bluuebunny/crossref_metadata_2025_split huggingface dataset:
Community-based Health Insurance Membership Renewal and Associated Factors among Communities in Addis Ababa, Ethiopia
Authors: Gashaw Walelign Mekonnen , Beyene Kidanemariam G/Michael , Tiruneh Mesafint Abeje 
Published: September 2022

AbstractIntroductionUtilization of contemporary health services in developing nations has remained low. Ethiopia has introduced community-based health insurance (CBHI) to improve access to health services and reduce out-of-pocket payments. However, high dropout and low enrolment rates hamper implementation of CBHI scheme. This study aimed to assess CBHI membership renewal and associated factors among communities in Addis Ababa.MethodsCommunity-based cross-sectional mixed study design was employed among 626 CBHI members and ten key informants in Addis Ababa from July 05 to August 30, 2021. Multi-stage sampling technique was used to select study participants, and purposive sampling technique was used to select key informants. Quantitative data was collected using structured interviewer administered questionnaire and analyzed using SPSS version 23.0, whereas semi-structured questionnaire was used for in-depth interviews. Binary logistic regression and thematic analysis were employed for quantitative and qualitative data respectively.ResultsMembership renewal of the community was 67.3%. Family size (AOR=2.54; 95%CI: 1.26-5.12), knowledge (AOR=1.87; 95%CI: 1.05-3.32), years of enrollment (AOR=2.22; 95%CI: 1.39-3.54), enrollment fee contributor (AOR=9.16; 95%CI: 5.29-15.82), benefit packages (AOR=1.99; 95%CI: 1.18-3.35), trust in CBHI scheme (AOR=3.53; 95%CI: 2.12-5.86), training (AOR=1.81; 95%CI 1.01-3.21), chronic illness (AOR=6.82; 95%CI: 3.80-12.24) and having children under five (AOR=1.98; 95%CI: 1.27-3.10) were significantly associated with CBHI membership renewal. Low level of awareness, limited benefit packages, unaffordable premium, poor quality health services, and shortage of supplies were determinant factors for CBHI membership renewal.ConclusionCBHI membership renewal was low. Family size, knowledge, years of enrollment, enrollment fee contributor, benefits packages, trust in CBHI scheme, training, chronic illness and having children under five were significantly associated with CBHI membership renewal. In addition, there are correctable gaps in community awareness, benefit packages, affordable premiums, quality health services, and availability of supplies. Hence, necessary measures at all levels must be taken to reduce dropouts from membership.
Head-to head comparison of anterior nares and nasopharyngeal swabs for SARS-CoV-2 antigen detection in a community drive-through test centre in the UK
Authors: Byrne Rachel L , Aljayyoussi Ghaith , Kontogianni Konstantina , Clerkin Karina , McIntyre Mathew , Wardale Jahanara , Williams Christopher T ,   CONDOR steering group, Body Richard , Adams Emily R , de Vos Margaretha , Escadafal Camille , Cubas Atienzar Ana I 
Published: September 2022

