bluuebunny/crossref_metadata_2025_split huggingface dataset:
Perceptions of adolescent mothers towards adolescent repeat childbirth in Soroti District, Teso sub-region, Uganda: A phenomenological study
Authors: Mulalu Posiano , Wanume Benon , David Soita , Amongin Dinnah , Wandawa Gabriel Julius 
Published: May 2022

AbstractThe percentage of adolescent mothers aged 15 to 19 years with a repeat childbirth in Uganda (26.1%) is higher than the global estimate (18.5%). Soroti district tops Teso (a region with highest adolescent childbearing rate nationally) in adolescent childbearing. Adolescent repeat childbearing (ARC) is associated with poor health outcomes, increased risk of stillbirth, maternal and child mortality, thus a public health concern. The explanations to the high prevalence of repeat childbirth in Soroti district remain unknown.We conducted a phenomenological study where theoretical saturation was achieved with 3 focus group discussions; each comprised of 8 respondents. Transcripts were organized and analyzed by QSR Nvivo following deductive approach.ResultsAdolescent marriage was viewed as a privilege, family planning methods were viewed as non-functional, man’s demand for sex was unchallengeable and non-supportive families including mistreatment of the participants by their families were perceived as risk factors for ARC.This therefore suggests that in order to prevent repeat adolescent childbearing in Soroti district, and contribute towards the achievement of the SDG numbered three (ensure healthy lives and promote well-being for all at all ages) there is need to awaken and strengthen the implementation of the anti-teen marriage programs and policies; strengthen sexual/reproductive education including family planning programs, and addressing identified myths regarding ARC.We also recommend further research to be done in Uganda, especially in other districts of Teso region to validate our findings.
mRNA-based COVID-19 booster vaccination is highly effective and cost-effective in Australia
Authors: Li Rui , Liu Hanting , Fairley Christopher K , Ong Jason J , Guo Yuming , Zou Zhuoru , Xie Li , Zhuang Guihua , Li Yan , Shen Mingwang , Zhang Lei 
Published: May 2022

AbstractBackgroundAustralia implemented an mRNA-based booster vaccination strategy against the COVID-19 Omicron variant in November 2021. We aimed to evaluate the effectiveness and cost-effectiveness of the booster strategy over 180 days.MethodsWe developed a decision-analytic Markov model of COVID-19 to evaluate the cost-effectiveness of a booster strategy (administered 3 months after 2nd dose) in those aged ≥16 years in Australia from a healthcare system perspective. The willingness-to-pay threshold was chosen as A$ 50,000.FindingsCompared with 2-doses of COVID-19 vaccines without a booster, Australia’s booster strategy would incur an additional cost of A$0.88 billion but save A$1.28 billion in direct medical cost and gain 670 quality-adjusted life years (QALYs) in 180 days of its implementation. This suggested the booster strategy is cost-saving, corresponding to a benefit-cost ratio of 1.45 and a net monetary benefit of A$0.43 billion. The strategy would prevent 1.32 million new infections, 65,170 hospitalisations, 6,927 ICU admissions and 1,348 deaths from COVID-19 in 180 days. Further, a universal booster strategy of having all individuals vaccinated with the booster shot immediately once their eligibility is met would have resulted in a gain of 1,599 QALYs, a net monetary benefit of A$1.46 billion and a benefit-cost ratio of 1.95 in 180 days.InterpretationThe COVID-19 booster strategy implemented in Australia is likely to be effective and cost-effective for the Omicron epidemic. Universal booster vaccination would have further improved its effectiveness and cost-effectiveness.FundingNational Natural Science Foundation of China. Bill and Melinda Gates Foundation
Long-term ambient hydrocarbon exposure and incidence of urinary bladder cancer
Authors: Zhang Han-Wei , Tsai Zhi-Ren , Kok Victor C , Peng Hsiao-Ching , Chen Yau-Hung , Tsai Jeffrey JP , Hsu Chun-Yi 
Published: May 2022

