bluuebunny/crossref_metadata_2025_split huggingface dataset:
Contribution of community health workers to the treatment of common illnesses among under 5-year-olds in rural Uganda
Authors: Bagenda Fred , Wesuta Andrew Christopher , Stone Geren , Ntaro Moses , Patel Palka , Kenney Jessica , Baguma Stephen , Ayebare David Santson , Bwambale Shem , Matte Michael , Kawungezi Peter Chris , Mulogo Edgar Mugema 
Published: October 2022

Abstract
Background
The control of malaria, pneumonia, and diarrhoea is important for the reduction in morbidity and mortality among children under 5 years. Uganda has adopted the Integrated Community Case Management strategy using Community Health Workers (CHWs) to address this challenge. The extent and trend of these three conditions managed by the CHWs are not well documented. This study was done to describe the epidemiology and trends of the three common illnesses treated by the CHWs in Bugoye Sub-County in rural Uganda.

Methods
A retrospective review of monthly morbidity data for children less than 5 years of age for the period April 2014–December 2018 for CHWs in rural Bugoye Sub-County in Kasese district, Uganda was done. The total number reviewed was 18,430 records. The data were analysed using STATA version 14.

Results
In total male were 50.2% of the sample, pneumonia was the highest cause of illness among the infants (< 1 year), while malaria was the highest among the children 1 year–59 months. Infection with a single illness was the commonest recorded cause of presentation but there were some children recorded with multiple illnesses. All the CHWs were managing the three common illnesses among children under 5 years. The trend of the three common illnesses was changing from malaria to pneumonia being the commonest. Children aged 12–24 months and 25–59 months were at 2.1 times (95% CI 1.7–2.4) and 5.2 times (95% CI 4.6–5.9), respectively, more likely to get malaria but less likely to get pneumonia and diarrhoea.

Conclusion
Community Health Workers in rural Uganda are contributing significantly to the management of all the three commonest illnesses among under-5 years-old children. The trend of the commonest illness is changing from malaria to pneumonia. Children under 1 year are at a higher risk of getting pneumonia and diarrhoea and at a lower risk of getting malaria.
Malaria surveillance and case management in remote and indigenous communities of Panama: results from a community-based health worker pilot
Authors: Bhavnani Darlene , García Espinosa Bernardo , Baird Madeline , Presley Nicholas , Le Menach Arnaud , Bradley Christina , Outten Marcela , González Oscar 
Published: October 2022

Abstract
Background
Panama is one of eight countries in Mesoamerica that aims to eliminate malaria by 2022. Malaria is concentrated in indigenous and remote regions like Guna Yala, a politically autonomous region where access to health services is limited and cases are predominately detected through intermittent active surveillance. To improve routine access to care, a joint effort was made by Guna Yala authorities and the Ministry of Health to pilot a network of community health workers (CHWs) equipped with rapid diagnostic tests and treatment. The impact of this pilot is described.

Methods
Access to care was measured using the proportion of villages targeted by the effort with active CHWs. Epidemiological impact was evaluated through standard surveillance and case management measures. Tests for differences in proportions or rates were used to compare measures prior to (October 2014-September 2016) and during the pilot (October 2016-September 2018).

Results
An active CHW was placed in 39 (95%) of 41 target communities. During the pilot, CHWs detected 61% of all reported cases from the region. Test positivity in the population tested by CHWs (22%) was higher than in those tested through active surveillance, both before (3.8%) and during the pilot (2.9%). From the pre-pilot to the pilot period, annual blood examination rates decreased (9.8 per 100 vs. 8.0 per 100), test positivity increased (4.2% to 8.5%, Χ2 = 126.3, p < 0.001) and reported incidence increased (4.1 cases per 1000 to 6.9 cases per 1000 [Incidence Rate Ratio = 1.83, 95% CI 1.52, 2.21]). The percent of cases tested on the day of symptom onset increased from 8 to 27% and those treated on the day of their test increased from 26 to 84%.

