bluuebunny/crossref_metadata_2025_split huggingface dataset:
The role of Emergency Medicine Interest Groups in the development of Emergency Medicine: A case of MUST-EMIG in Uganda
Authors: Kajjimu Jonathan , Odakha Justine Athieno , Makai Conrad , Kaginda Beneth Tusiime , Nakachwa Janat , Karungi Annet , Lubega Frank , Tukamuwebwa Jespa , Kakande Reagan , Lyon Mary Ellen , Tagg Andrew 
Published: February 2022

Abstract
BackgroundEmergency medicine (EM) is a new specialty in Uganda since 2017 which is currently actively engaged in improving its emergency care system. To build a strong emergency care system, it is important to have a critical mass of specially trained health professionals with the skillset and dedication to work in emergency departments. There is no current formal EM undergraduate curriculum and so most undergraduates do not get the chance to interact with the new specialists and to gain interest. The MUST-EMIG was established to bridge this gap. This study was done to assess the contribution of MUST-EMIG towards the development of this critical mass.Objectives1. Discover students' reasons for joining the Mbarara University of Science and Technology Emergency Medicine Interest Group (MUST-EMIG).2. Assess whether interest in learning emergency medicine was affected by participation in MUST-EMIG.3. Evaluate plans to pursue emergency medicine as a specialty before and after joining MUST-EMIG.4. Determine whether MUST-EMIG affected students’ perception of emergency medicine’s importance in Uganda’s health care system.5. Elicit feedback from students on their experience as members of MUST-EMIG. MethodsThe MUST-EMIG executive developed a membership survey which was reviewed by MUST-EMIG’s faculty advisor for suitability. Members of MUST-EMIG were voluntarily asked to participate in the online survey. Results of the survey were summarized using descriptive statistics and thematic analysis.Results49 responses (46.7% response rate) were collected and analysed. Participants included 29 (59.2%) male and 20 (40.8%) female medical students. The majority of participants were fourth year students 22 (44.9%). 44 (89.8%) students joined MUST-EMIG to learn how to handle medical emergencies, and expressed a desire of at least 6/10 to learn more about emergency medicine after utilising opportunities provided by MUST-EMIG. Overall, students had a good experience with MUST-EMIG. They reported that our interest group had provided them networking, unique learning, and leadership opportunities. Having an EMIG significantly affects students’ desire to pursue a career in emergency medicine and their perception of the relevance of emergency medicine.ConclusionAn EMIG helps develop interest of medical students in emergency medicine. Students passionate about emergency medicine need to be supported to help them preserve and further develop this passion.
Electronic Medical Record Use and Associated Factors in Diredawa, Eastern Ethiopia. A mixed Method Study
Authors: Tolera Abebe , Oljira Lamessa , Dingeta Tariku , Abaerei Admas Abera , Shore Hirbo 
Published: February 2022

Abstract
Background: Despite rapid growth in the information technology (IT), adoption rate of electronic medical records (EMR) in health care setting is lagging behind in Ethiopia. EMRs have long been considered as essential elements in improving healthcare quality and safety, enhance service performance, reduce adverse events for patients, and support clinical decision support system. However, utilization of EMR among healthcare providers still remains low and there has been little progress toward harnessing the benefits of EMR particularly in developing countries. Objective: This study, therefore, is aimed at exploring EMR use and its determinants among health care providers. Methods: Quantitative cross-sectional study was conducted on 402 health professionals working at public health facilities supplemented with an exploratory qualitative study in Dire Dawa, Ethiopia. Descriptive statistics and logistic regression analysis were used to explore determinant factors of EMR use while qualitative data were thematically analyzed. Results: Overall, about a quarter (26.6%) of health professionals were using electronic medical record. Work experience of 6 years or less (AOR=2.23; 95% CI: [1.15-4.31]), discussion on EMR (AOR=14.47; 95% CI: [5.58-37.57]), presence of EMR manual (AOR=3.10 95%CI: [1.28-7.38]), and positive attitude towards EMR system (AOR=11.15; 95%CI: [4.90-25.36]) and service quality (AOR=8.02; 95% CI: [4.09-15.72]) were independent determinants of EMR use.Conclusion: The analysis carried out indicates that EMR use by health professionals in the study area is very low. Therefore, there is a need to leverage through continuous technical support and commitment to enhance EMR use which has the potential to improve health service performance.
In vitro efficacy of albendazole-loaded β-cyclodextrin against protoscoleces of Echinococcus granulosus sensu stricto
Authors: Bakhtiar Nayer Mehdizad , Akbarzadeh Abolfazl , Ahmadpour Ehsan , Mahami-Oskouei Mahmoud , Casulli Adriano , Norouzi Roghayeh , Asadi Milad , Ebrahimi Mina , Asadi Nahideh , Oliveira Sonia M. Rodrigues , Pereira Maria de Lourdes , Spotin Adel 
Published: February 2022