AbstractObjectiveTo conduct a head-to-head diagnostic accuracy evaluation of professionally taken anterior nares (AN) and nasopharyngeal (NP) swabs for SARS-CoV-2 antigen detection using rapid diagnostic tests (Ag-RDT).MethodsNP swabs for SARS-CoV-2 reverse transcription quantitative polymerase chain reaction (RT-qPCR) testing and paired AN and NP swabs for the antigen detection were collected from symptomatic participants enrolled at a community drive-through COVID-19 test centre in Liverpool. Two Ag-RDT brands were evaluated: Sure-Status (PMC, India) and Biocredit (RapiGEN, South Korea). The visual read out of the Ag-RDT test band was quantitative scored and the 50% and 95% limit of detection (LoD) of both Ag-RDT brands using AN and NP swabs was calculated using a probabilistic logistic regression model.ResultsA total of 604 participants were recruited of which 241 (40.3%) were SARS-CoV-2 positive by RT-qPCR. Sensitivity and specificity of AN swabs was equivalent to the obtained with NP swabs: 83.2% (75.2-89.4%) and 98.8% (96.5-99.6%) utilising NP swabs and 84.0% (76.2-90.1%) and 99.2% (97.0-99.8%) with AN swabs for Sure-Status and; 81.2% (73.1-87.7%) and 99.0% (94.7-86.5%) with NP swabs and 79.5% (71.3-86.3%) and 100% (96.5-100%) with AN swabs for Biocredit. The agreement of the AN and NP swabs was high for both brands with an inter-rater relatability (κ) of 0.918 and 0.833 for Sure-Status and Biocredit, respectively. The overall 50% LoD and 95% LoD was 0.9-2.4 × 104and 3.0-3.2 × 108RNA copies/mL for NP swabs and 0.3-1.1 × 105and 0.7-7.9 × 107RNA copies/mL and for AN swabs with no significant difference on LoD for any of the swabs types or test brands. Quantitative read-out of test line intensity was more often higher when using NP swabs with significantly higher scores for both Ag-RDT brands.Conclusionsthe diagnostic accuracy of the two SARS-CoV-2 Ag-RDTs brands evaluated in this study was equivalent using AN swabs than NP swabs. However, test line intensity was lower when using AN swabs which could influence negatively the interpretation of the Ag-RDT results for lay users. Studies on Ag-RDT self-interpretation using AN and NP swabs are needed to ensure accurate test use in the wider community.
Associations Between Maternal Risk Factors and Intrinsic Placental and Fetal Brain Functional Properties in Congenital Heart Disease
Authors: Rajagopalan Vidya , Schmithorst Vanessa , El-Ali Alex , Reynolds William , Lee Vincent , Wallace Julia , Wienberg Jaqueline , Johnson Jennifer , Votava-Smith Jodie , Adibi Jennifer , Panigrahy Ashok 
Published: September 2022

AbstractBackgroundThe relationship between maternal risk factors (MRFs) (particularly pre-gravid obesity, diabetes, and hypertension) and congenital heart disease (CHD) to placental and fetal brain outcomes is poorly understood. Here, we tested the hypothesis that MRF and CHD would be associated with reduced intrinsic placental and fetal brain function using a novel non-invasive technique.MethodsPregnant participants with and without MRF and fetal CHD were prospectively recruited and underwent feto-placental MRI. Using intrinsic properties of blood oxygen level dependent imaging (BOLD) we quantified spatiotemporal variance of placenta and fetal brain. MRFs and CHD were correlated with functional characteristics of the placenta and fetal brain.ResultsCo- morbid MRF (hypertension, diabetes, and obesity) reduced spatiotemporal functional variance of placenta and fetal brain (p < 0.05). CHD predicted reduced fetal brain temporal variance compared to controls (p<0.05). Interaction of MRF and CHD status was associated with reduced intrinsic pBOLD temporal variance (p=0.047). There were no significant interactions of MRFs and CHD status on either temporal or spatial variance of intrinsic brain BOLD.ConclusionMRF and CHD reduced functional characteristic of placenta and brain in fetuses. MRF modification and management during pregnancy may have the potential to not only provide additional risk stratification but may also improve neurodevelopmental outcomes.
Persistence of a SARS-CoV-2 variant with a frameshifting deletion for the duration of a major outbreak
Authors: Foster Charles S.P. , Bull Rowena A. , Tedla Nicodemus , Santiago Fernando , Agapiou David , Adhikari Anurag , Walker Gregory J. , Shrestha Lok Bahadur , van Hal Sebastiaan J. , Kim Ki Wook , Rawlinson William D. 
Published: September 2022