AbstractBackgroundParticulate matter and volatile organic compounds, including total hydrocarbons (THCs), are major ambient air pollutants. The primary nonmethane hydrocarbons (NMHCs) originate from vehicle emissions. Studies on the association between air pollution and urinary bladder cancer (UBC) have revealed contradictory results.ObjectivesThe present study investigated whether long-term exposure to ambient hydrocarbons increases UBC risk among people aged ≥20 years in Taiwan.MethodsLinkage dataset research with longitudinal design was conducted on 600,666 cancer-free individuals from 2000–2013; 12 airborne pollutants were determined. Several Cox models considering potential confounders were employed. The study outcomes were invasive or in situ UBC incidence over time. The targeted pollutant concentration was divided into three tertiles: T1/T2/T3.ResultsThe mean age of the individuals at risk was 42.8 (SD, 15.7), and 50.2% were men. The mean daily average over 10-years of airborne THC concentration was 2.24 ppm (SD, 0.14), and NMHC was 0.29 ppm (SD, 0.09). There was a dose-dependent increase in UBC at follow-up. The incidence of UBC cases per 100,000 people by T1/T2/T3 exposure to THC was 60.3, 203.7, and 450.8, respectively; it was 180.2/202.4/453.8 per 100,000, corresponding to T1/T2/T3 exposure to NMHC, respectively. Without controlling for confounding air pollutants, the adjusted hazard ratio (adj.HR) was 1.77 (95% CI, 1.69–1.87) per 0.14 ppm increase of THC; after controlling for PM2.5, adj.HR was even higher at 2.10 (95% CI, 1.99– 2.22). The adj.HR was 1.38 (95% CI, 1.31–1.44) per 0.09 ppm increase in ambient NMHC concentration. After controlling for SO2 and CH4, the adj.HR was 1.16 (95% CI, 1.11–1.21). Sensitivity analyses showed that the UBC development risk was not sex-specific or influenced by diabetes status.DiscussionLong-term exposure to THC and NMHC may be a risk factor for UBC development. Acknowledging the pollutant sources can inform risk management strategies.
Genomic summary statistics and meta-analysis for set-based gene-environment interaction tests in large-scale sequencing studies
Authors: Wang Xinyu , Pham Duy T. , Westerman Kenneth E. , Pan Cong , Manning Alisa K. , Chen Han 
Published: May 2022

AbstractWe propose an efficient method to generate the summary statistics for set-based gene-environment interaction tests, as well as a meta-analysis approach that aggregates the summary statistics across different studies, which can be applied to large biobank-scale sequencing studies with related samples. Simulations showed that meta-analysis is numerically concordant with the equivalent pooled analysis using individual-level data. Moreover, meta-analysis accommodates heterogeneity between studies and enhances power in multi-ethnic studies. We applied the meta-analysis approach to the whole-exome sequencing data from the UK Biobank and successfully identified gene regions associated with waist-hip ratio, as well as those with sex-specific genetic effects.
The impact of rapid near-patient STI testing on service delivery outcomes: a controlled interrupted time series study
Authors: Walter Scott R , Jackson Joni , Myring Gareth , Redaniel Maria Theresa , Margelyte Ruta , Gardiner Rebecca , Clarke Michael D , Crofts Megan , McLeod Hugh , Hollingworth William , Phillips David , Muir Peter , Steer Jonathan , Turner Jonathan , Horner Patrick J , de Vocht Frank 
Published: May 2022

AbstractObjectivesTo evaluate the impact of a new clinic-based rapid STI testing, diagnosis and treatment service on healthcare delivery and resource needs in a sexual health service.DesignControlled interrupted time series study.SettingTwo sexual health services in UK: Unity Sexual Health in Bristol, UK (main site) and Croydon Sexual Health in London (control site).ParticipantsElectronic patient records for all attendances during the period one year before and one year after the intervention.InterventionIntroduction of an in-clinic rapid testing system for gonorrhoea and chlamydia in combination with revised treatment pathways.Outcome measuresTime-to-test notification, staff capacity, cost per episode of care and overall service costs. We also assessed rates of gonorrhoea culture swabs, follow-up attendances, and examinations.ResultsTime-to-notification and the rate of gonorrhoea swabs significantly decreased following implementation of the new system. There was no evidence of change in follow-up visits or examination rates for patients seen in clinic related to the new system. Staff capacity in clinics appeared to be maintained across the study period. Overall, the number of episodes per week was unchanged in the Unity SHS, and the mean cost per episode decreased by 7.5% (95%CI 5.7%, 9.3%). Conclusions: The clear improvement in time-to-notification, while maintaining activity at a lower overall cost, suggests that the implementation of clinic-based testing in parallel to postal testing kits had the intended impact, which bolsters the case for more widespread rollout in SHS.Strengths and limitations of this studyWe used controlled interrupted time series models with confounder adjustment to estimate the effect of the intervention distinct from any background changes and independent of other time varying factors.Model validity was bolstered by using a relatively long time series with good temporal resolution.Data from both the main and control sites was derived from the same electronic patient record system.There was a general consensus between main and sensitivity analyses.Our study was limited by being non-randomised, having only one control site, and the follow up period for females being truncated by the impact of the Covid-19 pandemic.
Understanding Health worker Perspectives on Risk Screening for HIV Testing - A Qualitative Study from Zimbabwe
Authors: Mugauri Hamufare D. , Chirenda Joconiah , Takarinda Kudakwashe , Mugurungi Owen , Ncube Getrude , Chikondowa Ishmael , Mantiziba Patrick , Tshimanga Mufuta 
Published: May 2022