Conclusions
The CHW network allowed for replacement of routine active surveillance with strong passive case detection leading to more targeted and timely testing and treatment. The higher test positivity among those tested by CHWs compared to active surveillance suggests that they detected cases in a high-risk population that had not previously benefited from access to diagnosis and treatment. Surveillance data acquired through this CHW network can be used to better target active case detection to populations at highest risk.
Longitudinal assessment of preparation for care transition among adolescents and young adults with rheumatologic disease: a single-center pilot study
Authors: Roberts Jordan E. , Halyabar Olha , Petty Carter R. , Alfieri Maria , Esty Brittany , Dallas Johnathan , Hazen Melissa , Stein Sandra , Son Mary Beth F. 
Published: October 2022

AbstractAdolescents and young adults (AYA) with rheumatologic diseases are at high risk for poor outcomes and gaps in care when transitioning from pediatric to adult care. However, tools for evaluating transition readiness and assessing the impact of transition interventions are limited. We implemented a written transition policy at our pediatric rheumatology center and evaluated preparation for transition among AYA 16 and older before and after distribution. 31 of 77 patients completed the follow-up survey (response rate 40%). Patient report of transition counseling increased following written transition policy implementation, though these results were not statistically significant in our small cohort. Most follow-up respondents (n = 19, 61%) had not yet completed care transfer; 4 (13%) had arranged a visit with an adult rheumatologist and 8 (26%) had fully transitioned to adult care. Those who successfully completed care transfer were older, had completed higher levels of education, and had significantly higher baseline transition preparation scores compared to those with no transfer arranged or planned visit only. Our single-center pilot study demonstrated that longitudinal assessment of transition preparation is feasible and that scores are significantly associated with care transfer outcomes. Tracking transition preparation over time may provide practices with information on areas of highest need for transition guidance and predict successful transfer among AYA with rheumatologic disease.
‘Choice should be made through… educated decisions not regressive dictates’: discursive framings of a proposed ‘sugar tax’ in Bermuda: analysis of submissions to a government consultation
Authors: Williams Sarah , Hill Sarah E. , Oyebode Oyinlola 
Published: October 2022

AbstractBackgroundSeveral governments have introduced taxes on products with high sugar content as part of their obesity prevention strategies. Bermuda is the first jurisdiction to apply such measures in the Caribbean – a region of small island developing states and territories with high obesity prevalence and substantial reliance on imported food products. This study examines how commercial and health actors framed the proposed introduction of a 75% import tariff on high-sugar products, based on written submissions to the Bermudan government.MethodsEleven submissions containing written comments were analysed with reference to their framing of the proposed import tariff, the ‘problem’ of obesity, and the relationship between the two (including alternative policy approaches for tackling obesity).ResultsKey emergent frames werecomplexity,partnership,products,personal responsibility,affordabilityandevidence. Respondents favoured different framings, depending on whether they supported or opposed the proposed import duty. Commercial actors were universally opposed, presenting obesity as a ‘complex’ problem that would be better addressed through government-industry partnerships (a framing particularly favoured by international and regional business associations). Increased product range and an emphasis on personal responsibility were also positioned as policy alternatives. Health actors expressed partial support for the proposed sugar tax, although this was tempered by a perceived lack of evidence where the proposal differed from sugar taxes introduced elsewhere. Like commercial respondents, health actors framed obesity as a ‘complex’ problem and emphasised the need for other measures, including efforts to address the affordability of fruits and vegetables.ConclusionIn responding to a proposed ‘sugar tax’ in Bermuda, commercial actors opposed the proposal and stated a clear preference for ‘partnership’ approaches to tackling obesity. Commercial responses were dominated by local businesses (with only two responses received from international or regional business associations), perhaps reflecting Bermuda’s reliance on tourism and hospitality and the specificity of the proposed intervention (that is, an import tariff rather than an excise tax). The much smaller number of responses from health actors suggests limited civil society capacity. Nevertheless, the Bermudan government successfully introduced a 75% tariff on high-sugar imports, demonstrating the potential for policy innovation to address obesity in small-island jurisdictions.
Dosimetric evaluation of VMAT and helical tomotherapy techniques comparing conventional volumes with clinical target volumes based on new ESTRO ACROP post-mastectomy with immediate implant reconstruction contouring guidelines
Authors: Göksel Evren Ozan , Tezcanli Evrim , Arifoğlu Alptekin , Küçücük Halil , Şenkesen Öznur , Abacıoğlu Ufuk , Aslay Işık , Şengöz Meriç 
Published: October 2022

