bluuebunny/crossref_metadata_2025_split huggingface dataset:
Impact of community health worker intervention on PrEP knowledge and use in Rakai, Uganda: A mixed methods, implementation science evaluation
Authors: Edwards Abagail J , Pollard Rose , Kennedy Caitlin E , Mulamba Jeremiah , Mbabali Ismail , Anok Aggrey , Kong Xiangrong , Nakyanjo Neema , Ddaaki William , Nishimura Holly , Wawer Maria , Amico K Rivet , Hutton Heidi E , Nakigozi Gertrude , Chang Larry W 
Published: August 2022

Background Effective models of support for HIV pre-exposure prophylaxis (PrEP) are needed for populations at elevated risk. In a hyperendemic Ugandan fishing community, PrEP counseling was provided through a situated Information, Motivation, and Behavioral Skills (sIMB)-based community health worker (CHW) intervention. We evaluated the intervention using a mixed-methods, implementation science design. Methods We surveyed all community members aged 15-49 through the Rakai Community Cohort Study. We used multivariable logistic regressions with generalized estimating equations to estimate the intervention’s effect on PrEP knowledge and utilization. To understand intervention experiences and mechanisms, we conducted 74 qualitative interviews with 5 informant types (clients, CHWs, program staff, community leaders, health clinic staff) and analyzed data using an iterative, deductive approach. A mobile phone application provided intervention process implementation data. Results Individuals self-reporting receipt of the CHW intervention showed significantly higher PrEP knowledge (N = 1848, PRR: 1.10, 95% CI: 1.06-1.14, p = <.0001), PrEP ever use (N = 1176, PRR: 1.77, 95% CI: 1.33-2.36, p = <.0001), and PrEP current use (N = 1176, PRR: 1.86, 95% CI: 1.22-2.82, p = 0.0039) compared to those who did not. Qualitative findings attributed positive PrEP outcomes to CHW counseling and effective use of motivational interviewing skills by CHWs. Salient themes across the RE-AIM framework included support for the CHW intervention and PrEP across clients, community, and implementers. Mobile application data demonstrated consistent delivery of the PrEP module throughout implementation. Conclusions CHWs improved PrEP knowledge and use among clients in an HIV hyperendemic fishing community. Mixed-methods, implementation science evaluations can inform adaptation of similar PrEP implementation strategies.
Distal Fibula Fractures—Intramedullary Fixation Versus Plating: A Systematic Review and Meta-analysis of Randomized Control Trials
Authors: Raj Vikash , Barik Sitanshu , Richa  
Published: August 2022

Purpose The aim of the present study is to compare the functional scores and complications of intramedullary fixation versus plate osteosynthesis of distal fibular fractures in adults. Methods Study was performed in accordance with Preferred Reporting Items for Systematic reviews and Meta-Analyses format from MEDLINE, Embase, Ovid, and Cochrane databases. The included articles were assessed according to the risk of bias assessment tool by Cochrane collaboration. Results A total of 5 randomized control trials were included for quantitative review. Random sequence generation and allocation concealment of the study subjects were the strengths of all the included studies. There was high heterogeneity among the included studies (I2 > 75%). There was no significant difference between the Olerud-Molander scores in both the groups but the trend favored the intramedullary nailing of distal fibula (mean difference of 3.42, 95% confidence interval [CI] of 8.90). Complications were significantly lesser in the intramedullary group across the studies (odds ratio 0.26, 95% CI of 0.81). Conclusion Intramedullary nailing of fibula with the use of modern locking fibular nails is an alternative to fibular plating for unstable distal fibular fractures in properly selected cases. There remains the need for standardizing the method of operative treatment of distal fibular fractures which can be done by a well-planned large-scale prospective study design. Level of Evidence: Level 1
The prognosis of different types of pleural tags based on radiologic-pathologic comparison
Authors: Meng Yao , Gao Jie , Wu Chongchong , Xie Mei , Ma Xidong , Zang Xuelei , Song Jialin , Zhou Meng , Guo Shikun , Huang Yemei , Deng Hengyu , Li Hongli , Wei Bo , Xue Xinying 
Published: August 2022

Abstract
Objectives
There are increasing numbers of studies of pleural tags (PTs). The purpose of this case series was to classify the PTs in patients with peripheral pulmonary adenocarcinoma based on radiologic-pathologic comparison and to study the prognosis.