AbstractBackgroundThe use of screening tools during targeted human immunodeficiency virus (HIV) testing services improves efficiency by identifying individuals who are likely to test positive. Effective utilization of screening tools requires an understanding of health care worker perception and willingness to use the tools. We determined health workers’ perspectives on screening tools to enhance their effective and consistent utilisation.MethodsWe conducted a qualitative study among healthcare workers at 8 selected primary healthcare facilities in Zimbabwe. Interviewer guided, in-depth interviews were conducted with healthcare workers and their immediate supervisors. Inductive and deductive coding (hybrid) was applied to develop and analyze themes following a framework built around the grounded theory model to describe perspectives that influence the effective and consistent utilization of HIV screening tools and suggestions for improved eligibility screening.ResultsBehavioural factors facilitating the utilisation of the screening tool included motivation to adhere to standard practice, awareness of screening role in targeting testing, and its ability to manage workload through screening out ineligible clients. This was evident across service delivery levels. Barriers included limited healthcare capacity, confidentiality space, multiple screening tools and opaque screening in/out criteria and the potential of clients not responding to screening questions truthfully.ConclusionsAcross geographical and service delivery levels, correct placing of the screening tool at HIV testing entry point, healthcare worker knowledge on screening in/out criteria emerged as enablers for correct and consistent use of the screening tools. Further, standardizing the tools used would improve the utilisation of the correct tool.
Structural modeling for Oxford histological classifications of immunoglobulin A nephropathy
Authors: Joh Kensuke , Nakazato Takashi , Hashiguchi Akinori , Shimizu Akira , Katafuchi Ritsuko , Okonogi Hideo , Koike Kentaro , Hirano Keita , Tsuboi Nobuo , Kawamura Tetsuya , Yokoo Takashi , Narita Ichiei , Suzuki Yusuke 
Published: May 2022

AbstractIn immunoglobulin A nephropathy (IgAN), Cox regression analysis can select independent prognostic variables for renal functional decline (RFD). However, the correlation of the selected histological variables with clinical and/or treatment variables is unknown, thereby making histology-based treatment decisions unreliable. We prospectively followed 946 Japanese patients with IgAN for a median of 66 mo. and applied structural equation modeling (SEM) to identify direct and indirect effects of histological variables on RFD as a regression line of estimated glomerular filtration rate (eGFR) via clinical variables including amount of proteinuria(UPE), eGFR, mean arterial pressure(MAP) at biopsy, and treatment variables such as steroid therapy with/without tonsillectomy(ST) and renin-angiotensin system blocker (RASB). Multi-layered correlations between the variables and RFD were identified by multivariate linear regression analysis and the model’s goodness of fit was confirmed. Only tubular atrophy/interstitial fibrosis (T) had an accelerative direct effect on RFD, while endocapillary hypercellularity (E) and active crescent (C) had an attenuating indirect effect via ST. S had an attenuating indirect effect via eGFR. M had accelerative indirect effect for RFD via UPE. Moreover, M and C had accelerative indirect effect via UPE, which can be controlled by ST. However, both T and S had additional indirect accelerative effects via eGFR0c or MAP, which cannot be controlled by ST. SEM identified a systemic path links between histological variables and RFD via dependent clinical and/or treatment variables. These findings lead to clinically applicable novel methodologies that can contribute to predict treatment outcomes using the Oxford classifications.
Mental health challenges and the associated factors in HIV-positive women who have children living with HIV in Indonesia: A qualitative study
Authors: Fauk Nelsensius Klau , Maria Silvia Merry , Mwanri Lillian , Hawke Karen , Ward Paul Russell 
Published: May 2022