Abstract
Background: Cystic echinococcosis (CE), a widespread helminthic disease caused by the larval stage of the dog tapeworm Echinococcus granulosus is represented as a public health concern in humans. The therapeutic failure of albendazole (ABZ) against CE depends on its low aqueous solubility and consequently its erratic bioavailability in plasma. Serious adverse effects have been also observed following the long-term use of ABZ in vivo. Methods: We evaluated the apoptotic effects of ABZ-loaded β-cyclodextrin (ABZ-β-CD) against protoscoleces (PSCs) versus ABZ alone. After 15 h of exposure time, Caspase-3 enzymatic activity was determined by fluorometric assay in PSCs treated with ABZ and ABZ-β-CD. To assess the treatment efficacy of ABZ-β-CD against PSCs, mRNA expression of Arginase (EgArg) and Thioredoxin peroxidase (EgTPx) were quantified by Real-time PCR. Results: A significant scolicidal activity of ABZ was observed only at a concentration of 800 μg/mL (100% PSCs mortality rate after 4 days of exposure), while the 200 and 400 μg/mL ABZ reached 100% PSCs mortality rate after 9 sequential days. The 400 μg/mL ABZ-β-CD had 100% scolicidal rate after 5 days of exposure. Morphological alterations using scanning electron microscopy in treated PSCs revealed that ABZ and ABZ-β-CD induced higher Caspase-3 activity than their controls, indicating a more potent apoptotic outcome on the PSCs. Also, we showed that the ABZ-β-CD can down-regulate the mRNA expression of EgArg and EgTPx, indicating more potent interference against growth and antioxidant properties of PSCs. Conclusions: These data provide new insights into the nanostructured β-CD carriers of ABZ appear as a promising candidate to improve the treatment of CE in vivo models.
A Landscape Assessment of the Activities and Capacities of Evidence to Policy Intermediaries (EPI) in Behavioral Health
Authors: Almquist Lars , Walker Sarah Cusworth , Purtle Jonathan 
Published: February 2022

Abstract
Background:A significant gap exists between the production of research evidence and its use in behavioral health policymaking. Organizations providing consulting and support activities for improving policy represent a promising source for strengthening the infrastructure to address this gap. Understanding the characteristics and activities of these evidence-to-policy intermediary (EPI) organizations can inform the development of capacity-building activities, leading to strengthened evidence-to-policy infrastructure and more widespread evidence-based policymaking.Methods:Online surveys were sent to 51 organizations from English-speaking countries involved in evidence-to-policy activities in behavioral health. The survey was grounded in a rapid evidence review of the academic literature regarding strategies used to influence research use in policymaking. The review identified 17 strategies, which were classified into four activity categories. We administered the surveys via Qualtrics and calculated descriptive statistics, scales, and internal consistency statistics using R.Results:A total of 31 individuals completed surveys from 27 organizations (53% response rate) in four English-speaking countries. EPIs were evenly split between university (49%) and non-university settings (51%). Nearly all EPIs conducted direct program support (mean=4.19/5 [sd=1.25]) and knowledge-building (4.03 [1.17]) activities. However, engagement with traditionally marginalized and nontraditional partners (2.84 [1.39]) and development of evidence reviews using formal critical appraisal methods (2.81 [1.70]) were uncommon.EPIs tend to be specialized, focusing on a group of highly related strategies rather than incorporating multiple evidence-to-policy strategies in their portfolios. Inter-item consistency was moderate to high, with scale α’s ranging from 0.67 to 0.85. Ratings of respondents’ willingness to pay for training in one of three evidence dissemination strategies revealed high interest in program and policy design.Conclusions:Our results suggests that evidence-to-policy strategies are frequently used by existing EPIs; however, organizations tend to specialize rather than engage a breadth of strategies. Further, few organizations reported consistently engaging with non-traditional or community partners. Focusing on building capacity for a network of new and existing EPIs could be a promising strategy for growing the infrastructure needed for evidence-informed behavioral health policymaking.
Carbon Stock And Spatial Dynamics In Natural Forests Of Awi Zone, Amhara Region, Northwestern Ethiopia: Implication For Climate Change Mitigation And Adaptation
Authors: Kassaye Melkamu , Derebe Yonas , Kibrie Wondwosson , Debebe Fekadu , Gedamu Bahiru 
Published: February 2022

