bluuebunny/crossref_metadata_2025_split huggingface dataset:
Barriers and enablers to utilisation of the WHO surgical safety checklist at the university teaching hospital in Lusaka, Zambia: a qualitative study
Authors: Munthali Judith , Pittalis Chiara , Bijlmakers Leon , Kachimba John , Cheelo Mweene , Brugha Ruairi , Gajewski Jakub 
Published: July 2022

Abstract
Background
Surgical perioperative deaths and major complications are important contributors to preventable morbidity, globally and in sub-Saharan Africa. The surgical safety checklist (SSC) was developed by WHO to reduce surgical deaths and complications, by utilising a team approach and a series of steps to ensure the safe transit of a patient through the surgical operation. This study explored barriers and enablers to the utilisation of the Checklist at the University Teaching Hospital (UTH) in Lusaka, Zambia.

Methods
A qualitative case study was conducted involving members of surgical teams (doctors, anaesthesia providers, nurses and support staff) from the UTH surgical departments. Purposive sampling was used and 16 in-depth interviews were conducted between December 2018 and March 2019. Data were transcribed, organised and analysed using thematic analysis.

Results
Analysis revealed variability in implementation of the SSC by surgical teams, which stemmed from lack of senior surgeon ownership of the initiative, when the SSC was introduced at UTH 5 years earlier. Low utilisation was also linked to factors such as: negative attitudes towards it, the hierarchical structure of surgical teams, lack of support for the SSC among senior surgeons and poor teamwork. Further determinants included: lack of training opportunities, lack of leadership and erratic availability of resources. Interviewees proposed the following strategies for improving SSC utilisation: periodic training, refresher courses, monitoring of use, local adaptation, mobilising the support of senior surgeons and improvement in functionality of the surgical teams.

Conclusion
The SSC has the potential to benefit patients; however, its utilisation at the UTH has been patchy, at best. Its full benefits will only be achieved if senior surgeons are committed and managers allocate resources to its implementation. The study points more broadly to the factors that influence or obstruct the introduction and effective implementation of new quality of care initiatives.
Explaining regional variation in elective hip and knee arthroplasties in Finland 2010 − 2017—a register-based cohort study
Authors: Manderbacka Kristiina , Satokangas Markku , Arffman Martti , Reissell Eeva , Keskimäki Ilmo , Leyland Alastair H. 
Published: July 2022

AbstractBackgroundA persistent research finding in industrialised countries has been regional variation in medical practices including elective primary hip and knee arthroplasty. The aim of the study was to examine regional variations in elective total hip and knee arthroplasties over time, and the proportions of these variations which can be explained by individual level or area-level differences in need.MethodsWe obtained secondary data from the Care Register for Health Care to study elective primary hip and knee arthroplasties in total Finnish population aged 25 + years between 2010 and 2017. Two-level Poisson regression models – individuals and hospital regions – were used to study regional differences in the incidence of elective hip and knee arthroplasties in two time periods: 2010 − 2013 and 2014 − 2017. The impact of several individual level explanatory factors (age, socioeconomic position, comorbidities) and area-level factors (need and supply of operations) was measured with the proportional change in variance. Predictions of incidence were measured with incidence rate ratios. The relative differences in risk of the procedures in regions were described with median rate ratios.ResultsWe found small and over time relatively stable regional variation in hip arthroplasties in Finland, while the variation was larger in knee arthroplasties and decreased during the study period. In 2010 − 2013 individual socioeconomic variables explained 10% of variation in hip and 4% in knee arthroplasties, an effect that did not emerge in 2014 − 2017. The area-level musculoskeletal disorder index reflecting the need for care explained a further 44% of the variation in hip arthroplasties in 2010 − 2013, but only 5% in 2014 − 2017 and respectively 22% and 25% in knee arthroplasties. However, our final models explained the regional differences only partially.ConclusionsOur results suggest that eligibility criteria in total hip and knee arthroplasty are increasingly consistent between Finnish hospital districts. Factors related to individual level and regional level need both had an important role in explaining regional variations. Further study is needed on the effect of health policy on equity in access to care in these operations.
Quality of Life instruments and their psychometric properties for use in parents during pregnancy and the postpartum period: a systematic scoping review
Authors: Brekke Malene , Berg Rigmor C. , Amro Amin , Glavin Kari , Haugland Trude 
Published: July 2022

