bluuebunny/crossref_metadata_2025_split huggingface dataset:
Intravitreal aflibercept for the treatment of patients with diabetic macular edema in routine clinical practice in Latin America: the AQUILA study
Authors: Rodríguez Francisco J. , Wu Lihteh , Bordon Arnaldo F. , Charles Martin , Lee JinKyung , Machewitz Tobias , Mueller Margarete , Gay Gabriela del Carmen , Fromow-Guerra Jans ,   the AQUILA Investigators, Reinhart Marcelo , Caride Gastón Gómez , Negri Herminio , Galván Gerónimo , Irungaray Juan , Irós Mariano , Vidosevich Matko , Rivero Noe , Zompa Tamara , Francos Juan Pablo , Salgado Paula , Caceres Barrios Gerardo , Regnasco Octavio , Rodríguez Francisco J. , Piñeros Hildegard , Arias Juan , Buendia Javier , Navarro Naranjo Gustavo Adolfo , Endo Beatriz , Hernandez Myrian , Wu Lihteh , Evans Tinoco Teodoro , Garcia Gerardo , Padilla Andres , Gómez Cespedes Adriana , Dalma Jose , Cano Rene , Fromow-Guerra Jans , Saldaña Natalia , Jimenez Juan Manuel , García Franco Renata del Carmen , Solis Vivanco Adriana , Hernandez Vazquez Angeles Yael 
Published: August 2022

Abstract
Background
AQUILA (NCT03470103) was a prospective, observational, 12-month cohort study to understand treatment patterns and to evaluate the clinical effectiveness and safety of intravitreal aflibercept (IVT-AFL) in patients from Latin America with diabetic macular edema (DME).

Methods
Treatment-naïve and previously treated (switching to IVT-AFL) patients (aged ≥ 18 years) were enrolled from March 2018, with a primary completion date of September 2020, from Argentina, Colombia, Costa Rica and Mexico. Patients received IVT-AFL in a routine clinical practice setting.

Results
Of 258 patients in the full analysis set, 181 were treatment-naïve and 77 had received previous treatment. The mean ± standard deviation number of IVT-AFL injections by Month 12 was 3.7 ± 1.8 (treatment-naïve) and 4.0 ± 2.2 (previously treated). The median duration from diagnosis to IVT-AFL treatment was 1.8 months (treatment-naïve) and 16.0 months (previously treated). Mean best-corrected visual acuity (Early Treatment Diabetic Retinopathy Study letters) improved from baseline to Month 12 by + 8.1 ± 17.7 (treatment-naïve; baseline: 54.5 ± 19.4) and + 4.6 ± 15.4 letters (previously treated; baseline: 52.9 ± 18.6).

Conclusion
AQUILA is the first study to assess the use of IVT-AFL in routine clinical practice in Latin America. Despite few patients being treated with the label-recommended regimen of 5 initial monthly doses or receiving ≥ 8 injections in 12 months, functional and anatomic visual outcomes improved during 12 months of treatment with IVT-AFL. Patients receiving the label-recommended number of injections had numerically greater improvements in visual acuity outcomes. Patients with DME treated regularly and more frequently with IVT-AFL therefore have the potential to achieve outcomes consistent with those observed in interventional studies.
Trial registration Clinicaltrials.gov, NCT03470103. Registered February 5, 2018, https://clinicaltrials.gov/ct2/show/NCT03470103
Long-term peripheral retinal vascular behavior in retinopathy of prematurity patients treated with ranibizumab intravitreal injection as monotherapy using fluorescein angiography
Authors: Al Rasheed Raghad , Adhi Mohammad Idrees , Alowedi Sarah Abdullah , Albdah Bayan , Aldebasi Tariq , Hazzazi Mohammad A. 
Published: August 2022

Abstract
Background
Few challenges are faced with the introduction of anti-VEGF agents as a modality of treatment for retinopathy of prematurity. The clinical behavior and time course of regression post injection differ compared to post laser ablation. This study aims to evaluate the long-term peripheral retinal vascularization outcome of Ranibizumab intravitreal injections monotherapy in the treatment of retinopathy of prematurity.

Method
Hospital-based quasi-experimental study. Include ROP patients who received intravitreal ranibizumab (IVR), as primary treatment for type 1 ROP. Patients were examined under general anaesthesia to ensure documentation of all junctions of vascular and avascular zones. Images were taken by RetCam III, Phoenix ICON and fluorescein angiography was performed to describe vascular behaviors.

