bluuebunny/crossref_metadata_2025_split huggingface dataset:
The role of procalcitonin in predicting risk of mechanical ventilation and mortality among moderate to severe COVID-19 patients
Authors: Twe Cher Wei , Khoo Delton Kah Yeang , Law Kian Boon , Ahmad Nordin Nur Sabreena binti , Sathasivan Subashini , Lim Kah Chuan , Atikah Sharifah Khairul , Syed Badaruddin Syarifah Nurul Ain bt , Chidambaram Suresh Kumar 
Published: April 2022

Abstract
Background
Serum procalcitonin (PCT) has become an emerging prognostic biomarker of disease progression in patients with COVID-19. This study aims to determine the optimal cut-off value of PCT with regards to important clinical outcomes, especially for mechanical ventilation and all-cause mortality among moderate to severe COVID-19 patients in Malaysia.

Methods
A total of 319 moderate to severe COVID-19 patients hospitalized at the National Referral Hospital in December 2020 were included in the study retrospectively. Demographics, comorbidities, the severity of COVID-19 infection, laboratory and imaging findings, and treatment given were collected from the hospital information system for analysis. The optimal cut-point values for PCT were estimated in two levels. The first level involved 276 patients who had their PCT measured within 5 days following their admission. The second level involved 237 patients who had their PCT measured within 3 days following their admission. Further, a propensity score matching analysis was performed to determine the adjusted relative risk of patients with regards to various clinical outcomes according to the selected cut-point among 237 patients who had their PCT measured within 3 days.

Results
The results showed that a PCT level of 0.2 ng/mL was the optimal cut-point for prognosis especially for mortality outcome and the need for mechanical ventilation. Before matching, patients with PCT ≥ 0.2 ng/mL were associated with significantly higher odds in all investigated outcomes. After matching, patients with PCT > 0.2 ng/mL were associated with higher odds in all-cause mortality (OR: 4.629, 95% CI 1.387–15.449, p = 0.0127) and non-invasive ventilation (OR: 2.667, 95% CI 1.039–6.847, p = 0.0415). Furthermore, patients with higher PCT were associated with significantly longer days of mechanical ventilation (p = 0.0213). There was however no association between higher PCT level and the need for mechanical ventilation (OR: 2.010, 95% CI 0.828–4.878, p = 0.1229).

Conclusion
Our study indicates that a rise in PCT above 0.2 ng/mL is associated with an elevated risk in all-cause mortality, the need for non-invasive ventilation, and a longer duration of mechanical ventilation. The study offers concrete evidence for PCT to be used as a prognostication marker among moderate to severe COVID-19 patients.
Real-world effectiveness and safety of fingolimod in patients with multiple sclerosis in the Czech Republic: results from core and extension parts of the GOLEMS study up to 48 months
Authors: Tichá Veronika , Počíková Zuzana , Vytlačil Josef , Štěpánová Radka 
Published: April 2022

Abstract
Background
Fingolimod, an oral sphingosine 1-phosphate receptor immunomodulator, is approved in Europe for people with multiple sclerosis (pwMS) with highly active disease despite a full and adequate course of treatment with ≥ 1 disease-modifying therapy or patients with rapidly evolving severe relapsing–remitting MS. GOLEMS, a national, multicenter, non-interventional, single-arm, real-world study showed a favorable benefit–risk profile of 12-month treatment with fingolimod in pwMS in the Czech Republic. Here, we evaluated the long-term effectiveness and safety of fingolimod and its impact on disability progression and work capability for up to 48 months in pwMS.

Methods
The endpoints assessed were the incidence and severity of MS relapses in fingolimod-treated patients and the proportion of relapse-free patients up to 48 months of fingolimod treatment, change from baseline in the Expanded Disability Status Scale (EDSS) score, and change from baseline in work capability assessment. Efficacy outcomes were analyzed in the completed and efficacy sets, and safety was evaluated in all the enrolled patients.

