.468 [95% CI: 1.271–1.695], and those aged 30–34 years at the time of birth [AOR = 1.479, 95% CI: 1.236–1.772] had the highest odds. Further, the odds of BC increased the most for mothers [AOR = 1.559, 95% CI: 1.329–1.829] and fathers [AOR = 1.394, 95% CI: 1.211–1.605] who were tertiary-educated. In addition, children in middle-income [AOR = 1.430, 95% CI: 1.197–1.707] or rich wealth HHs [AOR = 1.776, 95% CI: 1.455–2.169] or those whose families had bank accounts [AOR = 1.315, 95% CI: 1.187–1.456] had higher odds. Living in non-poor and within close proximity to a registration center (RC) act as protective factors for BC, while living in poor communities [AOR = 0.613, 95% CI: 0.486–0.774] and more than 10kms from an RC reduce the odds of BC [AOR = 0.466, 95% CI: 0.377–0.576]. The study identified several protective and risk factors which policymakers can adopt as strategic areas for universal birth certification. National and sub-national programs should integrate non-formal institutions as well as target child and maternal utilization of healthcare services to promote BC in Nigeria.
Emotional response patterns, mental health, and structural vulnerability during the COVID-19 pandemic in Canada: a latent class analysis
Authors: Richardson Chris , Goodyear Trevor , Slemon Allie , Gadermann Anne , Thomson Kimberly C. , Daly Zachary , McAuliffe Corey , Pumarino Javiera , Jenkins Emily K. 
Published: December 2022

Abstract
Background
The COVID-19 pandemic has contributed to increases in negative emotions such as fear, worry, and loneliness, as well as changes in positive emotions, including calmness and hopefulness. Alongside these complex emotional changes has been an inequitable worsening of population mental health, with many people experiencing suicidal ideation and using substances to cope. This study examines how patterns of co-occurring positive and negative emotions relate to structural vulnerability and mental health amid the pandemic.

Methods
Data are drawn from a cross-sectional monitoring survey (January 22–28, 2021) on the mental health of adults in Canada during the pandemic. Latent class analysis was used to group participants (N = 3009) by emotional response pattern types. Descriptive statistics, bivariate cross-tabulations, and multivariable logistic regression were used to characterize each class while quantifying associations with suicidal ideation and increased use of substances to cope.

Results
A four-class model was identified as the best fit in this latent class analysis. This included the most at-risk Class 1 (15.6%; high negative emotions, low positive emotions), the mixed-risk Class 2 (7.1%; high negative emotions, high positive emotions), the norm/reference Class 3 (50.5%; moderate negative emotions, low positive emotions), and the most protected Class 4 (26.8% low negative emotions, high positive emotions). The most at-risk class disproportionately included people who were younger, with lower incomes, and with pre-existing mental health conditions. They were most likely to report not coping well (48.5%), deteriorated mental health (84.2%), suicidal ideation (21.5%), and increased use of substances to cope (27.2%). Compared to the norm/reference class, being in the most at-risk class was associated with suicidal ideation (OR = 2.84; 95% CI = 2.12, 3.80) and increased use of substances to cope (OR = 4.64; 95% CI = 3.19, 6.75).

Conclusions
This study identified that adults experiencing structural vulnerabilities were disproportionately represented in a latent class characterized by high negative emotions and low positive emotions amid the COVID-19 pandemic in Canada. Membership in this class was associated with higher risk for adverse mental health outcomes, including suicidal ideation and increased use of substances to cope. Tailored population-level responses are needed to promote positive coping and redress mental health inequities throughout the pandemic and beyond.
Preceptors’ preparedness to teach about substance and opioid use disorder: a qualitative study
Authors: Lowe Enya , Kogan Alexis Coulourides , Feldman Corinne T. , Ma Sae Byul , Lie Désirée A. 
Published: December 2022

Abstract
Study aim
Little is known about preceptors’ comfort and readiness to teach clinical students about the care of patients with substance and opioid use disorder (SUD/OUD). This study explores preceptors’ views about caring for such patients, and their preparedness to teach about SUD/OUD management, to improve graduate competencies.