Methods
The clinical, imaging, pathological and prognostic data of 161 patients with peripheral pulmonary adenocarcinoma in three hospitals were analyzed retrospectively. We classified PTs using computed tomography (CT) for pathologic comparison.

Results
According to the relationship between tumors and pleural on CT images, PTs were classified into four types: type 1, one or more linear pleural tag; type 2, one or more linear pleural tag with soft tissue component at the pleural end; type 3, one soft tissue cord-like pleural tag; type 4, directly abutting the visceral pleura, pulling or pushing the visceral pleura. In these PTs, the incidence of visceral pleural invasion (VPI) was high in type 2 (46.88%) and type 3 (56.41%) of PTs. Our prognostic analysis showed that micropapillary or solid histological subtype (HR = 5.766, 95% CI: 1.435–23.159, P = 0.014) and type 3 of PTs (HR = 11.058, 95% CI: 1.349–90.623, P = 0.025) were two independent risk factors for tumor progression.

Conclusions
PT is a risk factor for poor prognosis in patients with peripheral pulmonary adenocarcinoma, the presence of which on CT images can remind us to provide patients with a more reasonable treatment.
Initiating antiretroviral therapy within 2 weeks of anti-Pneumocystis treatment does not increase mortality or AIDS-defining events in patients with HIV-associated moderate to severe Pneumocystis pneumonia: results of a prospective observational multicenter study
Authors: Zeng Yan-Ming , Li Yao , Lu Yan-Qiu , Liu Min , Nie Jing-Min , Yuan Jing , Harypursat Vijay , Zhou Yi-Hong , Qin Yuan-Yuan , Chen Xiao-Hong , Zhang Yu-Lin , Zhang De-Fa , Wang Ni , Chen Hui , Tian Qun , Zhou Yang , Qin Ying-Mei , Yang Xin-Ping , Chen Yao-Kai 
Published: August 2022

Abstract
Background
The mortality rate remains high among patients with coinfection with Pneumocystis pneumonia (PCP) and HIV. The timing for initiation of antiretroviral therapy (ART) after a diagnosis of moderate to severe PCP remains controversial, however. We therefore designed the present study to determine the optimal timing for ART initiation in AIDS-associated PCP (AIDS/PCP) patients.

Methods
This was a multicenter, observational, prospective clinical trial. Eligible participants were recruited from 14 hospitals in mainland China, and assigned to an Early ART arm (initiation of ART ≤ 14 days after PCP diagnosis) and a Deferred ART arm (initiation of ART > 14 days after PCP diagnosis). The primary outcomes were death and the incidence of AIDS-defining events at week 48. The secondary outcomes were the changes in CD4+ T-cell counts from baseline values at weeks 12, 24, and 48, the virological suppression rate at week 24 and week 48, the rate of development of PCP-associated immune reconstitution inflammatory syndrome (PCP/IRIS), and the rate of adverse events over 48 weeks.

Results
The present study was performed using the data of 363 participants, with 169 participants in the Early ART arm, and 194 participants in the Deferred ART arm. Immunological and virological outcomes were found to be similar in both treatment arms. At week 48, there were no significant differences for the incidence of mortality (20 vs. 26, p = 0.860), and AIDS-defining events (17 vs. 26, p = 0.412). Over 48 weeks, the rates of PCP/IRIS (2 vs. 3, p = 1.000), adverse events (70 vs. 72, p = 0.465), and grade 3 or 4 adverse events (28 vs. 34, p = 0.919) did not reach statistical significance. A significant difference observed between two study arms was that 11 participants (55.0%) in the Early ART arm compared to 23 participants (88.5%) in the Deferred ART arm (p = 0.026) succumbed before ART had ever been started.