Results
Of 240 enrolled patients, 237 were included into efficacy set. Patients with a minimum of a 12-month observation period in the core study who continued fingolimod treatment, were eligible to participate in the extension phase. Of 211 patients enrolled in extension study, 155 were evaluated in the completed set. Based on analysis of 48-month period of fingolimod treatment, 95/237 patients (40.1%) in the efficacy set, 54/155 (34.8%) in the completed set were free of relapses. The majority of relapses reported were moderate in intensity. Mean EDSS score remained stable throughout 48-month study period (Baseline, 3.4; Month 48, 3.6). No trend was observed in changes in work capability assessment or number of missed days of work. Of 240 enrolled patients, 147 (61.3%) had ≥ 1 treatment-emergent adverse event (AE) and 20 (8.3%) reported serious AEs. In total, 45 patients (18.8%) permanently discontinued treatment because of AEs related to study drug; two patients reported pregnancy after treatment initiation and subsequently discontinued the treatment; no deaths were reported.

Conclusion
GOLEMS study demonstrated the sustained effectiveness and manageable safety profile of fingolimod under real-world conditions over 48 months in patients with MS.

Trial registration
Not applicable.
Content validation of educational materials on maternal depression in Nigeria
Authors: Adefolarin Adeyinka Olufolake , Gershim Asiki 
Published: April 2022

Abstract
Background
This study describes the content validation process of the already developed English and Yoruba (poster and leaflet) and Yoruba (song) maternal depression educational materials in Nigeria.

Methods
This study is a cross sectional study which is a part of a larger study on training and supervision of Primary health care workers. Study utilized health professionals’ judgement for content validation, and maternal-child health clients’ evaluation for face validation with the use of Suitability Assessment of Materials (SAM). Six bilingual professionals validated both English and Yoruba version of materials (Song has only Yoruba version) and 50 clients evaluated each Yoruba material. Validity Index was calculated by formula and inter-rater agreement using intra-class coefficient (ICC) was analyzed on Professionals’ ratings. ICC, ‵t′ test and Pearson correlation were analyzed on professionals’ rating versus randomly selected six clients’ rating. Descriptive statistics, and fisher exact test were used for other statistical analysis with SPSS version 25.

Results
The mean age of the professionals for poster was 44.3 ± 6.0 years, for leaflet 39.8 ± 7.2 years, for song 43.8 ± 8.4 years. For maternal child health clients, mean age is: 30.7 ± 5.4 years for poster; 31.3 ± 5.2 for leaflet and 29.0 ± 5.1 for song. Outcomes of bilingual professionals’ validation are validity index: English {leaflet (0.94), poster (0.94)}, and Yoruba {leaflet (0.94) poster (0.94) and song (1.00)}. More than 80% clients rated the suitability of each material as superior. There is no significant relationship between clients’ sociodemographic characteristics and their ratings across content, literacy demand and cultural appropriateness domains of the three materials on fisher exact test. The inter-rater agreement among the professionals is excellent on leaflet and song ICC > 0.8, but it is weak on the poster ICC < 0.6. There is no inter-rater agreement on all the three Yoruba materials, but a negative linear correlation was found on the leaflet between the professionals’ ratings and the randomly selected clients’ ratings. ‵t′ test found no statistical difference in the ratings of the professionals and clients only on song material.

Conclusion
This study shows the process of validation of the English and Yoruba versions of the educational materials. This process should be leveraged in the content validation of other maternal-child health education materials in Africa.
A decade of molecular preimplantation genetic diagnosis of 350 blastomeres for beta-thalassemia combined with HLA typing, aneuploidy screening and sex selection in Iran
Authors: Keshvar Yeganeh , Sabeghi Solmaz , Sharifi Zohreh , Fatemi Kiyana Sadat , Fouladi Panti , Younesi Khah Shahrzad , Rahiminejad Faezeh , Joudaki Atefeh , Amini Masoume , Bagherian Hamideh , Ghaffari Novin Marefat , Movahedin Mansoureh , Mojbafan Marzieh , Zeinali Sirous 
Published: April 2022