Abstract
Background
The ESTRO-ACROP Consensus Guideline (EACG) recommends implant excluded clinical target volume (CTVp) definitions for post-mastectomy radiation therapy after implant-based immediate breast reconstruction (IBR). The purpose of this study is to investigate the effectiveness of Helical Tomotherapy (HTp) and Volumetric Modulated Arc Therapy (VMATp) treatment techniques in terms of CTVp coverage and reduced organ at risk (OAR), normal tissue and implant doses when CTVp was used for treatment planning as the target structure instead of conventional CTV.

Methods
Eight left-sided and eight right-sided breast cancer patients who underwent IBR after mastectomy were included in this study. Planning CT data sets were acquired during free breathing and patients were treated with HT technique targeted to conventional CTV. Retrospectively, CTVp was delineated based on EACG by the same radiation oncologist, and treatment plans with HTp and VMATp techniques were generated based on CTVp. For each patient, relevant dosimetric parameters were obtained from three different treatment plans.

Results
There was no statistically significant difference on target coverage in terms of, PTVp-D95, PTVp-Vpres, homogeneity index (p > 0.05) between HTp and VMATp plans. But, the conformity numbers were significantly higher (HTp vs VMATp, 0.69 ± 0.15 vs 0.79 ± 0.12) for VMATp (Z = − 2.17, p = 0.030). While HTp significantly lowered Dmax and Dmean for LAD (LAD-Dmax: χ2 = 12.25, p = 0.002 and LAD-Dmean: χ2 = 12.30, p = 0.002), neither HTp nor VMATp could reduce maximum and mean dose to heart (p > 0.05). Furthermore, heart volume receiving 5 Gy was significantly higher for VMATp when compared to HTp (21.2 ± 9.8 vs 42.7 ± 24.8, p: 0.004). Both techniques succeeded in reducing the mean dose to implant (HTp vs HT, p < 0.001; VMATp vs HT, p < 0.001; VMATp vs HTp, p = 0.005).

Conclusion
Both HTp and VMATp techniques succeeded to obtain conformal and homogeneous dose distributions within CTVp while reducing the mean implant dose. HTp was found to be superior to VMATp with regards to lowering all OAR doses except for CB.
Reducing global health inequalities for a rare disorder: evaluating the international Prader–Willi Syndrome Organisation’s Echo® programme
Authors: Rujeedawa Tanzil , McNairney Nora , Cordner Shelly , O’Brien James , Loughnan Georgina , Holland Anthony 
Published: October 2022

Abstract
Background
People with rare disorders face significant global health inequalities; the challenge is how to raise awareness and develop a nucleus of experts in a country who are then able to provide guidance to others in that country. The International Prader–Willi Syndrome Organisation (IPWSO) established Project ECHO® with the aim of facilitating the sharing of knowledge and the building of international partnerships to reduce global health inequalities for a particular rare genetically-determined neurodevelopmental disorder, Prader–Willi Syndrome (PWS). Four different ECHO programmes were established for the following groups: (a) Individuals (usually parents) who had taken on a leadership role in their country; (b) health professionals interested in PWS; (c) professional care providers supporting children and adults with PWS; and (d) a Latin American ECHO in Spanish. The programme started in 2020 and an evaluation was undertaken after one year to determine: the extent to which IPWSO had been able to recruit and retain individuals globally; the nature and extent of any benefits gained from the sessions; and examples of how individual involvement in the programme had led to local benefits. The methods included analysing routinely kept process indicators and survey data from the attendees of one component of the programme (the Leadership ECHO), together with a qualitative analysis of survey data and recorded interviews of attendees from countries of differing socio-economic status.