Methods
Participants were recruited by convenience and snowball sampling. Semi-structured interviews were conducted with physician, physician assistant, and nurse practitioner preceptors who taught medical and physician assistant students. Interviews were conducted via Zoom® videoconferencing. Transcripts were generated and independently analyzed for themes by 4 experienced coders using constant comparison and a grounded theory approach.

Results
Fifteen interviews were conducted to theme saturation. We identified 3 major themes and 10 subthemes supported by exemplar quotes. The major themes were: education about SUD/OUD in primary care (subthemes include need for longitudinal curriculum, redefining ‘success’ in treatment, and precepting challenges), treatment of SUD/OUD in primary care (need for systemic support and care continuity), and medication-assisted therapy (MAT) training as a tool for teaching (preceptors’ own training, and need for clinical students to be trained).

Conclusions
Preceptors agreed that treatment of SUD/OUD belongs in primary care and students should learn about SUD/OUD from the start of their medical education. Data analysis enabled the construction of an emerging conceptual framework reflecting a diversity of experiences and opinions of preceptor comfort and preparedness to teach about SUD/OUD, associated with various barriers and motivators. This framework can guide future strategies to address facilitators and obstacles to advance and promote preceptor preparedness to teach students about the care and management of patients with SUD/OUD.
Potential clinical utility of liquid biopsy in early-stage non-small cell lung cancer
Authors: Shen Haifeng , Jin Yichen , Zhao Heng , Wu Manqi , Zhang Kai , Wei Zihan , Wang Xin , Wang Ziyang , Li Yun , Yang Fan , Wang Jun , Chen Kezhong 
Published: December 2022

Abstract
Background
Liquid biopsy has been widely researched for early diagnosis, prognostication and disease monitoring in lung cancer, but there is a need to investigate its clinical utility for early-stage non-small cell lung cancer (NSCLC).

Methods
We performed a meta-analysis and systematic review to evaluate diagnostic and prognostic values of liquid biopsy for early-stage NSCLC, regarding the common biomarkers, circulating tumor cells, circulating tumor DNA (ctDNA), methylation signatures, and microRNAs. Cochrane Library, PubMed, EMBASE databases, ClinicalTrials.gov, and reference lists were searched for eligible studies since inception to 17 May 2022. Sensitivity, specificity and area under the curve (AUC) were assessed for diagnostic values. Hazard ratio (HR) with a 95% confidence interval (CI) was extracted from the recurrence-free survival (RFS) and overall survival (OS) plots for prognostic analysis. Also, potential predictive values and treatment response evaluation were further investigated.

Results
In this meta-analysis, there were 34 studies eligible for diagnostic assessment and 21 for prognostic analysis. The estimated diagnostic values of biomarkers for early-stage NSCLC with AUCs ranged from 0.84 to 0.87. The factors TNM stage I, T1 stage, N0 stage, adenocarcinoma, young age, and nonsmoking contributed to a lower tumor burden, with a median cell-free DNA concentration of 8.64 ng/ml. For prognostic analysis, the presence of molecular residual disease (MRD) detection was a strong predictor of disease relapse (RFS, HR, 4.95; 95% CI, 3.06–8.02; p < 0.001) and inferior OS (HR, 3.93; 95% CI, 1.97–7.83; p < 0.001), with average lead time of 179 ± 74 days between molecular recurrence and radiographic progression. Predictive values analysis showed adjuvant therapy significantly benefited the RFS of MRD + patients (HR, 0.27; p < 0.001), while an opposite tendency was detected for MRD − patients (HR, 1.51; p = 0.19). For treatment response evaluation, a strong correlation between pathological response and ctDNA clearance was detected, and both were associated with longer survival after neoadjuvant therapy.