AbstractBackgroundPreimplantation genetic diagnosis (PGD) has been developed to detect genetic disorders before pregnancy which is usually done on blastomeres biopsied from 8-cell stage embryos obtained from in vitro fertilization method (IVF).Here we report molecular PGD results for diagnosing of beta thalassemia (beta-thal) which are usually accompanied with evaluating chromosomal aneuploidies, HLA typing and sex selection.MethodsIn this study, haplotype analysis was performed using short tandem repeats (STRs) in a multiplex nested PCR and the causative mutation was detected by Sanger sequencing.ResultsWe have performed PGDs on 350 blastomeres from 55 carrier couples; 142 blastomeres for beta-thal only, 75 for beta-thal and HLA typing, 76 for beta-thal in combination with sex selection, and 57 for beta-thal and aneuploidy screening. 150 blastomeres were transferable, 15 pregnancies were happened, and 11 babies born.We used 6 markers for beta-thal, 36 for aneuploidy screening, 32 for sex selection, and 35 for HLA typing. To our knowledge combining all these markers together and the number of STR markers are much more than any other studies which have ever done.ConclusionsPGD is a powerful diagnostic tool for carrier couples who desire to have a healthy child and wish to avoid medical abortion.
A novel mutation GJA8 NM_005267.5: c.124G > A, p.(E42K) causing congenital nuclear cataract
Authors: Guo Ruru , Huang Dandan , Ji Jian , Liu Wei 
Published: April 2022

Abstract
Background
To identify the genetic mutation of a four-generation autosomal dominant congenital cataract family in China.

Methods
Targeted region sequencing containing 778 genes associated with ocular diseases was performed to screen for the potential mutation, and Sanger sequencing was used to confirm the mutation. The homology model was constructed to identify the protein structural change, several online software were used to predict the mutation impact. CLUSTALW was used to perform multiple sequence alignment from different species.

Results
A novel heterozygous mutation, GJA8 NM_005267.5: c.124G > A, p.(E42K) was found, which cosegregated with congenital cataract phenotype in this family. Bioinformatics analysis of the mutation showed that the surface potential diagram of proteins changed. Several online programs predicted the mutation was ‘Pathogenic’, ‘Damaging’, ‘Disease causing’ or ‘Deleterious’.

Conclusions
A novel mutation NM_005267.5(GJA8):c.124G > A was identified in our study. Our finding can broaden the mutation spectrum of GJA8, enrich the phenotype-genotype correlation of congenital cataract and help to better understand the genetic background of congenital cataract.
The prevalence of subthreshold psychiatric symptoms and associations with alcohol and substance use disorders: from a nationally representative survey of 36,309 adults
Authors: Johnson Jeremy C. S. , Byrne Gerard J. , Pelecanos Anita M. 
Published: April 2022

Abstract
Background
Our aim was to describe a broad number of subthreshold psychiatric symptoms (SPS) in a nationally representative population and evaluate associations with substance use. SPS describe groups of symptoms with significant pathology, but that do not quite meet full psychiatric diagnostic criteria. They have been associated with significant impairment and cost.

Methods
The National Epidemiologic Survey on Alcohol and Related Conditions-III was a multistage, weighted, cross-sectional survey completed in the United States in 2013 comprising 36,309 noninstitutionalized adults. We report lifetime prevalence rates of 14 SPS related to mood, anxiety, trauma, eating, and personality disorders. We then evaluate associations with lifetime alcohol use disorders (AUD) and all substance use disorders (SUD) using logistic regression and adjusted odds ratios. SPS and psychiatric diagnoses were mutually exclusive (could not co-occur).

Results
Lifetime prevalence of having at least one of 14 SPS was 57% compared with 37% for the related psychiatric disorders. This was similar for males and females, in contrast to psychiatric disorders in which prevalence was 42% in females and 31% in males. Otherwise, overall SPS and disorders had similar prevalence patterns across sociodemographic characteristics. Subthreshold personality symptoms had the highest prevalence rates (schizotypal 21.3%, antisocial 18.3%, and borderline 17.6%), followed by posttraumatic stress (13.1%). Subthreshold bipolar and depression had lifetime prevalence rates of 2.7 and 8.5%, respectively. Prevalence rates of subthreshold anxiety symptoms ranged from 2.2% (agoraphobia) to 9.8% (specific phobia). Subthreshold eating disorder related symptoms had the lowest prevalence rates (anorexia 1.5% and bulimia 1.7%). Half (seven) of the SPS had significantly increased odds of lifetime AUD. This number increased to 12 for all SUD. Subthreshold antisocial personality symptoms had the highest odds of AUD (2.2; 95% CI 2.00–2.37) and SUD (3.5; 95% CI 3.22–3.81).