Results
The mean gestational age was 24.67 weeks and the mean postmenstrual age at the time of intravitreal ranibizumab treatment was 36.3 weeks. Fluorescein angiography was performed at 155–288 weeks; most eyes showed two disk diameters of avascular peripheral retina. Only eyes with original aggressive ROP who required a second injection (six eyes) showed extensive peripheral avascular retina reaching zone I (13.64%). Neovascularization was evident in five eyes (11.36%), all with an original aggressive ROP and received multiple injections.

Conclusions
Ranibizumab treated babies with incomplete retinal vascularization require close and long-term follow-up visits to assess post injection vascular behavior. Peripheral retinal avascular zone of more than two-disc diameters was present in most of the patients evidenced by fluorescein angiography. Babies with initial diagnosis of aggressive ROP are more likely to have persistent peripheral neovascularization.
Awareness of obstetric fistula and its associated factors among women of reproductive age in sub-Saharan Africa
Authors: Budu Eugene , Ahinkorah Bright Opoku , Okyere Joshua , Seidu Abdul-Aziz , Aboagye Richard Gyan , Yaya Sanni 
Published: August 2022

Abstract
Background
Awareness about obstetric fistula and its concomitant factors is central to efforts to eliminate obstetric fistula in sub-Saharan Africa. We, therefore, assessed the magnitude of obstetric fistula awareness and its associated factors among women of reproductive age in sub-Saharan Africa.

Methods
Data for the study were extracted from the most recent Demographic and Health Surveys of 14 countries in sub-Saharan Africa. We included 185,388 women aged 15–49 years in this study. Percentages were used to summarise the prevalence of obstetric fistula awareness across the 14 countries studied. We adopted a multivariable multilevel binary logistic regression to examine the factors associated with obstetric fistula awareness in sub-Saharan Africa. We presented the results of the regression analysis using adjusted odds ratios with their 95% confidence intervals. Statistical significance was set at p < 0.05.

Results
The average prevalence of obstetric fistula awareness was 37.9%, ranging from 12.8% in Gambia to 63.9% in Uganda. Awareness of obstetric fistula was low among never married and cohabiting women compared to married women. Compared with women with parity 4 or more, those with no birth had the lowest odds of obstetric fistula awareness. The study also showed that obstetric fistula awareness was lower among women who were working, those who are not exposed to mass media, those in the poorest wealth category, those who have never had sex, and those in communities with low literacy level. The study however found that the odds of obstetric fistula awareness increased with age and education, and was higher in urban areas compared to rural areas. Women, who had ever terminated a pregnancy were more likely to be aware of obstetric fistula compared to those who had never terminated a pregnancy.

Conclusion
The study demonstrated a low awareness of obstetric fistula among women in sub-Saharan Africa. Educative and sensitisation interventions should incorporate the factors identified in the present study during its implementation. To raise women’s awareness of obstetric fistula, there is the need for sub-Saharan African countries to consciously raise community literacy rate, increase access to mass media platforms and invest intensively in formal education for women.
Sexual and reproductive health knowledge and practices among youth with and without mental illness in Uganda: a comparative study
Authors: Tumwakire Emily , Ashaba Scholastic , Mubangizi Vincent , Gavamukulya Yahaya 
Published: August 2022

Abstract
Background
Sexual and reproductive health challenges among youth in low-income countries have persistently remained a public health challenge. In addition to these challenges, approximately 25% of youth experience a mental health illness, a situation anticipated to steeply increase especially in sub-Saharan Africa. However, there is still a scarcity of knowledge on the sexual and reproductive health of youth with mental illness in comparison to youth without mental illness in low-income countries. In this paper, the objective was to compare the sexual and reproductive health knowledge and practices among youth with mental illness and without mental illness at Mbarara Regional Referral Hospital (MRRH), South Western Uganda.

Methods
Using a cross-sectional comparative study design, 104 youth with mental illness and 101 youth without mental illness were recruited as they sought medical health care services at MRRH. Structured interviews were conducted and they covered sexual and reproductive health knowledge and sexual practices.

Results
205 youth were interviewed and of these 53 males and 51 females had mental illness while 49 males and 52 females did not have a mental illness. More youth without mental illness (61.7%) had more knowledge of sexual and reproductive health compared to youth with mental illness (38.3%) with a prevalence odds ratio of 0.29 (CI 0.16–0.52) and p value of 0.001. All youth were knowledgeable about contraceptive methods. Youth with MI engaged more in risky sexual practices though the difference wasn’t statistically significant.