Abstract
Background: As a mitigation measure of climate change, the natural forest plays a key role in controlling the carbon cycle and ecosystem stability through sequestrating the carbon dioxide. However, there have been limited scientifically investigation and communication of the potential carbon stock potential of natural forest resources with the global community. Therefore, inventory and estimation of stocks and fluxes of carbon from natural vegetation under different forest communities and different environmental patterns should be done and communicate to the global community for conservation and to get appropriate credit. To do this, 9 forest communities in different agroecology were selected areas of Awi Zone, Northwest Ethiopia. To this end 76 quadrates with 20meter*20meter quadrate size 200meter distance within quadrates and transect lines Diameter, height, and environmental gradient data were collected and analyzed with R Ver.3.1, XLSTAT, and SPSS Ver.25. Result: There was a significant difference (p < 0.029) of above and belowground biomass, carbon stock, carbon dioxide sequestration potential, and soil organic carbon across forests communities, slope, altitude, aspect, and agro-ecologies. ‘Saharakani’ forest has the highest carbon stock as the overall pool. Highland forest communities had a better overall carbon pool. In terms of slop gradient, low slope gradient has recorded the highest allover carbon pool followed by a steep slope and lower slope. In altitude gradient all over carbon pool have in decreasing order with increasing of altitude. South facing had the highest carbon stock as overall pools followed by east-facing and west-facing and the least is north facing. Lowland forests had better Soil organic carbon followed by highland and mid-altitude forests. Carbon stock as an overall pool is especially dynamics within environmental patterns. Conclusion: There is a huge amount of carbon stock in the natural forest in the study area which has a great potential in carbon dioxide sequestration which mitigates the crisis of climate change. However, appropriate credit was not given yet for this natural forest and the resources are continuously declining. Thus, first of all, urgent conservation is required, and then further plan-based sustainable conservation should work should be done for successfully ecologically climate change mitigation.
Encephalitis on An Immunocompromised Patient Following Covid-19 Vaccination. Causal Or Coincidental Correlation?
Authors: Grosi Effrosyni , Tsolaki Anthoula , Saoulidis Iordanis , Liouta Eleni , Savopoulos Christos , Bakaimi Isidora , Spilioti Martha 
Published: February 2022

Abstract
The Covid-19 pandemic has made a major impact worldwide. The vaccines production was a huge biotechnology achievement empowering the defense against this fatal threat. However, as billions of shots have been administered, some safety issues have been raised. We present a case of a 55-year-old patient with a history of CLL(Chronic Lymphocytic Leukemia), who had encephalitis seventeen days post vaccination. Although the benefits outweigh the risk of vaccination at this point, all the rare and serious adverse events should be reported. The significance of such reports is even greater when refer to special patient sub-groups, regarded as immunocompromised.
Developing A Risk Stratification Tool For Predicting Opioid-Related Respiratory Depression After Noncardiac Surgery
Authors: Roy Sounak , Bruehl Stephen , Feng Xiaoke , Shotwell Matthew S. , De Ven Thomas Van , Shaw Andrew D. , Kertai Miklos D. 
Published: February 2022