Conclusions
In conclusion, our study indicated liquid biopsy could reliably facilitate more precision and effective management of early-stage NSCLC. Improvement of liquid biopsy techniques and detection approaches and platforms is still needed, and higher-quality trials are required to provide more rigorous evidence prior to their routine clinical application.
Isolation and identification of major bacteria from three Ethiopian rift valley lakes live and processed fish, and water samples: implications in sanitary system of fish products
Authors: Dissasa Guta , Lemma Brook , Mamo Hassen 
Published: December 2022

AbstractBacterial pathogens are a great threat to fish production. Gram-negative bacteria are among the major bacterial fish pathogens and are zoonotic with the potential to infect humans. This cross-sectional study was conducted to isolate and identify major gram-negative bacteria from live and processed fish, and water samples from Lakes Hawassa, Langanoo and Ziway. A total of 674 different types of samples: 630 tissue samples (210 samples for each intestine, Kkidney and liver collected from 210 live fish (Oreochromis niloticus, Cyprinus carpio and Clarias gariepinus), 20 processed fish samples from lake Ziway fish processing center and 24 lake water samples were included in the study from each lake. The mean values of pH, temperature, dissolved oxygen and nitrate in all water samples were within the normal range at which most freshwater fish species become non-stressed. Of a total of 674 samples included in the study, bacteria were isolated from 154(22.8%) samples with significant difference (P < 0.05) observed in some isolates with respect to sample origin. Of these 154 isolates, 103(66.8%) isolates were gram-negative bacteria consisting of 15 species based on morphology and a range of biochemical tests. From live fish samples, Escherichia coli was the dominant species with 15 isolates followed by Edwardsiella tarda (12), Salmonella Paratyphi (10), Salmonella Typhi (9), Shigella dysenteriae (7), Shigella flexneri (7), Klebsiella pneumonia (7), Enterobacter aerogenes (6), Enterobacter cloacae (5), Pseudomonas aeruginosa (5), Vibrio parahemolyticus (5), Aeromonas sobria (4), Citrobacter freundii (4), Citrobacter koseri (4) and Plesiomonas shigelloides (3). The detection of the common fecal coliforms (E. coli, K. pneumoniae and E. aerogenes) and Salmonella spp. in processed fish indicates the potential danger of passage of pathogenic bacteria and/or their poisons to humans via infected and/or contaminated fish products. Human infection by pathogenic fish bacteria and food poisoning is possible through contamination of fish product in fish production chain due to inadequate handling, poor hygiene and contact with contaminated water. Therefore, producers, consumers and all other stakeholders need to be cautious during handling, processing and consumption of fish harvested from the study lakes.
Construction of an lncRNA model for prognostic prediction of bladder cancer
Authors: Shi Changlong , Li Yifei , Wan Enming , Zhang Enchong , Sun Li 
Published: December 2022

Abstract
Objective
We aimed to investigate the role and potential mechanisms of long non-coding RNAs (lncRNAs) in bladder cancer (BC), as well as determine their prognostic value.

Methods
LncRNA expression data and clinical data from BC patients were downloaded from The Cancer Genome Atlas (TCGA) database. R software was used to carry out principal component analysis (PCA), differential analysis, and prognostic analysis. Lasso regression and multivariate Cox regression analyses were performed to identify potential prognostic genes. The expression of five identified genes and their correlation with prognosis were verified using TCGA and GSE13507 datasets. In addition, quantitative real-time polymerase chain reaction (qRT-PCR) was used to confirm the expression of these five genes in cell lines (two human BC cell lines and one human bladder epithelial cell line) and tissues (84 pairs of BC tissues and the corresponding paracancerous tissues). Risk scores that had been generated from the five genes and their prognostic ability were assessed by receiver operating characteristic (ROC) and Kaplan–Meier (KM) curves. Co-expressed genes were screened by WGCNA and analyzed by GO and KEGG, while functional enrichment and immune infiltration analyses were performed using STRING (https://cn.string-db.org/) and TIMER2.0 (http://timer.cistrome.org/) online tools, respectively.

Results
CYP4F8, FAR2P1, LINC01518, LINC01764, and DTNA were identified as potential prognostic genes. We found that these five genes were differentially expressed in BC tissue, as well as in BC cell lines, and were significantly correlated with the prognosis of BC patients. KM analysis considering risk scores as independent parameters revealed differences in overall survival (OS) by subgroups. The ROC curve revealed that a combined model consisting of all five genes had good predictive ability at 1, 3, and 5 years. GO and KEGG analyses of 567 co-expressed genes revealed that these genes were significantly associated with muscle function.