Conclusions
Youth generally have low sexual and reproductive health knowledge and this was found to be significantly lower in youth with mental illness compared to those without mental illness and they generally tend to engage in risky sexual behavior. It is recommended to incorporate SRH services among the mainstream general youth health care and mental health care services is critical to reducing sexual and reproductive health challenges among youth.
Evaluation of the soldier's physical fitness test results (strength endurance) ın relation to genotype: longitudinal study
Authors: Yıldırım Damla Selin , Erdoğan Murat , Dalip Metin , Bulğay Celal , Cerit Mesut 
Published: July 2022

Abstract
Background
The aim of this study is to determine the effect of ACE gene polymorphism on the parameters studied (push-up & sit-up) in a long-term study, which has been carried out for many years and to find out whether the differences in ACE gene's metabolism due to the influence of parameters such as outside impacts and lifestyle (active or sedentary life) have a role in the development of strength endurance or not.

Main text
59 male army officers made up the research team. A follow-up study of strength endurance (push-up and sit-up) test was conducted in the gym. The exam took two minutes to complete, and each application was tested separately. In both 2004 and 2019, persons with genotype ID had the best mean sit-up and push-up outcomes, followed by participants with genotype DD, and finally participants with genotype II (P 0.05). Compared to the original rates in 2004, all genotype groups showed a significant reduction in push-up and sit-up scores in the test.

Conclusion
The findings of this study may reveal if strength and lifestyle choices affect the metabolic implications of the genetic polymorphism in the body. Particular varieties actuated by genes, on either hand, don’t result in significant improvements without any changes in individuals’ practices or ways of living, as per the conclusions.
Integrating ART adherence support technologies in the care of pregnant and postpartum people with HIV: a qualitative study
Authors: Rendell Sara , Schmidt Harald , Neergaard Rebecca , Nkwihoreze Hervette , Barbati Zoe , Short William R. , Rana Aadia I. , Sheth Anandi N. , Scott Rachel K. , Sethi Sonia , Momplaisir Florence M. 
Published: August 2022

Abstract
Background
We have a limited understanding on how to best integrate technologies to support antiretroviral therapy (ART) adherence in routine HIV care.

Methods
We conducted semi-structured interviews with multidisciplinary providers caring for pregnant and postpartum people with HIV and asked providers about their perspectives on utilizing adherence support technologies such as text messages, video check-ins with providers or automated with facial recognition for directly-observed-therapy, signaling pill bottle, and signaling pill to support ART adherence. Each approach generated an adherence report. The interview instrument was guided by the Consolidated Framework for Implementation Research and included questions on the implementation climate, barriers, and facilitators to the clinical integration of the adherence approach and strategies that could be used to maximize this integration. The order of adherence support technologies was randomized to minimize bias. We used a modified grounded theory to develop the coding structure and two coders applied the codebook to the transcripts after establishing strong inter-rater reliability with 20% of interviews (kappa = 0.82).

Results
Between March and December 2020, we conducted 26 in-depth, semi-structured interviews with providers who weighed several factors when considering each approach, including the approach’s effect on patient-provider interaction in and outside of the clinic visit, timing for and duration of the approach’s utility, threat of disclosing status, and added burden to providers (e.g., needing to act on generated information) or to patients (e.g., needing to hide the signaling pills, responding to text messages). Providers’ most preferred approach was text-messages, and the least preferred was the signaling pill. Barriers to acceptability varied by approach and included perceived surveillance, violation of privacy, added time demand for providers, potential inaccuracy of the adherence data generated, and negative impact on the patient-provider relationship, particularly if the approach was perceived as coercive. Payers anticipated regulatory hurdles with unfamiliar approaches, particularly the signaling pill and signaling pill bottle. Facilitators included strengthened therapeutic alliance, predictable reminder mechanisms, and options for customization according to patient preference.