Results
We describe the IPWSO ECHO programme and report on the outcomes from the evaluation of one aspect of the programme, the Leadership ECHO. Attendance of the Leadership ECHO sessions was satisfactory, with a mean of 24.7 participants, with participants attending a mean of 5.67 sessions, i.e., 30% of sessions. There was also good global reach, with individuals attending from 34 countries, although there were notable geographic regions with very limited representation. Feedback and interviews demonstrated the positive impact of the programme with some early evidence of positive developments at national level.

Conclusions
Families and professionals from countries with a range of expertise and services offered to people with PWS remained engaged throughout the ECHO programme, established networks of support and fostered the development of good practice.
Factors affecting reproductive performance in the Swedish Bernese mountain dog
Authors: Axnér Eva , Rasmus Linda Sofia , Melangen Toril 
Published: October 2022

Abstract
Background
Good reproductive performance is fundamental for the development of a breed. Previous studies have indicated that the Bernese mountain dog has a relatively high prevalence of reproductive problems such as a high prevalence of dystocia and a low mean litter size. When reproduction is impaired, selection for other traits, including improved health, will become more difficult. The aim of this study was therefore to evaluate reproductive data and factors affecting these in the Bernese mountain dog. Data collected by the Swedish Sennenhund Club during the years 2010–2020 were evaluated by statistical analyses.

Results
Information from 1287 reported matings were included with a total of 614 bitches and 399 sires. For five reported matings that did not result in a litter, there was no information about the male identity. The reported matings resulted in 798 litters (62% whelping rate) from 502 bitches and 314 males. Paternal and maternal age had a significant effect on whelping rate with a negative effect of increasing age (P < 0.01). Median litter size at birth (LSB) was 6.00 (range 0–14) and was significantly affected by both paternal (P = 0.021) and maternal age (P < 0.001). Parity affected litter size at birth with a lower litter size in 4 year old bitches giving birth to their first litter compared to bitches giving birth to their second to fourth litters. Stillbirth occurred in 51.6% of the litters with a total of 15.4% puppies being stillborn. Total puppy mortality, including stillbirth, was 19.1%. The only factor affecting stillbirth was LSB while both LSB and season affected the risk of having post-natal puppy loss in the litter. The total prevalence of caesarean sections (CS) was 33.0%. The risk of CS decreased significantly with increasing parity and increased with increasing age. The risk of CS was significantly higher for litters with 1–2 puppies compared with litters with 3–9 puppies. The coefficient of inbreeding (F) calculated on 5 generations had no effect on any of the outcomes.

Conclusions
Parity and maternal age had opposite effects on reproductive outcomes with a positive effect of parity on increasing litter size and decreasing CS rate. The proportion of unsuccessful matings was high with a negative effect of increasing age of both males and females.
Dpr10 and Nocte are required for Drosophila motor axon pathfinding
Authors: Lobb-Rabe Meike , DeLong Katherine , Salazar Rio J. , Zhang Ruiling , Wang Yupu , Carrillo Robert A. 
Published: October 2022

AbstractThe paths axons travel to reach their targets and the subsequent synaptic connections they form are highly stereotyped. How cell surface proteins (CSPs) mediate these processes is not completely understood. The Drosophila neuromuscular junction (NMJ) is an ideal system to study how pathfinding and target specificity are accomplished, as the axon trajectories and innervation patterns are known and easily visualized. Dpr10 is a CSP required for synaptic partner choice in the neuromuscular and visual circuits and for axon pathfinding in olfactory neuron organization. In this study, we show that Dpr10 is also required for motor axon pathfinding. To uncover how Dpr10 mediates this process, we used immunoprecipitation followed by mass spectrometry to identify Dpr10 associated proteins. One of these, Nocte, is an unstructured, intracellular protein implicated in circadian rhythm entrainment. We mapped nocte expression in larvae and found it widely expressed in neurons, muscles, and glia. Cell-specific knockdown suggests nocte is required presynaptically to mediate motor axon pathfinding. Additionally, we found that nocte and dpr10 genetically interact to control NMJ assembly, suggesting that they function in the same molecular pathway. Overall, these data reveal novel roles for Dpr10 and its newly identified interactor, Nocte, in motor axon pathfinding and provide insight into how CSPs regulate circuit assembly.
General control nonderepressible 1 interacts with cationic amino acid transporter 1 and affects Aedes aegypti fecundity
Authors: Pinch Matthew , Muka Theodore , Kandel Yashoda , Lamsal Mahesh , Martinez Nathan , Teixeira Marialuisa , Boudko Dmitri Y. , Hansen Immo A. 
Published: October 2022

