bluuebunny/crossref_metadata_2025_split huggingface dataset:
The direct cost of dialysis supported by families for patients with chronic renal failure in Ouagadougou (Burkina Faso)
Authors: Toure Amadou Oury , Balde Mamadou Dioulde , Diallo Aissatou , Camara Sadan , Soumah Anne Marie , Sall Alpha Oumar , Kourouma Karifa , Camara Bienvenu Salim , Bocoum Fadima Yaya , Kouanda Seni 
Published: June 2022

Abstract
Background
Chronic renal failure can lead to dialysis and/or a kidney transplant in the final stage. The number of patients under dialysis has increased considerably in the world and particularly in sub-Saharan Africa. Dialysis is a very expensive care. This is the reason why this study on the costs of dialysis management was initiated in Burkina Faso. The objective of the study is to determine the direct medical and non-medical costs of managing chronic renal failure among dialysis patients in Ouagadougou in 2020.

Methods
An analytical cross-sectional study was conducted. Data were collected in the hemodialysis department of three public university hospitals in Ouagadougou, Burkina Faso. All dialysis patients with chronic renal failure were included in the study. Linear regression was used to investigate the determinants of the direct medical and non-medical cost of hemodialysis.

Results
A total of 290 patients participated in this study, including children, adults, and the elderly with extremes of 12 and 82 years. Almost half of the patients (47.5%) had no income. The average monthly total direct cost across all patients was 75842 CFA or US$134.41.The average direct medical cost was 51315 CFA or US$90.94 and the average direct non-medical cost was 24 527 CFA or US$43.47. Most of the patients (45.2%) funded their hemodialysis by their own source.
The multivariate analysis showed that the presence of an accompanying person during treatment, residing in a rural area, ambulatory care, use of personal cars, and treatment at the dialysis center of Yalgado Teaching Hospital were associated with higher direct costs.

Conclusion
The average cost of dialysis services borne by the patient and his family is very high in Burkina Faso, since it is 2.1 times higher than the country's minimum interprofessional wage (34664 CFA or US$61.4). It appears that the precariousness of the means of subsistence increases strongly with the onset of chronic renal failure requiring dialysis. Thus, to alleviate the expenses borne by dialysis patients, it would be important to extend the government subsidy scheme to the cost of drugs and to promote health insurance to ensure equitable care for these patients.
Identification and clinical validation of NUSAP1 as a novel prognostic biomarker in ovarian cancer
Authors: Gou Rui , Zheng Mingjun , Hu Yuexin , Gao Lingling , Wang Shuang , Liu Ouxuan , Li Xiao , Zhu Liancheng , Liu Juanjuan , Lin Bei 
Published: June 2022

AbstractBackgroundNucleolar and spindle-associated protein 1 (NUSAP1) was shown to be involved in cell cycle regulation in cancer. However, its prognostic value and underlying mechanism in ovarian cancer remain unclear.MethodsOncomine, TCGA, CCLE, and UALCAN databases were used to analyze the expression level of NUSAP1 in ovarian cancer. The Kaplan–Meier plotter database was used to evaluate its prognostic value. The results from these analyses were further validated using immunohistochemical assay. The potential molecular mechanism ofNUSAP1in ovarian cancer was assessed with respect to homologous recombination repair, mismatch repair, and immunology using different databases.ResultsDatabase analyses and experimental results demonstrated that NUSAP1 was highly expressed in ovarian cancer, its levels being correlated with the FIGO stage. High NUSAP1 expression was an independent risk factor affecting the prognosis of patients with epithelial ovarian cancer. Moreover,NUSAP1was associated with cell cycle, DNA replication, homologous recombination, and p53 signaling pathway. A positive correlation was identified between the expression ofNUSAP1andBRCA1/2in ovarian cancer. In addition,NUSAP1was associated with the expression of DNA mismatch repair genes and immune cell infiltration.ConclusionsNUSAP1 may be a valuable prognostic marker, as well as a novel biomarker for evaluating the response to immunotherapy of patients with ovarian cancer.
Brachial flow—mediated dilation and carotid intima—media thickness in glaucoma patients
Authors: Bojic Lovro , Rogosic Veljko , Markovic Domagoj , Rogosic Lucija Vanjaka , Glavas Duska 
Published: June 2022

Abstract
Background
The purpose of the study was to assess the ultrasound measurements of the brachial artery flow-mediated dilation (FMD) and carotid artery intima-media thickness (IMT) and their relationship in glaucoma patients.