Conclusions
We found high lifetime SPS prevalence rates and significant associations with AUD and SUD. To our knowledge, this is the first published study evaluating a broad number of SPS. This indicates possible opportunities for early intervention and prevention but requires additional research and development of infrastructure and guidelines to better understand and manage patients who experience SPS.
A multi-institutional study of post-traumatic stress disorder and its risk factors in Ethiopian pediatric patients with physical trauma
Authors: Tamir Tadesse Tarik , Kassa Selam Fisiha , Gebeyehu Daniel Ayelegne 
Published: April 2022

Abstract
Introduction
Post Traumatic Stress Disorder (PTSD) was more common in children who had suffered physical trauma than in adults. Despite its prevalence, the prevalence and factors associated with PTSD in pediatric patients with physical trauma are unknown in Ethiopia. As a result, the purpose of this study was to determine the prevalence of PTSD and associated factors among pediatric patients with physical trauma who attended Northwest Amhara referral hospitals.

Methods
An institutional-based cross-sectional study design was used in 422 pediatric patients with physical trauma aged 8–18 years from March 15 to May 15/2021. Using a systematic random sampling technique, data were collected from a sample of selected trauma patients via interviews and chart review. A standardized, pre-tested Child PTSD Symptom Scale was used to assess the severity of PTSD. Epidata 4.6 was used to enter the data, and Stata 14.0 was used to analyze it. Bivariable and multivariable binary logistic regression models were used to identify PTSD determinants.

Result
The study included 422 paediatric patients who had suffered physical trauma, with a response rate of 97.87 percent. PTSD was found in 22.03 percent of paediatric patients with physical trauma in Northwest Amhara referral hospitals. The study discovered that female gender (AOR = 3.04, 95 percent CI: 1.58–5.84), age of 8 to 10 years old (AOR = 3.70, 95 percent CI: 1.39–9.87), having a chronic medical illness (AOR = 5.99, 95 percent CI: 2.60–13.77), having severe pain (AOR = 3.17, 95 percent CI: 1.12–8.99), low social support (AOR = 8.97, 95 percent CI: 4.04–19 were associated with PTSD.

Conclusion and recommendation
The prevalence of PTSD was found to be high among pediatric patients who had experienced physical trauma. Special attention should be given to female patients, aged 8 to 10 years old, who have a chronic illness, for those who complain of severe pain and engaging others to provide good social support systems, are strongly recommended to alleviate PTSD in this segment of population.
Prevalence and determinants of nutritional status among women and children in Pakistan
Authors: Waghmare Hanumant , Chauhan Shekhar , Sharma Santosh Kumar 
Published: April 2022

Abstract
Background
Nutrition has been a low-priority area in Pakistan, with low visibility from the political leadership. Despite various efforts, Pakistan has been reported to have one of the highest prevalences of child and women malnutrition compared to other developing counties. Therefore, this study intends to examine the prevalence and determinants of nutritional status of women and children in Pakistan.

Methods
The present study uses the Demographic Health Survey (DHS) data from Pakistan 2012–13 (PDHS-3). The nutritional status of women was examined through Body-Mass Index (Underweight, normal, overweight, & obese), and that of children was examined through stunting (severe and moderate), wasting (severe, moderate, overweight), and underweight (severe, moderate, overweight). Descriptive statistics and bivariate analysis have been used along with multinomial logistic regression.

Results
A higher proportion of children in rural areas were severely stunted (19.6% vs. 12.5%), severe wasted (2.4% vs. 2.2%), and severe underweight (9.4% vs. 6%) than their urban counterparts. A higher proportion of rural women (9.5% vs. 5.5%) were underweight than urban women, whereas a higher proportion of urban women were obese (24.3% vs. 19.0%) than rural women. The odds of severe stunting (OR = 0.24; C.I. = 0.15–0.37), severe underweight (OR = 0.11; C.I. = 0.05–0.22) were lower among children from the richest wealth quintile than their poorest counterparts. The Relative Risk Ratio (RRR) of being overweight (RRR = 3.7; C.I. = 2.47–5.54) and Obese (RRR = 4.35; C.I. = 2.67–7.07) than normal BMI were higher among women from richest wealth quintile than women belonged to poorest wealth quintile.