AbstractPurposeTo identify instruments used to measure parents’ Quality of Life (QoL) during pregnancy and the postpartum period, and to describe their characteristics and psychometric properties.MethodsFor this scoping review we conducted systematic literature searches in MEDLINE, EMBASE, PsychINFO, CINAHL and HaPI in mid-December 2020, to identify studies evaluating psychometric properties. The COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN) were used to define and categorize psychometric properties. Two reviewers screened the studies independently, and customized screening questions were used to assess eligibility against inclusion criteria. Data were systematically extracted into a predesigned data charting matrix, and descriptively analyzed.ResultsThe searches identified 5671 studies, of which 53 studies met the inclusion criteria. In total, there were 19 QoL instruments: 12 generic and seven period specific. The most reported instruments were SF-36, SF-12 and WHOQOL-BREF, and the most evaluated instruments were SF-12, WHOQOL-BREF, QOL-GRAV, and PQOL. We found that none of the identified instruments had been evaluated for all nine psychometric properties recommended by the COSMIN. The most reported psychometric properties were internal consistency and structural validity. The instruments were primarily assessed in parents residing in Asia (50%), and 83% of the studies were conducted from 2010 to 2020. Only three studies included psychometric measures assessed on fathers.ConclusionOur review shows there is extensive evidence on the internal consistency and structural validity of QoL instruments used on parents during pregnancy and the postpartum period, but that the evidence on other psychometric properties is sparse. Validation studies and primary studies are needed to provide evidence on the reliability, validity, responsiveness, and interpretability of QoL instruments for this target group, in particular for fathers and partners.
Oral ecological environment modifications by hard-cheese: from pH to microbiome: a prospective cohort study based on 16S rRNA metabarcoding approach
Authors: Lorenzini Erna Cecilia , Lazzari Barbara , Tartaglia Gianluca Martino , Farronato Giampietro , Lanteri Valentina , Botti Sara , Biscarini Filippo , Cozzi Paolo , Stella Alessandra 
Published: July 2022

Abstract
Background
The oral ecosystem conditions dental health, and is known to be positively modified by oral hygiene which cannot always be performed between meals, especially outside home. It is therefore important to identify the practices to be adopted to influence the oral environment in an anticariogenic direction. Milk and cheese are considered functional foods and have a role on oral health. There are several mechanisms by which cheese exerts its beneficial effects on teeth. The aim of the present study was to examine whether short term consumption of hard cheese would affect the oral pH and microbial flora of healthy adults modifying ecological oral environment. The Next Generation Sequencing (NGS) approach was applied to study the effect of Italian Grana Padano (GP), as a prototype of typical hard cheese, on the oral microbiota composition. Finally, we explored Streptococcusmutans/sanguinis ratio as a marker of protective biofilm composition.

Methods
Nine oral-healthy adults were instructed to eat 25 gr of GP cheese for 5 consecutive days. Three time points were chosen for supragingival samples collection and pH measurement. 16S rRNA-gene sequences were obtained both from oral samples and GP cheese using the MiSeq platform and analyzed against the expanded Human Oral Microbiome Database (eHOMD). ProgPerm was used to perform statistical analyses to investigate strain differential representation after cheese consumption.

Results
Taxonomic analyses of the oral microbiota revealed that Firmicutes was the most abundant phylum, followed by Proteobacteria and Actinobacteria. GP cheese significantly modifies oral pH, causing a shift toward basic conditions which are kept for a few hours. The Streptococcus mutans/Streptococcus sanguinis ratio lowers in the last observed timepoint.