Abstract
Background: Accurately assessing the probability of significant respiratory depression following opioid administration can potentially enhance perioperative risk assessment and pain management. We developed and validated a risk prediction tool to estimate the probability of significant respiratory depression (indexed by naloxone administration) in patients undergoing noncardiac surgery. Methods: We studied n=63,084 patients (mean age 47.1±18.2 years; 50% male) who underwent emergency or elective noncardiac surgery between January 1st, 2007 and October 30th, 2017 at Vanderbilt University Medical Center. A derivation subsample reflecting two-thirds of available patients (n=42,082) was randomly selected for model development, and associations were identified between predictor variables and naloxone administration occurring within 5 days following surgery. The resulting probability model for predicting naloxone administration was then cross-validated in a separate validation cohort reflecting the remaining one-third of patients (n=21,002).Results: The rate of naloxone administration was identical in the derivation (n = 2,720 [6.5%]) and validation (n = 1,360 [6.5%]) cohorts. The risk prediction model identified female sex (Odds Ratio [OR]: 3.01; 95% confidence interval [CI]: 2.73-3.32), high-risk surgical procedures (OR: 4.16; 95% CI: 3.78-4.58), history of drug abuse (OR: 1.81; 95% CI: 1.52-2.16), and any opioids being administered on a scheduled rather than as-needed basis (OR: 8.31; 95% CI: 7.26-9.51) as risk factors for naloxone administration. Advanced age (OR: 0.40; 95% CI: 0.36-0.43), opioids administered via patient-controlled analgesia pump (OR: 0.55; 95% CI:0.49-0.62), and any scheduled non-opioids (OR: 0.63; 95% CI: 0.58-0.69) were associated with decreased risk of naloxone administration. An overall risk-prediction model incorporating the common clinically-available variables above displayed excellent discriminative ability both the derivation and validation cohorts (c-index = 0.820 and 0.814, respectively).Conclusion: Our cross-validated clinical predictive model accurately estimates the risk of serious opioid-related respiratory depression requiring naloxone administration in postoperative patients. In the precision medicine context, it may prove useful in facilitating selection of opioid-sparing pain management strategies for high-risk surgical patients.
Implementation Strategies Preferred by Primary Care Clinicians to Facilitate Cancer Prevention and Control Activities
Authors: Glasgow Russell , Brtnikova Michaela , Dickinson L. Miriam , Carroll Jennifer K. , Studts Jamie L. 
Published: February 2022

Abstract
Introduction: Key stakeholders need to be involved in the identification of feasible and impactful implementation strategies for evidence-based interventions. While a wide range of implementation strategies has been developed, there is little research on their applicability when addressing different cancer prevention and control (CPC) efforts in primary care.Methods: With an emphasis on rural practices, we conducted a survey of primary care physicians to identify implementation strategies they perceive as most feasible and impactful. The survey included both primary prevention behavior change counseling and cancer screening issues. Analyses contrasted ratings of feasibility and impact across these activities and nine implementation strategies, and among clinicians in different settings with a focus on comparisons between clinicians in rural vs. non-rural settings.Results: We had 326 respondents from a wide range of practice types, representing four different practice-based research networks, 49 states, and including 177 clinicians in rural settings. Ratings of impact were somewhat higher than those for feasibility. Few of the nine implementation strategies were high on both impact and feasibility. Only ‘adapting to my practice’ was rated higher than a 4 (“moderate”) on both impact and feasibility. There were relatively few differences between rural and non-rural clinicians or associated with other clinician or setting characteristics.Conclusions: There is considerable variability in perceived impact and feasibility of implementation strategies for CPC activities among primary care clinicians. It is important to assess both feasibility and impact of implementation strategies as well as their generalizability across settings. Our results suggest that optimal strategies to implement evidence-based CPC activities will likely need to be developed or adapted for primary care settings. Future research is needed to replicate these findings with different settings and interventions, and identify practical, stakeholder informed implementation strategies.
IL-2 and zoledronic acid therapy restores the in vivo anti-leukemic activity of human lymphocytes pre-exposed to simulated microgravity
Authors: Mylabathula Preteesh Leo , Diak Douglass M. , Baker Forrest L. , Niemiro Grace M. , Markofski Melissa M. , Crucian Brian E. , Katsanis Emmanuel , Simpson Richard J. 
Published: February 2022