Conclusions
Our study elucidates barriers and facilitators to integrating technology-based adherence support approaches in clinical care to support adherence of pregnant and postpartum people with HIV.
Assessing the content validity of the revised Health of the Nation Outcome Scales 65+: the HoNOS Older Adults
Authors: Harris Meredith G. , Tapp Caley , Arnautovska Urska , Coombs Tim , Dickson Rosemary , Smith Mark , Jury Angela , Lai Jennifer , James Mick , Painter Jon , Burgess Philip M. 
Published: August 2022

Aims and methodRecently, the Health of the Nation Outcome Scales 65+ (HoNOS65+) were revised. Twenty-five experts from Australia and New Zealand completed an anonymous web-based survey about the content validity of the revised measure, the HoNOS Older Adults (HoNOS OA).ResultsAll 12 HoNOS OA scales were rated by most (≥75%) experts as ‘important’ or ‘very important’ for determining overall clinical severity among older adults. Ratings of sensitivity to change, comprehensibility and comprehensiveness were more variable, but mostly positive. Experts’ comments provided possible explanations. For example, some experts suggested modifying or expanding the glossary examples for some scales (e.g. those measuring problems with relationships and problems with activities of daily living) to be more older adult-specific.Clinical implicationsExperts agreed that the HoNOS OA measures important constructs. Training may need to orient experienced raters to the rationale for some revisions. Further psychometric testing of the HoNOS OA is recommended.
Conceptual Framework for Cancer Care During a Pandemic Incorporating Evidence From the COVID-19 Pandemic
Authors: Milch Vivienne , Nelson Anne E. , Austen Melissa , Hector Debra , Turnbull Scott , Sathiaraj Rahul , Der Vartanian Carolyn , Wang Rhona , Anderiesz Cleola , Keefe Dorothy 
Published: August 2022

PURPOSE With successive infection waves and the spread of more infectious variants, the COVID-19 pandemic continues to have major impacts on health care. To achieve best outcomes for patients with cancer during a pandemic, efforts to minimize the increased risk of severe pandemic infection must be carefully balanced against unintended adverse impacts of the pandemic on cancer care, with consideration to available health system capacity. Cancer Australia's conceptual framework for cancer care during a pandemic provides a planning resource for health services and policy-makers that can be broadly applied globally and to similar pandemics. METHODS Evidence on the impact of the COVID-19 pandemic on cancer care and health system capacity to June 2021 was reviewed, and the conceptual framework was developed and updated. RESULTS Components of health system capacity vary during a pandemic, and capacity relative to pandemic numbers and severity affects resources available for cancer care delivery. The challenges of successive pandemic waves and high numbers of pandemic cases necessitate consideration of changing health system capacity in decision making about cancer care. Cancer Australia’s conceptual framework provides guidance on continuation of care across the cancer pathway, in the face of challenges to health systems, while minimizing infection risk for patients with cancer and unintended consequences of delays in screening, diagnosis, and cancer treatment and backlogs because of service interruption. CONCLUSION Evidence from the COVID-19 pandemic supports continuation of cancer care wherever possible during similar pandemics. Cancer Australia's conceptual framework, underpinned by principles for optimal cancer care, informs decision making across the cancer care continuum. It incorporates consideration of changes in health system capacity and capacity for cancer care, in relation to pandemic progression, enabling broad applicability to different global settings.
Detecting Sarcopenia Risk by Diabetes Clustering: A Japanese Prospective Cohort Study
Authors: Tanabe Hayato , Hirai Hiroyuki , Saito Haruka , Tanaka Kenichi , Masuzaki Hiroaki , Kazama Junichiro J , Shimabukuro Michio 
Published: July 2022

Abstract

Context
Previous studies have assessed the usefulness of data-driven clustering for predicting complications in patients with diabetes mellitus. However, whether the diabetes clustering is useful in predicting sarcopenia remains unclear.

Objective
To evaluate the predictive power of diabetes clustering for the incidence of sarcopenia in a prospective Japanese cohort.

Design
Three-year prospective cohort study,

Setting and Patients
We recruited Japanese patients with type 1 or type 2 diabetes mellitus (n = 659) between January 2018 and February 2020 from the Fukushima Diabetes, Endocrinology, and Metabolism cohort.

Interventions
Kaplan-Meier and Cox proportional hazards models were used to measure the predictive values of the conventional and clustering-based classification of diabetes mellitus for the onset of sarcopenia. Sarcopenia was diagnosed according to the Asian Working Group for Sarcopenia (AWGS) 2019 consensus update.

Main Outcome Measures
Onset of sarcopenia.