Conclusions
Early ART initiation results in no increase in mortality, AIDS-defining events, IRIS, adverse events, and immunological or virological outcomes. These results support the early initiation of ART in patients with moderate to severe AIDS/PCP.
Clinical trial registration
The present trial was registered at Chinese Clinical Trial Registry (ChiCTR1900021195). Registered 1 February 2019, http://www.chictr.org.cn/showproj.aspx?proj=35362.
The effect of interprofessional education on interprofessional professionalism behaviors of the surgical team members
Authors: Hosseinpour Azam , Keshmiri Fatemeh , Jambarsang Sara , Jabinian Fatemeh , Shiryazdi Seyed Mostafa 
Published: August 2022

Abstract
Introduction
Interprofessional professionalism (IPP) has been introduced as one of the critical sub-competencies of interprofessional collaboration. This study aimed to assess the effect of interprofessional education on the behavior of interprofessional professionalism among the surgical team in the intervention compared to the control group.

Methods
This is a quasi-experimental study. The participants were nurses in anesthetist and surgical technology and surgical residents of Shahid Sadoughi Hospital (n = 150) who were included in the study by the census. The intervention employed an interprofessional case-based learning strategy to explore themes of interprofessional professionalism. Two assessors used the Interprofessional Professionalism Assessment (IPA) tool to measure learners’ performance while observing them in practice prior to the intervention, one and three months after the intervention. Data were analyzed using descriptive tests (mean and SD) and RM-ANOVA.

Results
In this study, the participants in the intervention (n = 78) and the control (n = 72) groups entered the study. The Baseline IPA scores of participants were reported as 1.25 (0.12) and 1.21 (0.1) in the intervention and control groups, respectively. The IPA score of the participants in the intervention group (2.59 (0.26) and 2.54 (0.24)) was higher than the control group (1.17 (0.08) and 1.12 (0.07)) after one and three months of the intervention (P = 0.0001). The effect of educational interventions was reported at the large level (Eta Square = 0.89).

Conclusion
Interprofessional professionalism in surgical teams has been recognized as a critical element of team-based care. The present study used an interprofessional education strategy to develop IPP behavior. All professions benefited from interprofessional education. It is suggested that all surgical team professionals participate in interprofessional education.
A case of early onset adenocarcinoma associated with colorectal polyposis with an unknown germline mutation
Authors: Zenitani Masahiro , Inagaki Hidehito , Kurahashi Hiroki , Oue Takaharu 
Published: August 2022

Abstract
Background
Typically, in cases of adenomatous polyposis, colorectal cancer develops in the third or fourth decade of life. We report the case of a female patient with colorectal polyposis who developed adenocarcinoma at 8 years of age.

Case presentation
An 8-year-old girl was admitted with a 4-year history of occasional bloody stools. Colonoscopy revealed colon polyposis and histopathological assessment confirmed a well-differentiated adenocarcinoma in the adenomatous polyps, so laparoscopy-assisted proctocolectomy was performed in the lithotomy position by a simultaneous abdominal and anal approach. To completely resect the rectal mucosa, excision was commenced just distal to the dentate line. After the mucosal resection up to the peritoneal reflection level, an inverted muscular cuff was cut circumferentially, and the terminal ileum was pulled through the muscular cuff and anastomosed to the anal canal. Histopathology revealed multiple adenomatous polyps and scattered well-differentiated tubular adenocarcinomas (tub1) in the adenomatous polyps and the non-polypoid mucosal lesions. Because complete resection was achieved, additional adjuvant chemotherapy was not administered. Polymerase chain reaction (PCR)-direct sequencing of the entire coding region and the exon–intron junctions, and real-time PCR of DNA extracted from blood cells, revealed no mutations of either APC or MUTYH. No deletions, duplications, translocations or inversions of APC, MUTYH and GREM1 genes were found using multiplex ligation-dependent probe amplification (MLPA) and G-banding analysis. Multi-gene panels sequencing for polyposis syndromes or hereditary colorectal cancers, and trio-whole exome sequencing was conducted. However, no candidate pathogenic variants of genes were detected in de novo dominant or autosomal recessive model. Somatic mutation of APC was not detected in 4 polyps by loss of heterozygosity analysis at a single nucleotide polymorphism in intron 14. The patient has remained disease-free for 5 years. Currently, the patient is on loperamide and passes stool 5 times/day without any soiling.