Conclusion
Our results reveal that a portion of GP cheese eaten after dinner provides important micronutrients (i.e. calcium, vitamins and some aminoacids such as arginine) and changes oral pH toward basic conditions, resulting in a light modification of the oral microbiome towards the reduction of the overall amount of acidophilic bacteria. Furthermore, the S.mutans/S. sanguinis ratio is reduced, contributing to obtain a more protecting environment towards caries establishment and evolution.
A cannabidiol aminoquinone derivative activates the PP2A/B55α/HIF pathway and shows protective effects in a murine model of traumatic brain injury
Authors: Navarrete Carmen , García-Martín Adela , Correa-Sáez Alejandro , Prados María E. , Fernández Francisco , Pineda Rafael , Mazzone Massimiliano , Álvarez-Benito Marina , Calzado Marco A. , Muñoz Eduardo 
Published: July 2022

Abstract
Background
Traumatic brain injury (TBI) is characterized by a primary mechanical injury and a secondary injury associated with neuroinflammation, blood–brain barrier (BBB) disruption and neurodegeneration. We have developed a novel cannabidiol aminoquinone derivative, VCE-004.8, which is a dual PPARγ/CB2 agonist that also activates the hypoxia inducible factor (HIF) pathway. VCE-004.8 shows potent antifibrotic, anti-inflammatory and neuroprotective activities and it is now in Phase II clinical trials for systemic sclerosis and multiple sclerosis. Herein, we investigated the mechanism of action of VCE-004.8 in the HIF pathway and explored its efficacy in a preclinical model of TBI.

Methods
Using a phosphoproteomic approach, we investigated the effects of VCE-004.8 on prolyl hydroxylase domain-containing protein 2 (PHD2) posttranslational modifications. The potential role of PP2A/B55α in HIF activation was analyzed using siRNA for B55α. To evaluate the angiogenic response to the treatment with VCE-004.8 we performed a Matrigel plug in vivo assay. Transendothelial electrical resistance (TEER) as well as vascular cell adhesion molecule 1 (VCAM), and zonula occludens 1 (ZO-1) tight junction protein expression were studied in brain microvascular endothelial cells. The efficacy of VCE-004.8 in vivo was evaluated in a controlled cortical impact (CCI) murine model of TBI.

Results
Herein we provide evidence that VCE-004.8 inhibits PHD2 Ser125 phosphorylation and activates HIF through a PP2A/B55α pathway. VCE-004.8 induces angiogenesis in vivo increasing the formation of functional vessel (CD31/α-SMA) and prevents in vitro blood–brain barrier (BBB) disruption ameliorating the loss of ZO-1 expression under proinflammatory conditions. In CCI model VCE-004.8 treatment ameliorates early motor deficits after TBI and attenuates cerebral edema preserving BBB integrity. Histopathological analysis revealed that VCE-004.8 treatment induces neovascularization in pericontusional area and prevented immune cell infiltration to the brain parenchyma. In addition, VCE-004.8 attenuates neuroinflammation and reduces neuronal death and apoptosis in the damaged area.

Conclusions
This study provides new insight about the mechanism of action of VCE-004.8 regulating the PP2A/B55α/PHD2/HIF pathway. Furthermore, we show the potential efficacy for TBI treatment by preventing BBB disruption, enhancing angiogenesis, and ameliorating neuroinflammation and neurodegeneration after brain injury.
Virological outcomes and risk factors for non-suppression for routine and repeat viral load testing after enhanced adherence counselling during viral load testing scale-up in Zimbabwe: analytic cross-sectional study using laboratory data from 2014 to 2018
Authors: Mhlanga Trudy Tholakele , Jacobs Bart K. M. , Decroo Tom , Govere Emma , Bara Hilda , Chonzi Prosper , Sithole Ngwarai , Apollo Tsitsi , Van Damme Wim , Rusakaniko Simbarashe , Lynen Lutgarde , Makurumidze Richard 
Published: July 2022