Conclusion
LncRNAs can be good predictors of BC development and prognosis, and may act as potential tumor markers and therapeutic targets that may be beneficial in helping clinicians decide the most effective treatment strategies.
Interaction between caveolin-1 polymorphism and dietary fat quality indexes on visceral adiposity index (VAI) and body adiposity index (BAI) among overweight and obese women: a cross-sectional study
Authors: Ghaffarian-Ensaf Rasool , Shiraseb Farideh , Mirzababaei Atieh , Clark Cain C. T. , Mirzaei Khadijeh 
Published: December 2022

AbstractBackground and aimsCaveolin-1 (CAV-1) in adipocyte tissue and other body parts possesses numerous biological functions. In the present study, we sought to investigate the interaction between CAV-1 polymorphism and dietary fat quality indexes on visceral adiposity index (VAI) and body adiposity index (BAI) among overweight and obese women.MethodsThis study was conducted on 386 women aged 18–48 years old. Biochemical measurements were assessed by standard protocols. We used a food frequency questionnaire (FFQ) to calculate the dietary intake and the indexes of dietary fat quality intake. Anthropometric values and body composition were measured by standard methods. Finally, the CAV-1 genotype was measured using the PCR–RFLP method.ResultsWe found marginally significant differences between AA and GG genotypes of waist-to-hip ratio (WHR) (P = 0.06) and BAI (P = 0.06) of participants after adjusting for potential confounders. For dietary intakes, after adjusting with the energy intake, mean differences in biotin (P = 0.04) and total fiber (P = 0.06) were significant and marginally significant, respectively. The interaction between two risk alleles (AA) with omega-6 to omega-3 ratio (W6/W3) on BAI, after adjustment for potential confounders (age, physical activity, energy intake, education), was marginally positive (β = 14.08, 95% CI = − 18.65, 46.81,P = 0.07). In comparison to the reference group (GG), there was a positive interaction between the two risk alleles (AA) with W6/W3 ratio on VAI (β = 2.81, 95% CI = 1.20, 8.84,P = 0.06) in the adjusted model.ConclusionsWe found that there might be an interaction between CAV-1 genotypes with dietary quality fat indexes on VAI and BAI among overweight and obese women.
Self-care time and rating of health state in persons with diabetes: results from the population-based KORA survey in Germany
Authors: Icks Andrea , Stöbel Simon , Thorand Barbara , Holle Rolf , Laxy Michael , Schunk Michaela , Neumann Anja , Wasem Jürgen , Gontscharuk Veronika , Chernyak Nadja 
Published: December 2022

AbstractBackgroundThe amount of empirical research on whether people in fact include health-related changes in leisure time into health state valuations is limited and the results are inconclusive. In this exploratory study, we analyse whether time aspects of diabetes self-care might explain the ratings of the health state (HSR) in addition to the effects of physical and mental health-related quality of life.MethodsUsing the data from participants with diagnosed type 2 diabetes in the population-based KORA FF4 study (n = 190, 60% Male, mean age 69 ± 10 years), multiple logistic regression models were fitted to explain HSR (good vs. poor) in terms of the SF-12 physical and mental component summary (PCS and MCS) scores, time spent on diabetes self-care and a number of background variables.ResultsThere was no significant association between time spent on diabetes self-care and HSR in models without interaction. Significant interaction term was found between the SF-12 PCS score and time spent on self-care. In models with interaction self-care time has a small, but significant impact on the HSR. In particular, for a PCS score under 40, more time increases the chance to rate the health state as “good”, while for a PCS score above 40 there is a reverse effect.ConclusionsThe additional impact of self-care time on HSR in our sample is small and seems to interact with physical health-related quality of life. More research is needed on whether inclusion of health-related leisure time changes in the denominator of cost-effectiveness analysis is sufficient.