Abstract
Background
The amino acid transporter protein cationic amino acid transporter 1 (CAT1) is part of the nutrient sensor in the fat body of mosquitoes. A member of the SLC7 family of cationic amino acid transporters, it is paramount for the detection of elevated amino acid levels in the mosquito hemolymph after a blood meal and the subsequent changes in gene expression in the fat body.

Methods
We performed a re-annotation of Aedes aegypti cationic amino acid transporters (CATs) and selected the C-terminal tail of CAT1 to perform a yeast two-hybrid screen to identify putative interactors of this protein. One interesting interacting protein we identified was general control nonderepressible 1 (GCN1). We determined the expression pattern of GCN1 in several adult organs and structures using qRT-PCR and western blots. Finally, we knocked down GCN1 using double-stranded RNA and identified changes in downstream signaling intermediates and the effects of knockdown on vitellogenesis and fecundity.

Results
In a screen for Ae. aegypti CAT1-interacting proteins we identified GCN1 as a putative interactor. GCN1 is highly expressed in the ovaries and fat body of the mosquito. We provide evidence that eukaryotic translation initiation factor 2 subunit alpha (eIF2α) phosphorylation changed during vitellogenesis and that RNA interference knockdown of GCN1 in whole mosquitoes reduced egg clutch sizes of treated mosquitoes relative to controls.

Conclusions
Aedes aegypti CAT1 and GCN1 are likely interacting partners and GCN1 is likely necessary for proper egg development. Our data suggest that GCN1 is part of a nutrient sensor mechanism in various mosquito tissues involved in vitellogenesis.

Graphical Abstract
Spontaneous rupture of a large splenic artery aneurysm in a 59-year-old male patient with pemphigus vulgaris: a case report
Authors: Hosseinzadeh Ahmad , Shahriarirad Reza , Asgharzadeh Majdazar Vahid , Moeini Farsani Mohammad , Tadayon Seyed Mohammad Kazem 
Published: October 2022

Abstract
Background
There is currently no information on the anatomical risk factors for splenic artery aneurysm rupture, specifically the location or size of the lesion; therefore, reporting this entity to obtain data and ultimately reduce morbidity and mortality is essential. Here we report a case of a male patient with spontaneous rupture of a large splenic artery aneurysm presenting with abdominal pain.

Case presentation
A 59-year middle-eastern male, with known pemphigus vulgaris presented with a chief complaint of headache and syncope, followed by abdominal pain along with severe metabolic acidosis. A contrast-enhanced computed tomography scan of the abdomen and pelvic showed a splenic artery aneurysm of 33 × 30 mm with a 150 × 90 mm hematoma formation around the aneurysm site. The patient underwent an operation and splenectomy, with confirmation of the diagnosis of ruptured splenic artery aneurysm.

Conclusion
It is essential to consider splenic aneurysm rupture as a second-line differential diagnosis, especially among patients with comorbid diseases, as this can lead to timely and appropriate lifesaving intervention.
Oscillatory and spectral properties of fourth-order differential operator and weighted differential inequality with boundary conditions
Authors: Baiarystanov Askar , Kalybay Aigerim , Oinarov Ryskul 
Published: October 2022

AbstractIn the paper, we study the oscillatory and spectral properties of a fourth-order differential operator. These properties are established based on the validity of some weighted second-order differential inequality, where the inequality’s weights are the coefficients of the operator. The inequality, in turn, is established for functions satisfying certain boundary conditions that depend on the boundary behavior of its weights at infinity and at zero.