Methods
Thirty-seven patients with glaucoma and thirty-one healthy controls were included in the study. All glaucoma patients and controls underwent ultrasound measurement of FMD of the brachial artery and ultrasound measurement of IMT of the carotid artery.

Results
The mean values of brachial FMD were significantly lower among the glaucoma compared with controls (16.4 ± 10.6% vs 20.3 ± 8.5%, p = 0.034). No significant difference was found in carotid IMT (1.2 ± 0.4 vs. 1.1 ± 0.4, p = 0.3), and brachial artery diameter at rest (4.7 ± 0.6 vs. 4.9 ± 0.3, p = 0.2) between the glaucoma patients and controls. The significant difference in brachial artery diameter in hyperemia between the glaucoma patients and controls (5.5 ± 0.6 vs. 5.9 ± 0.4 p = 0.002) was found. A negative correlation among brachial FMD and carotid IMT as well as among brachial FMD and brachial artery diameter at rest was found.

Conclusions
Impaired brachial FMD indicates presence of systemic vascular endothelial dysfunction in glaucoma; glaucoma patients with lower values of the brachial FMD are at increased risk of having thickened carotid IMT.
LUNCH—Lung Ultrasound for early detection of silent and apparent aspiratioN in infants and young CHildren with cerebral palsy and other developmental disabilities: study protocol of a randomized controlled trial
Authors: Fiori S , Scaramuzzo RT , Moretti E , Amador C , Controzzi T , Martinelli A , Filippi L , Guzzetta A , Gargagni L 
Published: June 2022

Abstract
Background
Children with neurological impairment may have dysphagia and/or gastro-esophageal reflux disease (GERD), which predispose to complications affecting the airways, increasing risk for aspiration-induced acute and chronic lung disease, or secondarily malnutrition, further neurodevelopmental disturbances, stressful interactions with their caregivers and chronic pain. Only multidisciplinary clinical feeding evaluation and empirical trials are applied to provide support to the management of feeding difficulties related to dysphagia or GERD, but no standardized feeding or behavioral measure exists at any age to assess aspiration risk and support the indication to perform a videofluoroscopic swallowing study (VFSS) or a fibre-optic endoscopic examination of swallowing (FEES), in particular in newborns and infants with neurological impairments. Lung ultrasound (LUS) has been proposed as a non-invasive, radiation-free tool for the diagnosis of pulmonary conditions in infants, with high sensitivity and specificity.

Methods
A RCT will be conducted in infants aged between 0 and 6 years having, or being at risk for, cerebral palsy, or other neurodevelopmental disease that determines abnormal muscular tone or motor developmental delay assessed by a quantitative scale for infants or if there is the suspicion of GERD or dysphagia based on clinical symptoms. Infants will be allocated in one of 2 groups: 1) LUS-monitored management (LUS-m); 2) Standard care management (SC-m) and after baseline assessment (T0), both groups will undergo an experimental 6-months follow-up. In the first 3 months, infants will be evaluated a minimum of 1 time per month, in-hospital, for a total of 3 LUS-monitored meal evaluations. Primary and secondary endpoint measures will be collected at 3 and 6 months.

Discussion
This paper describes the study protocol consisting of a RCT with two main objectives: (1) to evaluate the benefits of the use of LUS for monitoring silent and apparent aspiration in the management of dysphagia and its impact on pulmonary illness and growth and (2) to investigate the impact of the LUS management on blood sample and bone metabolism, pain and interaction with caregivers.

Trial registration
Trial registration date 02/05/2020; ClinicalTrials.gov Identifier: NCT04253951.
Exploring the facilitators and barriers to high-risk behaviors among school transportation drivers: a qualitative study
Authors: Fathizadeh Shadi , Karimy Mahmood , Tavousi Mahmoud , Zamani-Alavijeh Fereshteh 
Published: June 2022

Abstract
Background
School transportation (ST) crashes are associated with serious adverse consequences, particularly for students in developing countries. High-risk behaviors (HRBs) of ST drivers are a major factor contributing to ST crashes. This study aimed at exploring the facilitators and barriers to HRBs among ST drivers.