AbstractAustralia experienced widespread COVID-19 outbreaks from infection with the SARS-CoV-2 Delta variant between June 2021 and February 2022. Whole-genome sequencing of virus from an early case revealed a sub-consensus level of sequencing reads supporting a 17-nucleotide frameshift-inducing deletion in ORF7a that truncated the peptide sequence. The variant rapidly became represented at the consensus level (Delta-ORF7aΔ17del) in most of the outbreak cases in Australia. Retrospective analysis of ORF7a deletions in all GISAID clade GK Delta genomes showed that of 4,018,216 genomes, 134,751 (∼3.35%) possessed a deletion in ORF7a, with the ORF7aΔ17del mutation by far the most common. Approximately 99.05% of Delta-ORF7aΔ17del genomes on GISAID originated from the Australian Delta outbreak, and comprised 87% of genomes in the outbreak. In vitro comparison of lineages in cell culture showed a significantly greater proportion of cells were infected with Delta-ORF7aΔ17del than with a contemporaneous Delta variant without ORF7aΔ17del (Delta-ORF7aintact), and the proportion was also measurably higher than an early SARS-CoV-2 strain (A.2.2). These results showed that Delta-ORF7aΔ17del potentially has a slight growth advantage compared to Delta-ORF7aintact. Delta-ORF7aΔ17del viruses still produced ORF7a protein, but significantly less than A.2.2, in a different cellular distribution with a more diffuse expression throughout the cytoplasm of infected cells. These data suggest that the proliferation of Delta-ORF7aΔ17del genomes during the Australian Delta outbreak was likely not a result of an intrinsic benefit of the ORF7aΔ17del mutation, but rather a chance founder effect. Nonetheless, the abundance of different ORF7a deletions in genomes worldwide suggests these have some benefit to virus transmission.IMPORTANCEDeletions in the ORF7a region of SARS-CoV-2 have been noted since early in the COVID-19 pandemic, but are generally reported as transient mutations that are quickly lost in the population. Consequently, ORF7a deletions are considered disadvantageous to the virus through possible loss-of-function effects. In constrast to these earlier reports, we present the first report of a SARS-CoV-2 variant with an ORF7a deletion that dominated for the entirety of a protracted outbreak, and found no associated fitness disadvantage or advantage in cell culture. The relatively common rise and fall of ORF7a deletion variants over time likely represent chance founder events followed by proliferation until a more fit variant(s) is introduced to the population. Our global clade-level survey of ORF7a deletions will be a useful resource for future studies into this gene region.
Multicentre accuracy trial of FUJIFILM SILVAMP TB LAM test in people with HIV reveals lot variability
Authors: Székely Rita , Sossen Bianca , Mukoka Madalo , Muyoyeta Monde , Nakabugo Elizabeth , Hella Jerry , Van Nguyen Hung , Ubolyam Sasiwimol , Chikamatsu Kinuyo , Macé Aurélien , Vermeulen Marcia , Centner Chad M , Nyangu Sarah , Sanjase Nsala , Sasamalo Mohamed , Dinh Huong Thi , Ngo The Anh , Manosuthi Weerawat , Jirajariyavej Supunnee , Mitarai Satoshi , Nguyen Nhung Viet , Avihingsanon Anchalee , Reither Klaus , Nakiyingi Lydia , Kerkhoff Andrew D. , MacPherson Peter , Meintjes Graeme , Denkinger Claudia M , Ruhwald Morten ,   FujiLAM Study Consortium
Published: September 2022