Abstract
Background: We have previously shown that the anti-tumor activity of human lymphocytes is diminished in vitro after 12-hours pre-exposure to simulated microgravity (SMG). Here we used an immunocompromised mouse model to determine if this loss of function would extend in vivo, and to also test the efficacy of IL-2 and zoledronic acid (ZOL) therapy as a potential countermeasure against SMG-induced immune dysfunction. We adoptively transferred human lymphocytes that were exposed to either SMG or 1G-control into NSG-Tg(Hu-IL 15) mice 1-week after they were injected with a luciferase-tagged human chronic myeloid leukemia (K562) cell line. Tumor growth was monitored 2x weekly with bioluminescence imaging (BLI) for up to 6-weeks. Results: Mice that received lymphocytes exposed to SMG showed greater tumor burden compared to those receiving lymphocytes exposed to 1G (week 6 BLI: 1.8e10 ± 8.07e9 versus 2.22e8 ±1.39e8 photons/second; p<0.0001). Peak BLI was also higher in the SMG group compared to 1G-control (2.34e10 ±1.23e10 versus 3.75e8 ±1.56e8 photons/second; p=0.0062). Exposure to SMG did not affect the ability of human lymphocytes to engraft or evoke xeno-graft-versus-host disease in the mice. Additionally, we injected the mice with IL-2 and zoledronic acid (ZOL) to expand and activate the anti-tumor activity of NK cells and γδ-T cells, respectively. This was found to revive the loss in anti-leukemic function observed in vivo when lymphocytes were pre-exposed to SMG. Conclusion: Microgravity plays a contributory role in loss of tumor control in vivo. Immuno-stimulating agents like ZOL+IL-2 may offer an important countermeasure for immune dysregulation during prolonged spaceflight.
Pneumonia in Primary Antibody Deficiency Patients Receiving Immunoglobulin Therapy, Risk Factors, and Role of Prophylactic Antibiotics: Data From the US Immunodeficiency Network (USIDNET)
Authors: Syed Maha N. , Kutac Carleigh , Miller Jennifer M , Marsh Rebecca , Rundles Charlotte Cunningham , Fuleihan Ramsay L , Kheradmand Farrah , Hajjar Joud 
Published: February 2022

Abstract
Background Despite immunoglobulin replacement (IgRT) therapy, some patients with Primary Antibody Deficiency (PAD) continue to develop respiratory infections. Recurrent and severe respiratory infections, particularly pneumonia, can lead to significant morbidity and mortality. Therefore, we sought to determine the risk factors of developing pneumonia in PAD patients, already receiving IgRT.MethodsWe evaluated clinical, and laboratory features of PAD patients enrolled in the US Immune Deficiency Network (USIDNET) registry by April 2017. Patients were included if they met the following criteria: 1) PAD diagnosis (common variable immunodeficiency (CVID), Agammaglobulinemia, hypogammaglobinemia, and specific antibody deficiency (SAD). 2) Available data on infections before and after IgRT. Patients were excluded if they were not receiving IgRT, or no pre/post infections data were available. Descriptive and multivariable logistic regression analyses were used to identify factors associated with pneumonia post-IgRT.Results A total of 1286 patients met the inclusion criteria. Following IgRT, 226 patients (17.6%) were reported to have at least one pneumonia episode. Using multivariate logistic regression analysis, we found a statistically significant increased risk of pneumonia in patients with asthma (OR: 1.79, 95% CI [1.20-2.67], p=0.004), bronchiectasis (OR: 2.81, 95% CI [1.64-4.80], p<0.001), and interstitial lung disease (ILD) (OR: 2.90, 95% CI [1.26-6.70], p=0.013). Patients who did not receive prophylactic antibiotics had a much higher risk of pneumonia (OR: 27.65, 95% CI [8.63-88.59]; p<0.001), compared to those who received prophylactic antibiotics. For every 50 unit increase in IgA, the odds of reporting pneumonia post-IgRT decreased significantly (OR: 0.82, 95% CI [0.69-0.97], p=0.018). Patients with X-Linked Agammaglobulinemia had a lower risk of pneumonia than other PAD diagnoses (OR: 0.84; 95% CI [0.75-0.93]; p=0.001). The infectious organism was reported in 39 of 226 patients who reported pneumonia after IgRT. Haemophilus influenzae was the most frequently reported (n=11, 28.21%), followed by Streptococcus Pneumoniae (n=9, 23.08%).ConclusionOur findings suggest a role for prophylactic antibiotics patients with PAD, especially in those with pre-existing lung disease. However, our study is limited by the cross-sectional nature of the USIDNET database and limited longitudinal data. Therefore, prospective studies evaluating the indications of prophylactic antibiotics are warranted.Clinical ImplicationsPatients with primary antibody deficiency and structural lung disease may benefit from prophylactic antibiotics to prevent persisted infections despite IgRT.