Methods
This qualitative study was conducted in 2019–2020. Participants were ST drivers, students, parents, and school staff purposively selected from Tehran, Iran. Data were collected through in-depth semi-structured interviews and focus group discussions and were concurrently analyzed through conventional content analysis.

Findings
Participants were fifteen ST drivers with a mean age of 45 ± 10.2 years and 24 students, parents, and school staff with a mean age of 28.62 ± 16.08 years. The facilitators and barriers to HRBs came into five main categories, namely previous experiences of HRBs, perceived gains and risks of HRBs, motivating and inhibiting feelings and emotions, positive and negative subjective norms, and perceived mastery in driving.

Conclusion
A wide range of facilitators and barriers can affect HRBs among ST drivers. Strategies for preventing HRBs among ST drivers should be multidimensional and individualized and should focus on strengthening the barriers and removing the facilitators to HRBs.
A scoping review of strategies to support public health recovery in the transition to a “new normal” in the age of COVID-19
Authors: Belita Emily , Neil-Sztramko Sarah E. , Miller Alanna , Anderson Laura N. , Apatu Emma , Bellefleur Olivier , Kapiriri Lydia , Read Kristin , Sherifali Diana , Tarride Jean-Éric , Dobbins Maureen 
Published: June 2022

AbstractBackgroundDuring the COVID-19 pandemic, the public health workforce has experienced re-deployment from core functions such as health promotion, disease prevention, and health protection, to preventing and tracking the spread of COVID-19. With continued pandemic deployment coupled with the exacerbation of existing health disparities due to the pandemic, public health systems need to re-start the delivery of core public health programming alongside COVID-19 activities. The purpose of this scoping review was to identify strategies that support the re-integration of core public health programming alongside ongoing pandemic or emergency response.MethodsThe Joanna Briggs Institute methodology for scoping reviews was used to guide this study. A comprehensive search was conducted using: a) online databases, b) grey literature, c) content experts to identify additional references, and d) searching reference lists of pertinent studies. All references were screened by two team members. References were included that met the following criteria: a) involved public health organizations (local, regional, national, and international); b) provided descriptions of strategies to support adaptation or delivery of routine public health measures alongside disaster response; and c) quantitative, qualitative, or descriptive designs. No restrictions were placed on language, publication status, publication date, or outcomes. Data on study characteristics, intervention/strategy, and key findings were independently extracted by two team members. Emergent themes were established through independent inductive analysis by two team members.ResultsOf 44,087 records identified, 17 studies were included in the review. Study designs of included studies varied: descriptive (n = 8); qualitative (n = 4); mixed-methods (n = 2); cross-sectional (n = 1); case report (n = 1); single-group pretest/post-test design (n = 1). Included studies were from North America (n = 10), Africa (n = 4), and Asia (n = 3) and addressed various public health disasters including natural disasters (n = 9), infectious disease epidemics (n = 5), armed conflict (n = 2) and hazardous material disasters (n = 1). Five emergent themes were identified on strategies to support the re-integration of core public health services: a) community engagement, b) community assessment, c) collaborative partnerships and coordination, d) workforce capacity development and allocation, and e) funding/resource enhancement.ConclusionEmergent themes from this study can be used by public health organizations as a beginning understanding of strategies that can support the re-introduction of essential public health services and programs in COVID-19 recovery.
Ultrasonographic assessment of entheseal sites of upper and lower extremities in hemodialysis patients using Madrid Sonography Enthesitis Index
Authors: Sabry Reham , Tharwat Samar , Nassar Mohammed Kamal , Eltoraby Ehab E. 
Published: June 2022

Abstract
Background
There is no much information about the entheseal involvement among hemodialysis (HD) patients. The aim of this study was to assess the frequency and distribution of ultrasonographic (US) entheseal alterations in HD patients and to evaluate the association between US abnormalities and both clinical and laboratory data.

Methods
This study was conducted on 41 HD patients and 23 sex- and age- matched controls. All participants were evaluated clinically for any signs of enthesopathy. Six entheses sites were scanned bilaterally using grey scale (GS) and power Doppler (PD) US and were scored using Madrid Sonography Enthesitis Index (MASEI) scoring system.