Conclusions
The genetic analysis suggests that she may have a germline mutation at unscreened region of these genes or in unidentified FAP gene. The patient will be carefully followed up for residual rectal carcinoma and for the development of other cancers.
Revisiting the overlooked role of recycled sewage water in high-income countries in adenoviral outbreaks such as the “2022 pediatric hepatitis’ outbreak”
Authors: AbdelMassih Antoine , Kamel Aya , Zaki Ali Mohamed , Aboudeif Ayten , Emad Clara , Ramadan Dina , Gaber Hanya , Bastorous Harvey , Shaker Mehraiel , Salah Nancy , Hany Nourhan , El-Mestkawy Nur , Sawiris Rana Adel Naguib , Mamdouh Rana , Atalla Sandy , Abozeid Sara , Ghazi Sarah Ismail , Youssef Steven A. , ElMaghraby Youssef , Khudhair Zainab , Hozaien Rafeef , El Husseiny Nadine , El Shershaby Meryam 
Published: August 2022

Abstract
Background
On the 5th of April 2022, cases of adenovirus-induced hepatitis were reported in Scotland and then reached multiple parts of the world. While adenovirus normally presents with diarrhea, vomiting, and fever, these novel cases also resulted in the development of fulminant hepatitis in non-immunocompromised cases.

Main body
The responsible pathogen “Adenovirus 41” is an enterovirus. Enteroviruses are spread by the fecal-oral route and are resistant to drying. As such, they predominate in sewage water. Hepatitis is normally restricted to poorer countries, yet this new wave seems to be confined to mostly high-income countries in Europe and the USA. These countries treat and recycle a higher percentage of sewage water. We also propose that the fulminant nature of this strain could be due to either a cross-species mutation or the general decrease in trained immunity post-COVID-19 lockdown.

Short conclusion
Evidence strongly suggests that the link between these new hepatitis cases is recycled sewage water. This should warrant further investigations on the origin of this outbreak by re-visiting the role of recycled sewage water in causing such outbreak.
Neuro-immunological complications post COVID-19 vaccination: two case reports
Authors: Aljamea Dana , Al Sadah Zhra , Alokley Alia , Altaweel Hassan , Alabdali Majed , AlQarni Mustafa 
Published: August 2022

Purpose: To add to the growing literature regarding the possible link between the onset of Guillain Barre syndrome (GBS) and Bickerstaff brainstem encephalitis (BBE) and the coronavirus disease (COVID-19) vaccines. Case reports: The first patient is a 38-year-old man that presented muscle weakness and an unsteady gait for a duration of one week. Initially, he developed an unsteady gait, then gradually worsening generalized muscle fatigue and ascending weakness in all limbs. He tested positive for GM1 and GQ1D antibodies, and magnetic resonance imaging (MRI) of the lumbar spine with contrast and nerve conduction study (NCS) results were both suggestive of acute motor axonal neuropathy (AMAN). The second patient is a 54-year-old man that developed generalized fatigue and subjective fever associated with headache and blurry vision followed by bulbar dysfunction. During hospitalization, his consciousness level started to be affected and he developed ataxia with ophthalmoparesis. A diagnosis of BBE was made based on clinical, imaging, and cerebrospinal fluid (CSF) findings. Conclusion: Since temporal relationships do not signify causation, we cannot draw any conclusions regarding the association between COVID-19 vaccines and these neurological disorders. However, it is vital that new cases are reported so that the knowledge base is built upon, and to increase healthcare workers’ vigilance for early signs of GBS or BBE.
The roles of self efficacy and sharia financial literacy to SMES performance: business model as intermediate variable
Authors: Srisusilawati Popon , Malik Zaini Abdul , Silviany Irma Yulita , Eprianti Nanik 
Published: August 2022