AbstractBackgroundSince the scale-up of routine viral load (VL) testing started in 2016, there is limited evidence on VL suppression rates under programmatic settings and groups at risk of non-suppression. We conducted a study to estimate VL non-suppression (> 1000 copies/ml) and its risk factors using "routine" and "repeat after enhanced adherence counselling (EAC)" VL results.MethodsWe conducted an analytic cross-sectional study using secondary VL testing data collected between 2014 and 2018 from a centrally located laboratory. We analysed data from routine tests and repeat tests after an individual received EAC. Our outcome was viral load non-suppression. Bivariable and multivariable logistic regression was performed to identify factors associated with having VL non-suppression for routine and repeat VL.ResultsWe analysed 103,609 VL test results (101,725 routine and 1884 repeat test results) collected from the country’s ten provinces. Of the 101,725 routine and 1884 repeat VL tests, 13.8% and 52.9% were non-suppressed, respectively. Only one in seven (1:7) of the non-suppressed routine VL tests had a repeat test after EAC. For routine VL tests; males (vs females, adjusted odds ratio (aOR) = 1.19, [95% CI 1.14–1.24]) and adolescents (10–19 years) (vs adults (25–49 years), aOR = 3.11, [95% CI 2.9–3.31]) were more at risk of VL non-suppression. The patients who received care at the secondary level (vs primary, aOR = 1.21, [95% CI 1.17–1.26]) and tertiary level (vs primary, aOR = 1.63, [95% CI 1.44–1.85]) had a higher risk of VL non-suppression compared to the primary level. Those that started ART in 2014–2015 (vs < 2010, aOR = 0.83, [95% CI 0.79–0.88]) and from 2016 onwards (vs < 2010, aOR = 0.84, [95% CI 0.79–0.89]) had a lower risk of VL non-suppression. For repeat VL tests; young adults (20–24 years) (vs adults (25–49 years), (aOR) = 3.48, [95% CI 2.16 -5.83]), adolescents (10–19 years) (vs adults (25–49 years), aOR = 2.76, [95% CI 2.11–3.72]) and children (0–9 years) (vs adults (25–49 years), aOR = 1.51, [95% CI 1.03–2.22]) were at risk of VL non-suppression.ConclusionClose to 90% suppression in routine VL shows that Zimbabwe is on track to reach the third UNAIDS target. Strategies to improve the identification of clients with high routine VL results for repeating testing after EAC and ART adherence in subpopulations (men, adolescents and young adolescents) at risk of viral non-suppression should be prioritised.
Short-term temporal analysis and children's knowledge of the composition of important medicinal plants: the structural core hypothesis
Authors: Sousa Daniel Carvalho Pires , Ferreira Júnior Washington Soares , Albuquerque Ulysses Paulino 
Published: July 2022

Abstract
Background
Measures of the importance of medicinal plants have long been used in ethnobotany and ethnobiology to understand the influence of social-ecological system factors in the formation of individuals’ differential knowledge and use. However, there is still a gap in empirical studies that seek to understand the temporal aspects of this process.

Methods
To overcome this issue, we used the concept of the structural core of medicinal plants, a theoretical-evolutionary model, which argues that the importance of medicinal plant resources is related to the increase in individual and population fitness. It represents the set of the most effective and available resources that would treat the most common diseases in an environment. This composition of knowledge would be conservative over space and time. To test these questions, we hypothesized that the composition of the structural core remains constant during temporal changes in a social-ecological context, and that the composition of the infantile structural core (new generation) is similar to that of the adults (older generation). For 2 years, we tracked the structure of important medicinal plants among the same 49 residents of a community located in Vale do Catimbau in Pernambuco, Brazil. We also compared the importance of the medicinal plants among two different generations, children/adolescents and adults, in the same space/time context.

Results and Conclusion
Our results refuted both hypotheses. Regarding the composition of important medicinal plants through temporal variations and for children's learning, our results were not predicted by the model. This suggests that the structural core should not be regarded as a conservative phenomenon, but rather a congenital, dynamic, and plastic occurrence that has adapted to configure itself as a short-term population response to the treatment of local diseases.
An observational, non-interventional study for the follow-up of patients with amyloidosis who received miridesap followed by dezamizumab in a phase 1 study
Authors: Richards Duncan , Millns Helen , Cookson Louise , Lukas Mary Ann 
Published: July 2022

Abstract
Background
Miridesap depletes circulating serum amyloid P (SAP) and dezamizumab (anti-SAP monoclonal antibody) targets SAP on amyloid deposits, triggering amyloid removal. In a phase 1, first-in-human study (FIHS), progressive amyloid removal was observed in some patients after ≤ 3 cycles of miridesap/dezamizumab.