Results
Cluster analysis of a Japanese population revealed 5 diabetes clusters: cluster 1 [severe autoimmune diabetes (SAID)], cluster 2 [severe insulin-deficient diabetes (SIDD)], cluster 3 (severe insulin-resistant diabetes, cluster 4 (mild obesity-related diabetes), and cluster 5 (mild age-related diabetes). At baseline, 38 (6.5%) patients met the AWGS sarcopenia criteria, and 55 had newly developed sarcopenia within 3 years. The SAID and SIDD clusters were at high risk of developing sarcopenia after correction for known risk factors.

Conclusions
This study reveals that among the 5 diabetes clusters, the SAID and SIDD clusters are at a high risk for developing sarcopenia. Clustering-based stratification may be beneficial for predicting and preventing sarcopenia in patients with diabetes.
Longitudinal Branched-Chain Amino Acids, Lifestyle Intervention, and Type 2 Diabetes in the Finnish Diabetes Prevention Study
Authors: Kivelä Jemina , Meinilä Jelena , Uusitupa Matti , Tuomilehto Jaakko , Lindström Jaana 
Published: August 2022

Abstract

Context
Circulating branched-chain amino acids (BCAAs) are associated with the risk of type 2 diabetes (T2D).

Objective
We examined to what extent lifestyle intervention aiming to prevent T2D interacts with this association and how BCAA concentrations change during the intervention.

Methods
We computed trajectory clusters by k-means clustering of serum fasting BCAAs analyzed annually by mass spectrometry during a 4-year intervention. We investigated whether baseline BCAAs, BCAA trajectories, and BCAA change trajectories predicted T2D and whether BCAAs predicted T2D differently in the intervention (n = 198) and control group (n = 196).

Results
Elevated baseline BCAAs predicted the incidence of T2D in the control group (hazard ratio [HR] 1.05 per 10 μmol/L, P = 0.01), but not in the intervention group. BCAA concentration decreased during the first year in the whole cohort (mean −14.9 μmol/L, P &lt; 0.001), with no significant difference between the groups. We identified 5 BCAA trajectory clusters and 5 trajectory clusters for the change in BCAAs. Trajectories with high mean BCAA levels were associated with an increased HR for T2D compared with the trajectory with low BCAA levels (trajectory with highest vs lowest BCAA, HR 4.0; P = 0.01). A trajectory with increasing BCAA levels had a higher HR for T2D compared with decreasing trajectory in the intervention group only (HR 25.4, P &lt; 0.001).

Conclusion
Lifestyle intervention modified the association of the baseline BCAA concentration and BCAA trajectories with the incidence of T2D. Our study adds to the accumulating evidence on the mechanisms behind the effect of lifestyle changes on the risk of T2D.
An Asymptomatic Case With MEN1 Slipping Through Genetic Screening by SNV-dependent Allelic Dropout
Authors: Kosugi Rieko , Ariyasu Hiroyuki , Kyo Chika , Yonemoto Takako , Ogawa Tatsuo , Kotani Masato , Saito Kohei , Inoue Tatsuhide , Usui Takeshi 
Published: July 2022

Abstract

Context
Genetic testing is useful not only for the diagnosis of the MEN1 proband but also for determining the putative asymptomatic variant carriers to improve the prognosis or to avoid unnecessary medical intervention. However, we must be aware of the putative pitfalls of polymerase chain reaction (PCR)-based genetic testing in specific conditions that lead to medical mismanagement.

Objective
To warn of the putative pitfalls of PCR-based genetic testing, we report an overlooked case of MEN1 due to PCR allelic dropout.

Methods
A 69-year-old man was clinically diagnosed with MEN1, and genetic testing revealed that he had a pathogenic variant in the MEN1 gene. His 36-year-old son was completely asymptomatic. As the son was 50% at risk of MEN1, he was willing to undergo genetic testing himself after genetic counseling.

Results
Genetic testing was carried out in 2 independent laboratories. Although laboratory A showed that he carried a pathogenic variant, laboratory B showed that he had the wild-type genotype of MEN1. The discrepancy in these results was due to PCR allelic dropout by single-nucleotide variations of the MEN1 gene in the 5′ region. The surveillance revealed that he had asymptomatic primary hyperparathyroidism and a neuroendocrine tumor of the pancreas.

Conclusion
PCR-dependent genetic analysis may be susceptible to PCR allelic dropout in an SNV-specific manner. We must be careful when genetically testing individuals of relatives with clinical MEN1 disease.