bluuebunny/crossref_metadata_2025_split huggingface dataset:
Uptake of cervical cancer screening among sex workers living with HIV in Nairobi, Kenya: a cross-sectional study
Authors: Akolo Maureen , Gelmon Lawrence , Musembi Horatius , Mutwiri Benard , Kambo Isabel , Kimani Joshua , Akolo Christopher 
Published: September 2024

Background: Hospitals within Nairobi County, Kenya, offer cervical cancer screening services. However, most female sex workers do not seek this service. Objective: To determine uptake of cervical cancer screening among female sex workers living with HIV in Nairobi, Kenya. Design: A descriptive cross-sectional study. Methods: Computerized simple random sampling was used to select 75 study participants who met the inclusion criteria; data were collected using a structured questionnaire. The study was carried out among female sex workers living with HIV in Nairobi, Kenya, attending the Sex Workers Outreach Program. Results: 40% ( n = 30) of respondents were aged 18–25 years. Only 45.3% (34) had been screened for cervical cancer within the last 1 year. 65.3% ( n = 49) of respondents knew that cervical cancer affects the cervix but were not aware of what caused the disease. 77.6% ( n = 58) found the 8 am–5 pm health facility opening hours a hinderance to seeking services and 66.7% ( n = 50) found the screening method uncomfortable. Cultural practices and beliefs fostered stigma in 39.2% ( n = 29) of the sex workers; hence, they did not seek out services. Conclusion: Lack of information, cultural barriers, and facility operating hours prevent female sex workers living with HIV from getting tested for cervical cancer. These barriers once addressed could improve cervical cancer screening uptake among this high-risk population.
Combined genomic evaluation of Merino and Dohne Merino Australian sheep populations
Authors: Wicki Marine , Brown Daniel J. , Gurman Phillip M. , Raoul Jérôme , Legarra Andrés , Swan Andrew A. 
Published: September 2024

Abstract
Background
The Dohne Merino sheep was introduced to Australia from South Africa in the 1990s. It was primarily used in crosses with the Merino breed sheep to improve on attributes such as reproduction and carcass composition. Since then, this breed has continued to expand in Australia but the number of genotyped and phenotyped purebred individuals remains low, calling into question the accuracy of genomic selection. The Australian Merino, on the other hand, has a substantial reference population in a separate genomic evaluation (MERINOSELECT). Combining these resources could fast track the impact of genomic selection on the smaller breed, but the efficacy of this needs to be investigated. This study was based on a dataset of 53,663 genotypes and more than 2 million phenotypes. Its main objectives were (1) to characterize the genetic structure of Merino and Dohne Merino breeds, (2) to investigate the utility of combining their evaluations in terms of quality of predictions, and (3) to compare several methods of genetic grouping. We used the ‘LR-method’ (Linear Regression) for these assessments.

Results
We found very low Fst values (below 0.048) between the different Merino lines and Dohne breed considered in our study, indicating very low genetic differentiation. Principal component analysis revealed three distinct groups, identified as purebred Merino, purebred Dohne, and crossbred animals. Considering the whole population in the reference led to the best quality of predictions and the largest increase in accuracy (from ‘LR-method’) from pedigree to genomic-based evaluations: 0.18, 0.14 and 0.16 for yearling fibre diameter (YFD), yearling greasy fleece weight (YGFW) and yearling liveweight (YWT), respectively. Combined genomic evaluations showed higher accuracies than the evaluation based on the Dohne reference only (accuracies increased by 0.16, 0.06 and 0.07 for YFD, YGFW, and YWT, respectively). For the combined genomic evaluations, metafounder models were more accurate than Unknown Parent Groups models (accuracies increased by 0.04, 0.04 and 0.06 for YFD, YGFW and YWT, respectively).

Conclusions
We found promising results for the future transition of the Dohne breed from pedigree to genomic selection. A combined genomic evaluation, with the MERINOSELECT evaluation in addition to using metafounders, is expected to enhance the quality of genomic predictions for the Dohne Merino breed.
Efficacy and safety of direct-acting antiviral regimen for patients with hepatitis C virus genotype 2: a systematic review and meta-analysis
Authors: Lei Pek Kei , Liu Zicheng , Ung Carolina Oi Lam , Hu Hao 
Published: September 2024

Abstract
Background
Direct-acting antivirals (DAAs) show high cure rates in treating chronic hepatitis C virus (HCV). However, the effect of DAAs on patients infected with genotype 2 (GT2) is difficult to determine despite the availability of several DAA regimens.