Methods
This observational, non-interventional study in patients who received miridesap/dezamizumab during the FIHS (planned follow-up: 5 years) evaluated response to treatment based on routine assessments of disease status and key organ function. In a post hoc analysis, patients responding to treatment in the FIHS during follow-up were identified as responders and further categorized as sustained or declining responders.

Results
In the FIHS, 17/23 patients were treatment responders. Of these patients, seven (immunoglobulin light chain [AL], n = 6; serum amyloid A, n = 1) were considered sustained responders and ten (fibrinogen-a alpha chain [AFib], n = 5; AL, n = 4; apolipoprotein A-I, n = 1) were considered declining responders. We primarily present responder patient-level data for functional, cardiac, laboratory and imaging assessments conducted during the follow-up period, with non-responder data presented as supplementary.

Conclusion
No further development of miridesap/dezamizumab is planned in amyloidosis. However, long-term follow-up of these patients may provide insight into whether active removal of amyloid deposits has an impact on disease progression.

Trial registration

ClinicalTrials.gov, NCT01777243. Registered 28 January 2013, https://clinicaltrials.gov/ct2/show/study/NCT01777243.
Evaluation of antiplasmodial activity in silico and in vitro of N-acylhydrazone derivatives
Authors: Oliveira Fernanda A. , Pinto Ana Claudia S. , Duarte Caique L. , Taranto Alex G. , Lorenzato Junior Eder , Cordeiro Cleydson Finotti , Carvalho Diogo T. , Varotti Fernando P. , Fonseca Amanda L. 
Published: July 2022

AbstractN-acylhydrazones are considered privileged structures in medicinal chemistry, being part of antimicrobial compounds (for example). In this study we show the activity of N-acylhydrazone compounds, namely AH1, AH2, AH4, AH5 in in vitro tests against the chloroquine-resistant strain of Plasmodium falciparum (W2) and against WI26 VA-4 human cell lines. All compounds showed low cytotoxicity (LC50 > 100 µM). The AH5 compound was the most active against Plasmodium falciparum, with an IC50 value of 0.07 μM. AH4 and AH5 were selected among the tested compounds for molecular docking calculations to elucidate possible targets involved in their mechanism of action and the SwissADME analysis to predict their pharmacokinetic profile. The AH5 compound showed affinity for 12 targets with low selectivity, while the AH4 compound had greater affinity for only one target (3PHC). These compounds met Lipinski's standards in the ADME in silico tests, indicating good bioavailability results. These results demonstrate that these N-acylhydrazone compounds are good candidates for future preclinical studies against malaria.
Graphical Abstract
Multiple fluctuating targets track-before-detect using multi-Bernoulli filter in radar sensor
Authors: Li Dongsheng , Wu Sunyong , Deng Honggao , Sun Xiyan , Cai Ruhua 
Published: July 2022

AbstractThis paper addresses the detection and tracking of multiple fluctuating targets for a track-before-detect algorithm based on the Multi-Bernoulli (MB-TBD) filter in surveillance radar systems. MB-TBD usually considers target amplitude information and ignores the fact that radar measurements are complex-valued. In this paper, we first propose to utilize phase information to improve the discrimination of targets from noise. More precisely, complex likelihood ratios are used instead of squared modulus measurements likelihood ratios for fluctuations of types Swerling 0, 1, 3. Secondly, the traditional MB-TBD filter cannot solve the problem of coexistence between targets with stronger amplitude and weaker amplitude when multiple fluctuating targets are moving. To address this limitation, an adaptive birth distribution based on joint successive target cancellation and measurement likelihood ratio driven is proposed. Moreover, in order to reduce computational complexity, the Bernoulli components of the same targets are merged after the MB-TBD updating. Finally, the proposed algorithm is implemented using Sequential Monte Carlo technology. The simulation results show that in challenging scenarios, the performance of the improved algorithm is better than the traditional algorithm, and it has a good application prospect.