AbstractWomen living with HIV (WLHIV) are vulnerable to various mental health challenges. However, there is a paucity of studies globally and in the Indonesian context that have specifically explored mental health challenges among HIV-positive mothers who also have children living with HIV (CLHIV). This qualitative study explored mental health challenges and the associated factors in HIV-positive mothers with CLHIV in Yogyakarta, Indonesia. In-depth interviews were employed to collect data from the participants (n=23) who were recruited using the snowball sampling technique. A qualitative data analysis framework was used to guide the analysis of the findings. The findings showed that the mothers experienced a range of mental health issues due to their own, and their child’s diagnosis; stress, depression, anxiety, fear, sadness, and guilt. Lack of knowledge about HIV, fear of death, shame, not knowing whom to talk with and what to do after their own HIV diagnosis, and the HIV diagnosis of their children were factors that challenged their mental health. Difficulties in dealing with daily life or social activities of their CLHIV, dilemma in addressing questions and complaints of their CLHIV about HIV treatment, and concerns about the health condition of their CLHIV and how their children cope with any potential negative social impacts also impacted the mothers’ mental health. Social factors such as unsympathetic expressions from friends towards them and their CLHIV and negatively worded religious-related advice from parents and relatives also contributed to their poor mental health. Our findings indicate the need for intervention programs that support HIV-positive mothers and their CLHIV. Future large-scale studies involving HIV-positive mothers with CLHIV in Indonesia and other settings globally are needed to obtain a comprehensive understanding of mental health challenges and the associated factors they face.
Performance of the SD Bioline rapid diagnostic test as a good alternative to the detection of Human African Trypanosomiasis in Cameroon
Authors: Deutou Wondeu Andrillene Laure , Okoko Aline , Djeunang Dongho Ghyslaine Bruna , Doll Christian , Bahebegue Samuel , Mpeli Mpeli Ulrich Stéphane , Ninko Christian Chouamou , Montesano Carla , Dologuele Nicolas Félicien , Awono Ambene Herman Parfait 
Published: May 2022

AbstractBackgroundThe management of human African trypanosomiasis (HAT), caused by Trypanosoma brucei gambiense relies on case detection. As part of this, the routine screening by the card agglutination test for trypanosomiasis (CATT) is the critical step before parasitological confirmation. Individual rapid diagnostic tests (RDTs) have recently been developed for the serodiagnosis of HAT.ObjectiveThe objective of the current study was to assess the input of SD Bioline HAT on the serological screening of human African trypanosomiasis in Cameroonian foci.MethodsBlood samples were collected during the surveys in the foci of Campo, Yokadouma and Fontem between June 2014 and January 2015. Diagnostic performance indicators such as sensitivity (Se) and specificity (Sp) of SD Bioline HAT was determined from the CATT, used as gold standard for the detection of specific antibodies of Trypanosoma brucei gambiense.ResultsA total of 88 samples were tested in Campo 59.1% (n=52), Yokadouma 31.8% (n=28) and Fontem 9.1% (n=8). The gender distribution was 61.4% (n=54) male and 38.4% (n=34) female, with an average age of 35.4 ± 19.0 years. The overall seroprevalence was 11.4% (95% CI: 6.3- 19.7) with the CATT method and 18.2% (95% CI: 11.5- 27.5) with the SD Bioline HAT RDT method in probed foci. The Se and Sp were 80.0% and 89.7% respectively for the SD Bioline HAT.ConclusionThis study showed that the overall performance of the SD Bioline HAT was close to that of the CATT, with significant specificity in the serological detection of HAT.
Two phenotypes of Chronic Recurrent Multifocal Osteomyelitis with different patterns of bone involvement
Authors: Cebecauerová Dita , Malcová Hana , Koukolská Veronika , Kvíčalová Zuzana , Souček Ondřej , Wagenknecht Lukáš , Bronský Jiří , Šumník Zdeněk , Kynčl Martin , Cebecauer Marek , Horváth Rudolf 
Published: May 2022