Background: SMEs have made a major contribution to the national economy, but Pandemic covid-19 made the decline of SMEs which directly affected the economy in Indonesia. The purpose of this research focus to explore the innovation of business models the novelty of the research model in the business model of innovation research models is to include the variable self-efficacy. This research emphasizes self-efficacy and Islamic financial literacy as independent variables, business model innovation as an intermediate model and business performance variables as dependent variables, with the focus of research on SMEs. Methods: This quantitative study uses partial least square structural equation modeling (PLS-SEM) and a questionnaire survey to analyze the 40 Street Vendors which is categorized as SMEs around Unisba. In the initial stages, the Questionnaire was tested with the Validity and Reliability test. In the PLS-SEM analysis, the validity of the indicators / items forming latent variables is based on the significance value of t arithmetic obtained from the loading factor value divided by the standard error. After being collected, the data is then processed and analyzed. The analytical method used in this study is the simultaneous equation model, namely Partial Least Square (PLS). The statistical tool used to test the hypothesis is Smart PLS. Results: The results showed that self-efficacy and Islamic financial literacy through business model innovation, had a positive effect on SMEs business performance simultaneously or partially. Conclusion: So that by having good self-efficacy and good Islamic financial literacy plus an appropriate business innovation model, it will improve the business performance of SMEs.
Older adults identified as frail by Frailty Index and FRAIL scale who were intensively treated for hypertension were at increased risk of 2-year adverse health outcomes in The Irish Longitudinal Study on Ageing (TILDA)
Authors: O'Donoghue Patrick , O'Halloran Aisling , Kenny Rose Anne , Romero-Ortuno Roman 
Published: August 2022

Background: Frailty is associated with adverse health outcomes. In frail older adults, blood pressure (BP) treated intensively may result in adverse events. We hypothesised that frail older adults, with BP treated below the threshold of the 2018 European Society of Cardiology/European Society of Hypertension (ESC/ESH) guideline (<130/70 mmHg), could be associated with adverse health outcomes. Methods: Data was gathered from participants in Wave 1 (W1) of The Irish Longitudinal Study on Ageing (TILDA) who were aged ≥65 years and on treatment for hypertension. Frail classifications as per a 32-item Frailty Index (FI) and FRAIL (Fatigue, Resistance, Ambulation, Illnesses & Loss of Weight) scale were compared in their ability to predict W2 (2-year) adverse outcomes associated with intensive BP control (‘below threshold (BT)’: <130/70 mmHg vs. ‘above threshold (AT)’: ≥130/70 mmHg). We created eight participant groups based on frailty-BP status. W2 outcomes were analysed using adjusted binary logistic regression models. Results: In W1, 1,920 participants were included. Of these 1,274 had complete FI-BP and 1,276 FRAIL-BP data. The frail by FI treated BT and frail by FRAIL treated BT had increased risk of hospitalisation, heart failure and falls/fracture by W2. The frail by FRAIL treated BT also had increased risk of mortality by W2. The frail by FI treated AT had increased risk of syncope and falls/fractures. The non-frail by FI or FRAIL did not have any increased risk of the adverse outcomes studied. Conclusions: FI and FRAIL captured increased risk of adverse health outcomes when BP was treated below the current ESC/ESH threshold. FI and FRAIL could be more useful than other frailty identification tools to signal risks associated with tighter BP control in frail older adults. Future hypertension management guidelines should consider incorporating specific frailty identification tools to help guide clinicians in making personalised BP medication treatment decisions.
Using Machine Learning Methods Incorporating Individual Reader Annotations to Classify Paediatric Chest Radiographs in Epidemiological Studies
Authors: Mwaniki Paul , Kamanu Timothy , Akech Samuel , Eijkemans M. J. C 
Published: August 2022

Introduction: Epidemiological studies that involve interpretation of chest radiographs (CXRs) suffer from inter-reader and intra-reader variability. Inter-reader and intra-reader variability hinder comparison of results from different studies or centres, which negatively affects efforts to track the burden of chest diseases or evaluate the efficacy of interventions such as vaccines. This study explores machine learning models that could standardize interpretation of CXR across studies and the utility of incorporating individual reader annotations when training models using CXR data sets annotated by multiple readers. Methods: Convolutional neural networks were used to classify CXRs from seven low to middle-income countries into five categories according to the World Health Organization's standardized methodology for interpreting paediatric CXRs. We compared models trained to predict the final/aggregate classification with models trained to predict how each reader would classify an image and then aggregate predictions for all readers using unweighted mean. Results: Incorporating individual reader's annotations during model training improved classification accuracy by 3.4% (multi-class accuracy 61% vs 59%). Model accuracy was higher for children above 12 months of age (68% vs 58%). The accuracy of the models in different countries ranged between 45% and 71%. Conclusions: Machine learning models can annotate CXRs in epidemiological studies reducing inter-reader and intra-reader variability. In addition, incorporating individual reader annotations can improve the performance of machine learning models trained using CXRs annotated by multiple readers.