AbstractRationaleThere is an urgent need for rapid, non-sputum point-of-care diagnostics to detect tuberculosis.ObjectivesThis prospective trial in seven high tuberculosis burden countries set out to evaluate the diagnostic accuracy of the point-of-care urine-based lipoarabinomannan assay FUJIFILM SILVAMP TB LAM (FujiLAM) among inpatient and outpatient people living with HIV.MethodsDiagnostic performance of FujiLAM at point of care was assessed among adult people with HIV against a mycobacterial reference standard (sputum culture, blood culture, and Xpert Ultra from urine and sputum at enrollment, and additional sputum culture ≤7 days from enrollment), an extended mycobacterial reference standard including available non-study test results, and a composite reference standard including clinical evaluation.Measurements and Main ResultsOf 1624 participants enrolled, 294 (18·0%) were classified as TB positive by eMRS. Median age was 40 years, median CD4 cell count was 372 cells/ul, 52% were female and 78% were taking antiretroviral therapy at enrollment. Overall FujiLAM sensitivity was 54·8% (95% CI: 49·1–60·4), and overall specificity was 85·1% (83·1–86·9), against the extended mycobacterial reference standard. Sensitivity and specificity estimates varied between sites, ranging from 26·5% (95% CI: 17·4%–38·0%) to 83·3% (43·6%–97·0%), and 75·0 (65·0%–82·9%) to 96·5 (92·1%–98·5%), respectively. Post-hoc exploratory analysis identified significant variability in the performance of the six FujiLAM lots used in this study.ConclusionsLot variability limited interpretation of FujiLAM test performance. Although the results with the current version of FujiLAM are too variable for clinical decision-making, the lipoarabinomannan biomarker still holds promise for tuberculosis diagnostics.
Knowledge, Attitude and Practice (KAP) study on COVID-19 among the general population of Nepal
Authors: Shrestha Salina , Malla Rabin , Shrestha Sadhana , Singh Pallavi , Sherchand Jeevan B. 
Published: September 2022

AbstractThe COVID-19 pandemic has become one of the global health challenges in the current context. In Nepal, the first confirmed case was reported on 23 January 2020, and since then it has resulted in several negative impacts including economic disruption and deterioration of physical and mental health. In such a pandemic, it is indispensable to understand the knowledge and behavioral patterns of the general population regarding COVID-19. Therefore, our study aimed to assess the knowledge, attitude and practice on COVID-19, among the general population and its relationship with socio-demographic conditions.The questionnaire survey was conducted to collect data from eight districts of Nepal which included Kathmandu, Bhaktapur, Lalitpur, Morang, Sunsari, Rupandehi, Chitwan, and Kaski. Descriptive statistics, parametric and non-parametric statistical tests, and a logistic regression model were used for analysis. The study showed that 93.3% of respondents had knowledge of overall preventive practice whereas only 32% had knowledge of overall symptoms of COVID-19. Regarding attitude, only 14.3% believed that they will get rid of COVID-19 soon. The preventive practice was reduced after lockdown compared to that during lockdown. The respondents with white-collar occupations, high-income, and unmarried were good at KAP. Similarly, highly educated and those residing in urban areas had good knowledge and practice.The study findings will help in the development of targeted programs to improve the knowledge, attitude, practice of the general population on COVID-19, which is of paramount importance to deal with the existing pandemic and also such possible future waves of the pandemic.
Increased Levels of N-Lactoylphenylalanine After Exercise are Related to Adipose Tissue Loss During Endurance Training in Humans With Overweight and Obesity
Authors: Hoene Miriam , Zhao Xinjie , Machann Jürgen , Birkenfeld Andreas L. , Heni Martin , Peter Andreas , Niess Andreas , Moller Anja , Lehmann Rainer , Xu Guowang , Weigert Cora 
Published: September 2022

AbstractObjectiveThe exercise-inducible metabolite N-Lactoylphenylalanine (Lac-Phe) has recently been shown to reduce food intake and adipose tissue mass in mice. We addressed whether Lac-Phe could have a similar function in humans.MethodsSedentary subjects with overweight and obesity completed an 8-week supervised endurance exercise intervention (n=22). Before and after the intervention, blood plasma levels of Lac-Phe were determined by UHPLC-MS in the resting state and immediately after an acute endurance exercise test. Adipose tissue and muscle volume were quantified by MRI.ResultsAcute exercise caused a pronounced increase in Lac-Phe, both before and after the intervention. Higher levels of Lac-Phe after acute exercise were associated with a greater reduction in abdominal subcutaneous and, to a lower degree, visceral adipose tissue during the intervention.ConclusionsLac-Phe produced during physical activity could boost weight loss in humans with obesity and overweight, possibly by transmitting or enhancing the appetite-suppressing effects of lactate. Exercise-induced Lac-Phe could be employed to predict and, potentially, improve the effectiveness of lifestyle interventions in subjects with overweight and obesity.Trial RegistrationClinicaltrials.govNCT0315159022 May 2017https://clinicaltrials.gov/ct2/show/NCT03151590
The aerobiology of SARS-CoV-2 in UK hospitals and the impact of aerosol generating procedures
Authors: Gould Susan , Byrne Rachel L , Edwards Thomas , Aljayyoussi Ghaith , Wooding Dominic , Buist Kate , Kontogianni Konstantina , Bennett Allan , Atkinson Barry , Moore Ginny , Dunning Jake , Todd Stacy , Hoyle Marie-Claire , Turtle Lance , Solomon Tom , Fitzgerald Richard , Beadsworth Mike , Garner Paul , Adams Emily R , Fletcher Tom 
Published: September 2022