Methods
A systematic search of six databases (PubMed, Embase, Cochrane Library, Web of Science, CNKI, and Clinicaltrial.gov) was conducted through April 20, 2022. We considered the sustained virological response 12 weeks after treatment (SVR12) as the efficacy outcome, and adverse events (AEs) as the safety outcome. By calculating the mean SVR12 and the proportion of AEs among patients, we considered the intervention effect for each DAA regimen. The random effect model was then used in all meta-analyses. This systematic review and meta-analysis aimed to summarize the evidence on efficacy and safety of DAAs in patients infected with HCV GT2. The Bayesian Markov Chain Monte Carlo (MCMC) network metanalysis was used to indirectly compare regimen in GT2 patients.

Results
Among 31 articles included (2,968 participants), consisting of 1,387 treatment-naive patients and 354 patients with cirrhosis. The overall pooled SVR12 rate was 94.62% (95% CI: 92.43-96.52%) among the participants who received all doses of treatment. Meta-analysis results of AEs revealed that fatigue was the most common AE (14.0%, 95% CI: 6.4-21.6%), followed by headache (13.1%, 95% CI: 9.2-17.1%), whereas death and serious adverse events were uncommon.

Conclusions
We compared DAA-based treatments indirectly using meta-analysis and found the combination of Sofosbuvir plus Velpatasvir and Glecaprevir plus Pibrentasvir, each administered over a 12-week period, were identified as the most effective and relatively safe in managing chronic hepatitis C virus genotype 2 (HCV GT2) infection. Both treatments achieved a SVR12 of 100% (95% CI 99–100%).
Is chemodenervation with incobotulinumtoxinA an alternative to invasive chronic anal fissure treatments?
Authors: Calderón T. , Arriero L. , Cruz P. , Gómez L. , Asanza J. , Santiago J. C. , Garrido R. , Bustamante C. , Balsa T. 
Published: September 2024

Abstract
Background
Botulinum toxin type A is currently strongly recommended for the treatment of anal fissures (AFs). However, there is still no consensus on dosage or injection technique. This study provides further efficacy and safety evidence in a 2-year follow-up.

Method
Prospective, open-label, single-arm, single-center study carried out in adult patients with AFs non-responsive to previous treatments. Patients were treated with incobotulinumtoxinA (incoBoNT/A) injected in both laterals and posterior intersphincteric groove. Healing rate at 2 years was the primary endpoint. Secondary endpoints included internal anal sphincter pressures, incontinence, and safety.

Results
A total of 49 patients were treated with a mean incoBoNT/A dose of 40.5 U (spread across three locations). Healing rate at 2 years was 83.9% with a 24.5% of recurrence throughout the study. Only 7 patients (14.3%) reported adverse events (AEs) that were mild and temporary. Mean reduction in anal resting pressure was -9.1 mmHg at 3 months (p = 0.001). Mean reduction in voluntary squeeze pressure was -27.5 mmHg at 3 months (p < 0.001). Mean pain perception measured with a visual analog scale decreased by -6.5 points at 2 years (p < 0.001). There was an incontinence increase at 1 month of 1.3 points (p = 0.006), but baseline values were restored at 6 months.

Conclusion
We present results that support the use of incoBoNT/A as a second line for AFs that do not respond to ointment therapy. IncoBoNT/A injection is a less invasive treatment that should be considered before surgery due to its efficacy and its safety which includes no permanent impairment.

Trial registration
ISRCTN90354265; Registered on 16th February 2024. Retrospectively registered.
Calling for allied efforts to strengthen digital health literacy in Sweden: perspectives of policy makers
Authors: Bywall Karin Schölin , Norgren Therese , Avagnina Beatrice , Gonzalez Marta Pisano , Andersson Sarah Wamala ,   IDEAHL consortium
Published: September 2024

Abstract
Background
A more digitalised world comes with the promise to improve people’s lives. Therefore, it is essential that policymakers also align digital interventions with initiatives to empower citizens and strengthen their digital health literacy. The aim of this study was to explore the views of Swedish policymakers regarding the potential and barriers of a European strategy to strengthen digital health literacy.