Results
In HD patients, at least one clinical sign suggestive of enthesopathy was found in 69 (14%) of 492 entheses. HD patients had statistically significant higher scores of structural tendon abnormalities (p < 0.001), enthesis thickening (p < 0.001), bone erosions (p < 0.001) and calcification (p = 0.037) than the healthy controls. Total MASEI score was higher in HD patients than healthy controls (median;18 vs 8, p < 0.001), also, MASEI-inflammatory (median;11 vs 3, p < 0.001) and damage scores (median;6 vs 0, p < 0.001). There was a statistically significant positive association between total MASEI score and both age (p = 0.032) and duration of HD (p = 0.037). Duration of HD was predictive for both MASEI-damage component (p = 0.004) and total MASEI score (p = 0.014).

Conclusion
There is a high prevalence of subclinical enthesopathy in HD patients. The entheseal US alterations is much higher in HD patients than in healthy subjects. The duration of HD is the significant predictor of enthesopathy in HD patients.
Long-term patient satisfaction and removal rate after essure sterilization: a follow-up study
Authors: Žegura Andrić Branka , Rosič Maja , Serdinšek Tamara , Šumak Rok 
Published: June 2022

Abstract
Background
The objective of our study was to assess the rate and causes for Essure® micro-insert system removal and patients’ long term satisfaction rate with the procedure.

Methods
All patients who underwent Essure® hysteroscopic sterilization at our tertiary centre between years 2007 and 2018 were included in this follow-up study. A questionnaire was sent to all patients per standard mail. Patients who did not respond to questionnaires per mail, were called by phone. The satisfaction with the Essure® sterilization, as well as any additional procedures after the insertion or insertion-related complications were analysed.

Results
From the year 2007 to 2018, we performed 427 Essure® hysteroscopic sterilizations and of these, 329 patients responded to the questionnaire (response rate 77%). Ten patients (3%) had Essure® removal, two of them due to pain (0.6%). Patients were very satisfied with the procedure (9.5 on scale 0–10). Most patients (95.3%) would recommend the procedure to their friend.

Conclusions
Essure® hysteroscopic sterilization is a procedure with a very high satisfaction rate and a very low removal rate due to sterilization-related complications.
Trial registration Institutional review board of University medical centre Maribor approved the study, approval number UKC-MB-KME-73/19.
Ellagic acid effects on testis, sex hormones, oxidative stress, and apoptosis in the relative sterility rat model following busulfan administration
Authors: Rostami Amirabbas , Vakili Sina , Koohpeyma Farhad , Jahromi Bahia Namavar , Aghajari Ziba Afshari , Mahmoudikohani Fatemeh , Saki Forough , Mahmoodi Marzieh , Jaberi Khojaste Rahimi , Movahedpour Ahmad , Khorchani Majid Jafari , Noroozi Saam 
Published: June 2022

Abstract
Background
Busulfan is an antineoplastic medication that is broadly utilized for cancer treatment. It affects the testicular function and leads to sterility. The present study aimed to evaluate the effects of ellagic acid on testicular tissue changes, sexual hormones, antioxidant defense system, and caspase-9 and Bcl2 gene expression in the busulfan-induced relative sterile rat model.

Methods
This is an interventional-experimental animal study that was performed on 65 Adult male rats; they were randomly divided into five groups including control (1 ml of 0.9% normal saline), ellagic acid (50 mg/kg); busulfan (10 mg/kg); and busulfan plus ellagic acid (10 mg/kg and 50 mg/kg). At the end of the experiment, blood samples were collected, and plasma levels of sex hormones, antioxidant system, apoptosis-related genes, and testis histology were assessed.

Results
Busulfan reduced the levels of serum testosterone, total antioxidant capacity, gene expression of Bcl2, testicular volume, seminiferous tubule, germinal epithelium, interstitial tissue volume, and the number of spermatogonia, spermatocyte, round spermatid, elongated spermatid, Sertoli cells and Leydig cells (p < 0.05). Busulfan administration resulted in a significant increase (p < 0.05) in the level of LH, FSH, malondialdehyde, and caspase 9. Busulfan + ellagic acid (50 mg/kg) showed higher serum levels of testosterone, gene expression of Bcl-2 and antioxidant markers, and lower LH, FSH levels, and gene expression of caspase 9 compared to the Busulfan-treated rats (p < 0.05). Stereological parameters were also ameliorated in the group treated with Busulfan+ 50 mg/kg ellagic acid (p < 0.05).