AbstractBackgroundSARS-CoV-2 nosocomial transmission to patients and healthcare workers (HCWs) has occurred throughout the COVID-19 pandemic. Aerosol generating procedures (AGPs) seemed particularly risky, and policies have restricted their use in all settings. We examined the prevalence of aerosolized SARS-CoV-2 in the rooms of COVID-19 patients requiring AGP or supplemental oxygen compared to those on room air.MethodsSamples were collected prospectively near to adults hospitalised with COVID-19 at two tertiary care hospitals in the UK from November 2020 – October 2021. The Sartorius MD8 AirPort air sampler was used to collect air samples at a minimum distance of 1.5 meters from patients. RT-qPCR was used following overnight incubation of membranes in culture media and extraction.ResultsWe collected 219 samples from patients’ rooms: individuals on room air (n=67), receiving oxygen (n=65) or AGP (n=67). Of these, 54 (24.6%) samples were positive for SARS-CoV-2 viral RNA. The highest prevalence was identified in the air around patients receiving oxygen (32.3%, n=21, CI95% 22.2 to 44.3%) with AGP and room air recording prevalence of (20.7%, n=18, CI95% 14.1 – 33.7%) and (22.3%, n=15, CI95% 13.5 – 30.4%) respectively. We did not detect a significant difference in the observed frequency of viral RNA between interventions.InterpretationSARS-CoV-2 viral RNA was detected in the air of hospital rooms of COVID-19 patients, and AGPs did not appear to impact the likelihood of viral RNA. Enhanced respiratory protection and appropriate infection prevention and control measures are required to be fully and carefully implemented for all COVID-19 patients to reduce risk of aerosol transmission.
Changes in presentation, treatment, and survival of patients with hepatocellular carcinoma in Damietta, Egypt, 2007-2019: a retrospective monocentric cohort study
Authors: Jean Kévin , Tawheed Ahmed , Luong Nguye Liem Binh , Heikal Tarek , Eldaly Usama , Elhadidy Neven , Elghaieb Ahmed , Aboudonia Ahmed , Tondeur Laura , Dublineau Amélie , Fontanet Arnaud , El-Kassas Mohamed 
Published: September 2022