Method
Representatives from Swedish governmental agencies and regions were purposively approached by email to ask them to participate in online workshops to discuss the potential and barriers of developing a European strategy to strengthen digital health literacy.

Results
The results highlight the need for a national strategy to strengthen digital health literacy. The findings point to critical areas for improvement, ethical and social considerations, and the importance of inclusive and accessible health information online. Participants identified vulnerable groups requiring targeted support to enhance their digital health literacy, particularly those at risk of digital exclusion. Participants emphasised the importance of considering various combinations of conditions or problems that people may have, urging policymakers to adopt a nuanced approach to enhance digital literacy.

Conclusions
There is a critical need for policymakers to strengthen digital health literacy in the population to ensure health equity in relation to digitalisation opportunities. Policymakers advocate for a dedicated national strategy, supporting policymakers to prioritize digital health literacy. Tailoring information, enhancing digital support for prevention, and considering ethical implications are reported as important aspects to improve digital health literacy.
Clinical, radiographic and biochemical assessment of proximal cavities restored with composite resin using incremental vs. bulk packing techniques: One-year randomized clinical trial
Authors: Abdelaziz Monaliza Maher , Fathy Shereen , Alaraby Amany Ahmed , Shehab Wessam Ibrahim , Temirek Marwa Mohamed 
Published: September 2024

Abstract
Background
Bulk-fill resin composites may suffer from recurrent caries around compound proximal restorations in posterior teeth, especially at the proximo-gingival interface.Over 12 months, will the bulk fill technique affect the caries recurrence rate at gingival margins when compared to the conventional incremental packing technique? How early will the first clinical, radiographical, and biochemical evidence of caries recurrence occur?

Methods
After randomization, in 30 patients with two compound (OM or OD) supragingival lesions, one tooth was restored using the bulk fill technique on one side (group 1) (n = 15). In contrast, the other tooth on the other side was restored utilizing the incremental layering technique (group 2) (n = 15). Both teeth received restorative material (X-tra fil, Voco, Cuxhaven, Germany). The FDI criteria were used to evaluate restorations. As for the periodontal assessment, the gingival index, plaque index, papillary bleeding scoring index and periodontal pocket depth were evaluated. The gingival crevicular fluid (GCF) specimens were gathered, and MMP-9 was extracted and quantitated by ELISA. A customized radiographic template was designed, and 3D printed digital bitewing radiographs were taken. Assessments were done clinically, radiographically and biochemically at baseline (1 week) and after 3, 6 and 12 months. Data was statistically analyzed.

Results
The null hypothesis was accepted clinically; no statistically significant differences appeared between bulk and incrementally filled posterior restorations. As for the radiographic assessment, the null hypothesis was accepted except for increased periodontal ligament width at 3 months. The null hypothesis for the biochemical evaluation was rejected as there were significant changes in levels of MMP-9 at different testing times.

Conclusions
1. With similar results but less sensitivity and significant time saving, the bulk fill technique can be considered an efficient alternative to the incremental fill technique in restoring proximal cavities. 2. Early evidence of caries recurrence can be correlated to an increase in the MMP-9 level in gingival crevicular fluid, followed by an increase in radiographic periodontal ligament width measurement.

Trial registration
An ethical approval from the Research Ethics Committee at the Faculty of Dentistry, October 6 University, (Approval No. RECO6U/5-2022). The study was registered at the Pan African Clinical Trials Registry on 24/07/2023 with an identification number (PACTR202307573531455).
Strengths, weaknesses, opportunities, and threats (SWOT) of the electronic prescribing systems executed in Iran from the physician’s viewpoint: a qualitative study
Authors: Jebraeily Mohamad , Naji Shahryar , Nourani Aynaz 
Published: September 2024

Abstract
Background
Electronic prescribing (e-prescribing) is an essential technology in the modern health system. This technology has made many changes in the prescription process, which have advantages and disadvantages and have created opportunities for transforming the health system. This study aimed to investigate the strengths, weaknesses, opportunities, and threats of the e-prescribing system implemented in Iran from the physician’s viewpoint.