Conclusion
In conclusion, the consumption of ellagic acid may have beneficial effects on the antioxidant defense system, sexual hormone abnormality, and testicular tissue damage induced by busulfan.
Comparison between two asynchronous teaching methods in an undergraduate dental course: a pilot study
Authors: Alharbi Fahad , Alwadei Saleh H. , Alwadei Abdurahman , Asiri Saeed , Alwadei Farhan , Alqerban Ali , Almuzian Mohammed 
Published: June 2022

Abstract
Background
Properly designed and implemented eLearning can lead to improvement of dental teaching quality. Various strategies have been proposed to increase the effectiveness of eLearning in dental education, however, there is a lack of research to assess the effectiveness of these strategies.

Objective
To investigate dental students’ learning performance and perception of a virtual flipped learning format compared to a virtual traditional learning method.

Methods
A crossover pilot study was conducted at the College of Dentistry, Princes Sattam Bin Abdulaziz University, Saudi Arabia. Computer-generated randomization, blinded from researchers who analyzed the results, was performed to allocate 32 participants (aged 23.27 ± 0.86 years) to one of two groups. Participants in the control group were taught through the virtual traditional learning method (VTL) using live video lectures. In contrast, participants in the intervention group were taught through the virtual flipped learning method (VFL) using recorded online lectures and post-lecture virtual discussions. Learning gain and preference were measured by pre- and post-test average score differences and a modified validated survey, respectively.

Results
There was no significant difference in learning performance between VFL and VTL groups (P > 0.05). However, students preferred VFL over VTL and the differences were significant among all survey items, except for the opportunity to ask questions.

Conclusion
Health professions educators are encouraged to carefully design online curricula with efficient learning strategies that help students improve learning performance and foster self-directed learning skills while valuing active learning in an online environment.

Trial registration
NCT04692142, 31/12/2020.
Assessed and discharged – diagnosis, mortality and revisits in short-term emergency department contacts
Authors: Al-Mashat Hassan , Lindskou Tim A. , Møller Jørn M. , Ludwig Marc , Christensen Erika F. , Søvsø Morten B. 
Published: June 2022

Abstract
Background
Emergency departments (EDs) experience an increasing number of patients. High patient flow are incentives for short duration of ED stay which may pose a challenge for patient diagnostics and care implying risk of ED revisits or increased mortality. Four hours are often used as a target time to decide whether to admit or discharge a patient.

Objective
To investigate and compare the diagnostic pattern, risk of revisits and short-term mortality for ED patients with a length of stay of less than 4 h (visits) with 4–24 h stay (short stay visits).

Methods
Population-based cohort study of patients contacting three EDs in the North Denmark Region during 2014–2016, excluding injured patients. Main diagnoses, number of revisits within 72 h of the initial contact and mortality were outcomes. Data on age, sex, mortality, time of admission and ICD-10 diagnostic chapter were obtained from the Danish Civil Registration System and the regional patient administrative system. Descriptive statistics were applied and Kaplan Meier mortality estimates with 95% CI were calculated.

Results
Seventy-nine thousand three hundred forty-one short-term ED contacts were included, visits constituted 60%. Non-specific diagnoses (i.e. symptoms and signs and other factors) were the most frequent diagnoses among both visits and short stay visits groups (67% vs 49%). Revisits were more frequent for visits compared to short stay visits (5.8% vs 4.2%). Circulatory diseases displayed the highest 0–48-h mortality within the visits and infections in the short stay visits (11.8% (95%CI: 10.4–13.5) and (3.5% (95%CI: 2.6–4.7)). 30-day mortality were 1.3% (95%CI: 1.2–1.5) for visits and 1.8% (95%CI: 1.7–2.0) for short stay visits. The 30-day mortality of the ED revisits with an initial visit was 1.0% (0.8–1.3), vs 0.7% (0.7–0.8) for no revisits, while 30-day mortality nearly doubled for ED revisits with an initial short stay visit (2.5% (1.9–3.2)).

Conclusions
Most patients were within the visit group. Non-specific diagnoses constituted the majority of diagnoses given. Mortality was higher among patients with short stay visits but increased for both groups with ED revisits. This suggest that diagnostics are challenged by short time targets.