Conclusion
This study has highlighted determinants associated with maternal and child nutritional status, whereby the child’s nutritional status was measured by stunting, wasting, and underweight, and BMI measured the mother’s nutritional status. The main risk factors for a child’s poor nutritional status include low household wealth, urban residence, and mother’s educational status. Similarly, the main risk factors for women’s poor nutritional status include increasing the women’s age, educational status, rural residence, and household wealth. Poor households should be provided special attention to improve the nutritional status among women and children in poor households.
A content analysis of Canadian influencer crisis messages on Instagram and the public’s response during COVID-19
Authors: MacKay Melissa , Ford Caitlin , Colangeli Taylor , Gillis Daniel , McWhirter Jennifer E. , Papadopoulos Andrew 
Published: April 2022

AbstractSuccessful mitigation of emerging infectious disease requires that the public adopt recommended behaviours, which is directly influenced by effective crisis communication. Social media has become an important communication channel during COVID-19 where official actors, influencers, and the public are co-creating crisis messages. Our research examined COVID-19-related crisis messages across Canadian influencer accounts within news media, politicians, public health and government, science communicators, and brand influencer and celebrities, posted on Instagram between December 2019 and March 2021 for Health Belief Model and Extended Parallel Processing Model constructs and the corresponding public comment sentiment and engagement. Thirty-three influencer accounts resulted in a total of 2,642 Instagram posts collected, along with 461,436 comments, which showed overall low use of constructs in both captions and images. Further, most posts used no combinations (n = 0 or 1 construct per post) of constructs in captions and images and very infrequently used captions that combined threat (severity and susceptibility) with cues to action and efficacy. Brand influencers and celebrities, politicians, and science communicators had above average post engagement while public health and government and news media had lower. Finally, most influencers saw the largest proportion of neutral sentiment comments. Crisis messages must be designed to include combinations of constructs that increase message acceptance and influence risk perception and efficacy to increase the adoption of recommended and mandated behaviours.
Predicting the protective behavioral intentions for parents with young children that possess different levels of education in Hong Kong using the theory of planned behavior for air polluted with PM2.5
Authors: Woo Siu-Kei , LePage Ben , Chiang Yi-Te , Fang Wei-Ta 
Published: April 2022

Abstract
Background
Air pollution has fast become an issue with great environmental and human health problems that can be attributed to rapid global industrialization and urbanization that has strong negative impacts on human health. Children are particularly vulnerable. While studies on the effects and toxicology of particulate matter pollutants that are 2.5 microns or smaller in size (PM2.5) are abundant, understanding the factors that influence human behaviors against or the avoidance of exposure/contact to air polluted with high levels of PM2.5 is lacking. In this study, this gap was narrowed by used the Theory of Planned Behavior (TPB) to investigate the effects of Attitudes (AT), Subjective Norms (SN), and Perceived Behavioral Controls (PBC) on the Behavioral Intentions (BI) of parents with young children with different levels of education against or avoiding contact/exposure to air polluted with high levels of PM2.5.

Methods
The TPB model was used to predict the BI of parents with young children with different levels of education that live in Hong Kong using the results collected from 410 online questionnaires. Aspects of the BI influencing parents with young children that earned undergraduate group and post-graduate group were analysed using Smart Partial Least Squares 2.0 software.

Results
Our results revealed there were substantial differences in the AT of parents with young children that earned undergraduate and post-graduate degrees with respect to exposure to air with PM2.5 pollution.

Conclusions
In this study we assessed the factors that influence the air pollution prevention and avoidance behaviors of parents of the undergraduate and post-graduate groups that were exposed to air polluted with PM2.5. Our results show the AT, SN, PBC, and BI used in the air pollution protection model for the parents of both groups are connected by separate pathways. The undergraduate group has a higher PBC compared to the post-graduate group because the SN associated with their social ecosystems contribute to their BI. Using path analysis, we revealed that the undergraduate and post-graduate groups had different BI paths. The BI path of the undergraduate group is purer and simpler when compared with the path of the post-graduate group.