Methods
This phenomenological qualitative study was conducted in 2022. The participants were 15 Iranian specialist physicians working at Urmia University of Medical Sciences, selected purposively and deliberately. Data was collected through in-depth semi-structured interviews using an interview guide comprising 16 questions. Interviews were conducted until data saturation was reached. The audio data was transcribed into text and analyzed using the thematic analysis. To ensure the validity and reliability of the findings, the criteria introduced by Lincoln and Guba were employed.

Results
The results of this study showed that the e-prescribing system executed in Iran has diverse and multidimensional strengths, weaknesses, opportunities, and threats. In the strengths section, the analysis of the interviews led to the extraction of semantic units in the categories of prescription process, prescriber, patient, technical, economic, communication, and insurance. Also, the weaknesses in the three categories of the prescriber, patient, and technical were debatable. The opportunities extracted from the narratives of the interviewees were placed in four categories including technical, national macro policies, Ministry of Health macro-policies, and socio-cultural issues. Finally, the discussed threats are classified into two technical and macro policies of the Ministry of Health categories. On the other hand, technical issues played an effective role in all aspects of the SWOT model.

Conclusion
The e-prescribing system in Iran has strengths, weaknesses, opportunities, and threats. An overarching factor across all aspects of the SWOT model was technical infrastructure. A robust technical infrastructure is considered a strength and an opportunity for the growth of the electronic prescribing system in Iran. Conversely, any shortcomings in these systems are viewed as weaknesses and pose a threat to the system’s sustainability.
Mediator complex subunit 1 promotes oral squamous cell carcinoma progression by activating MMP9 transcription and suppressing CD8+ T cell antitumor immunity
Authors: Li Zhe , Sun Mengke , Yang Ruimeng , Wang Zheng , Zhu Qianyu , Zhang Yue , Yang Haosun , Meng Zhaosong , Hu Lizhi , Sui Lei 
Published: September 2024

Abstract
Background
The role of Mediator complex subunit 1 (MED1), a pivotal transcriptional coactivator implicated in diverse biological pathways, remains unexplored in the context of oral squamous cell carcinoma (OSCC). This study aims to elucidate the contributory mechanisms and potential impact of MED1 on the progression of OSCC.

Methods
The expression and clinical significance of MED1 in OSCC tissues were evaluated through the bioinformatics analyses. The effects of MED1 on the biological behavior of OSCC cancer cells were assessed both in vitro and in vivo. Dual-luciferase reporter assay, chromatin immunoprecipitation (ChIP) assay, bioinformatic analysis, CD8+ T cell isolation experiment, coculture experiment, enzyme-linked immunosorbent assay (ELISA), and flow cytometric analysis were employed to elucidate the underlying mechanism through which MED1 operates in the progression of OSCC.

Results
MED1 exhibited upregulation in both OSCC tissues and multiple OSCC cell lines, which correlated with decreased overall survival in patients. In vitro experiments demonstrated that knockdown of MED1 in metastatic OSCC cell lines SCC-9 and UPCI-SCC-154 hindered cell migration and invasion, while overexpression of MED1 promoted these processes. Whereas, MED1 knockdown had no impact on proliferation of cell lines mentioned above. In vivo studies further revealed that downregulation of MED1 effectively suppressed distant metastasis in OSCC. Mechanistically, MED1 enhanced the binding of transcription factors c-Jun and c-Fos to the matrix metalloprotein 9 (MMP9) promoters, resulting in a significant upregulation of MMP9 transcription. This process contributes to the migration and invasion of SCC-9 and UPCI-SCC-154 cells. Furthermore, MED1 modulated the expression of programmed death-ligand 1 (PD-L1) through the Notch signaling pathway, consequently impacting the tumor-killing capacity of CD8+ T cells in the tumor microenvironment.