ABSTRACTContextWe aimed to assess temporal changes in the presentation and survival of patients with hepatocellular carcinoma (HCC) in the northern Egypt region, one of the regions reporting the highest incidence of the disease globally.MethodWe conducted a monocentric retrospective study. Patients presenting at the Damietta Oncology referral center between 2007 and 2019 with a diagnosed HCC were eligible. Individual, clinical and tumor characteristics at HCC diagnosis, including the Barcelona Clinic Liver Cancer (BCLC) staging, were retrieved from medical files and patients’ final vital status was ascertained by combining various data sources. Patients were divided into 2 groups based on diagnosis period: pre- and post-2014. Survival was analysed based on Kaplan-Meier curves and differences in restricted mean survival time (RMST).ResultsData from 5,097 patients (among 5,210 eligible, 97.8%) wereere analyzed. We observed a significant trend toward HCC diagnosed at earlier stage in the post- vs. pre-2014 period (BCLC stage 0/A or B: 37.2% vs. 27.1%, p<10−3). Overall patient’s survival after the HCC diagnosis was poor, with a median of 8.1 months. The BCLC staging system performed well in predicting survival (median survival for patients diagnosed with BCLC stage 0/A, B, C, and D: 28, 25, 7, and 4 months, respectively, p<10−3). Despite a trend toward HCC diagnosed at earlier stages, we did not observe a significant improvement in survival over time. Overall, treatments offered in this medical center were in line with international guidelines, and 16.1% of the patients who received a curative treatment had an improved survival (30.7 months in median). However, HCC recurrence was frequent among patients cured for HCC, with a median time to recurrence of 22 months.ConclusionOverall survival after HCC diagnosis in Egypt remains poor but is significantly improved by curative therapy. Despite a trend toward earlier diagnosis of HCC, we did not observe a general improvement in survival over time, which remains to be clearly understood.
The association between heterosexual anal intercourse and HIV acquisition in three prospective cohorts of women
Authors: Silhol Romain , Nordsletten Ashley , Maheu-Giroux Mathieu , Elmes Jocelyn , Staunton Roisin , Owen Branwen , Shacklett Barbara , McGowan Ian , Feliciano Kailazarid Gomez , van der Straten Ariane , Eller Leigh Anne , Robb Merlin , Marrazzo Jeanne , Dimitrov Dobromir , Boily Marie-Claude 
Published: September 2022

AbstractReceptive anal intercourse (RAI) may substantially increase HIV acquisition risk per sex act compared to receptive vaginal intercourse (RVI). To understand how levels of RAI change over time and evaluate the impact of exposure definitions for RAI on HIV incidence, we analysed three prospective HIV cohorts of women: RV217, MTN-003 (VOICE), and HVTN 907. At baseline 16.0% (RV 217), 17.5% (VOICE) of women reported RAI in the past 3 months and 27.3% (HVTN 907) in the past 6 months, with RAI declining during follow-up by around 3-fold. Hazard ratios, adjusted for potential confounders (aHR), indicate that reporting RAI at baseline increased HIV incidence in the three cohorts: 1.1 (95% Confidence interval: 0.8-1.5) for VOICE, aHR of 3.3 (1.6-6.8) for RV 217, and 1.9 (0.6-6) for HVTN 907. Using time-varying exposure definition slightly increased the estimated association for VOICE (aHR=1.2; 0.9-1.6), however reporting >30% RAI sex acts during VOICE follow-up was not associated with higher HIV incidence (aHR=0.7 (0.4-1.1)). Women who always reported RAI during follow-up where also at increased HIV acquisition risk. Overall, we found that precisely estimating RAI and HIV association after multiple RVI/RAI exposures is sensitive to RAI exposure definitions and may be influenced by measurement errors.
Rapid emergence of extensively drug-resistant Shigella sonnei in France
Authors: Lefèvre Sophie , Njamkepo Elisabeth , Feldman Sarah , Ruckly Corinne , Carle Isabelle , Lejay-Collin Monique , Fabre Laëtitia , Yassine Iman , Frezal Lise , de la Gandara Maria Pardos , Fontanet Arnaud , Weill François-Xavier 
Published: September 2022

ABSTRACTShigella sonnei, the main cause of bacillary dysentery in high-income countries, has become increasingly resistant to antibiotics. We monitored the antimicrobial susceptibility of 7,121 S. sonnei isolates collected in France between 2005 and 2021. We identified a dramatic increase in the proportion of extensively drug-resistant (XDR) isolates (i.e., simultaneously resistant to ciprofloxacin, third-generation cephalosporins and azithromycin), to 22.3% of all S. sonnei isolates in 2021. Our genomic analysis identified 13 different clusters of XDR isolates descended from a ciprofloxacin-resistant sublineage originating from South Asia. The 164 XDR isolates detected were resistant to azithromycin, principally through a pKSR100-like plasmid, and to third-generation cephalosporins through various genes and plasmids. This rapid emergence of XDR S. sonnei in different transmission networks, particularly among men who have sex with men, is a matter of concern, and good laboratory-based surveillance of Shigella infections will be crucial for informed decision-making and appropriate public health action.