AbstractIntroductionChronic Recurrent Multifocal Osteomyelitis (CRMO) is an autoinflammatory bone disorder with predominantly paediatric onset. Children present with multifocal osteolytic lesions accompanied by bone pain and soft tissue swelling. Patients often exhibit extraosseous co-morbidities such as psoriasis, inflammatory bowel disease, and arthritis.ObjectivesComparison of children with two different phenotypes of CRMO defined by presence or absence of extraosseous co-morbidities.MethodsChildren diagnosed with CRMO at the Motol University Hospital between 2010-2020 were retrospectively reviewed, and according to the absence or presence of extraosseous manifestations divided into two cohorts – osteolytic CRMO and complex CRMO. The two groups were compared in terms of demographic data, age at disease onset, number and site of bone lesions, laboratory biomarker values, and need of escalation to a second-line therapyResultsThirty-seven children (30 female, 7 male) with confirmed CRMO were included in the analysis. The mean age at disease onset was ten years. All but 3 patients presented with multifocal disease. Twenty-three children (62%) had at least one extraosseous manifestation (13 sacroiliitis, 8 inflammatory bowel disease, 6 skin disease [acne, pustulosis, or psoriasis], 7 arthritis). Complex CRMO was associated with a significantly higher ESR rate (p=0.0064) and CRP level (p=0.018). The groups did not differ in number of foci or in age at disease onset. Bone lesion distribution differed between the two groups with significantly more frequent involvement of clavicle (p=0.011) and pelvis (p=0.038) in patients with complex CRMO. Children with complex CRMO more often needed escalation of therapy to DMARDs and biologic agents.ConclusionOur data suggest that CRMO affecting solely the skeleton has milder course compared to complex CRMO with extraskeletal features. Further studies are needed to explore the clinical as well as the patient reported outcomes and promote individually tailored therapeutic strategies in both CRMO phenotypes.
Elevated liver enzymes and bilirubin following SARS-CoV-2 infection in children under 10
Authors: Kendall Ellen K. , Olaker Veronica R. , Kaelber David C. , Xu Rong , Davis Pamela B. 
Published: May 2022

AbstractRecently, the Centers for Diseases and Control released a nationwide health alert about an increase in hepatitis cases of unknown origin in children, raising concern about potential sequelae of COVID-19 infection. In this study, we test whether there was increased risk of elevated serum liver enzymes and bilirubin following COVID-19 infection in children. We performed a retrospective cohort study on a nation-wide database of patient electronic health records (EHRs) in the US. The study population comprise 796,369 children between the ages of 1-10 years including 245,675 who had contracted COVID-19 during March 11, 2020 - March 11, 2022 and 550,694 who contracted non-COVID other respiratory infection (ORI) during the same timeframe.Compared to children infected with other respiratory infections, children infected with COVID-19 infection were at significantly increased risk for elevated AST or ALT (hazard ratio or HR: 2.52, 95% confidence interval or CI: 2.03-3.12) and total bilirubin (HR: 3.35, 95% CI: 2.16-5.18). These results suggest acute and long-term hepatic sequelae of COVID-19 in pediatric patients. Further investigation is needed to clarify if post-COVID-19 related hepatic injury described in this study is related to the current increase in pediatric hepatitis cases of unknown origin.
Unrealistic optimism in the eye of the storm: Positive bias towards the consequences of COVID-19 during the second and third waves of the pandemic
Authors: Maksim Ada , Śpiewak Sławomir , Lipp Natalia , Dużmańska-Misiarczyk Natalia , Gustaw Grzegorz , Rębilas Krzysztof , Strojny Paweł 
Published: May 2022

AbstractResearch conducted at the outset of the pandemic shows that people are vulnerable to unrealistic optimism (UO). However, the Weinstein model suggests that this tendency may not persist as the pandemic progresses. Our research aimed at verifying whether UO persists during the second (Study 1) and the third wave (Study 2) of the pandemic in Poland, whether it concerns the assessment of the chances of COVID-19 infection (Study 1 and Study 2), the chances of severe course of the disease and adverse vaccine reactions (Study 2). We show that UO towards contracting COVID-19 persists throughout the pandemic. However, in situations where we have little influence on the occurrence of the event, the participants do not show UO. The exceptions are those who have known personally someone who has died from a coronavirus infection. These results are discussed in terms of self-esteem protection and the psychological threat reduction mechanism.