Conclusions
Our findings indicate that MED1 plays a pivotal role in OSCC progression through the activation of MMP9 transcription and suppression of CD8+ T cell antitumor immunity, suggesting that MED1 may serve as a novel prognostic marker and therapeutic target in OSCC.
BAP1 regulates HSF1 activity and cancer immunity in pancreatic cancer
Authors: Yuan Weiwei , Zhang Qiyue , Zhao Yuhan , Xia Wentao , Yin Shilin , Liang Xueyi , Chen Taoyu , Li Gaofeng , Liu Yanshen , Liu Zhiqiang , Huang Jinxi 
Published: September 2024

Abstract
Background
The vast majority of pancreatic cancers have been shown to be insensitive to single-agent immunotherapy. Exploring the mechanisms of immune resistance and implementing combination therapeutic strategies are crucial for PDAC patients to derive benefits from immunotherapy. Deletion of BAP1 occurs in approximately 27% of PDAC patients and is significantly correlated with poor prognosis, but the mechanism how BAP1-deletion compromises survival of patients with PDAC remain a puzzle.

Methods
Bap1 knock-out KPC (KrasG12D/+; LSLTrp53R172H/+; Pdx-1-Cre) mice and control KPC mice, syngeneic xenograft models were applied to analysis the correlation between BAP1 and immune therapy response in PDAC. Immunoprecipitation, RT-qPCR, luciferase and transcriptome analysis were combined to revealing potential mechanisms. Syngeneic xenograft models and flow cytometry were constructed to examine the efficacy of the inhibitor of SIRT1 and its synergistic effect with anti-PD-1 therapy.

Result
The deletion of BAP1 contributes to the resistance to immunotherapy in PDAC, which is attributable to BAP1’s suppression of the transcriptional activity of HSF1. Specifically, BAP1 competes with SIRT1 for binding to the K80 acetylated HSF1. The BAP1-HSF1 interaction preserves the acetylation of HSF1-K80 and promotes HSF1-HSP70 interaction, facilitating HSF1 oligomerization and detachment from the chromatin. Furthermore, we demonstrate that the targeted inhibition of SIRT1 reverses the immune insensitivity in BAP1 deficient PDAC mouse model.

Conclusion
Our study elucidates an unrevealed mechanism by which BAP1 regulates immune therapy response in PDAC via HSF1 inhibition, and providing promising therapeutic strategies to address immune insensitivity in BAP1-deficient PDAC.
Consensus on innovations and future directions of community first responder schemes in United Kingdom: a national nominal group technique study
Authors: Patel Gupteswar , Botan Vanessa , Phung Viet-Hai , Trueman Ian , Hosseini Mehrshad Parvin , Smith Murray D. , Ørner Roderick , Pattinson Julie , Asghar Zahid , Rowan Elise , Spaight Robert , Mortimer Craig , Brewster Amanda , Mountain Pauline , Miller Joshua , Brown Martina , Siriwardena Aloysius Niroshan 
Published: September 2024

Abstract
Aim
We aimed to achieve consensus among NHS and community stakeholders to identify and prioritise innovations in Community First Responder (CFR) schemes.

Methods
We conducted a mixed-methods study, adopting a modified nominal group technique with participants from ambulance services, CFR schemes and community stakeholders. The 1-day consensus workshop consisted of four sessions: introduction of innovations derived from primary research; round-robin discussions to generate new ideas; discussion and ranking of innovations; feedback of ranking, re-ranking and concluding statements. Innovations were ranked on a 5-point Likert scale and descriptive statistics of median and interquartile range calculated. Discussions were recorded, transcribed, and analysed thematically.

Results
The innovations found were classified into two categories: process innovations and technological innovations. The process innovations included six types of innovations: roles, governance, training, policies and protocols, recruitment, and awareness. The technological innovations included three aspects: information and communication; transport; and health technology. The descriptive statistics revealed that innovations such as counselling and support for CFRs (median: 5 IQR 5,5), peer support [5 (4,5)], and enhanced communication with control room [5 (4,5)] were essential priorities. Contrastingly, innovations such as the provision of dual CFR crew [1.5 (1,3)], CFR responsibilities in patient transport to hospital [1 (1,2)], and CFR access to emergency blue light [1 (1,1.5)] were deemed non-priorities.

Conclusions
This article established consensus on innovations in the CFR schemes and their ranking for improving the provision of care delivered by CFRs in communities. The consensus-building process also informed policy- and decision-makers on the potential future change agenda for CFR schemes.