bluuebunny/crossref_metadata_2025_split huggingface dataset:
Health-illness transition processes in children with complex chronic conditions and their parents: a scoping review
Authors: Loura David , Ferreira Ana Margarida , Romeiro Joana , Charepe Zaida 
Published: July 2024

Abstract
Background
The prevalence of complex chronic conditions (CCC), which cause serious limitations and require specialized care, is increasing. The diagnosis of a CCC is a health-illness transition for children and their parents, representing a long-term change leading to greater vulnerability. Knowing the characteristics of these transitional processes is important for promoting safe transitions in this population. This scoping review aimed to map the available evidence on health-illness transition processes in children with complex chronic conditions and their parents in the context of healthcare.

Methods
Six databases were searched for studies focusing on children aged 0–21 years with CCC and their parents experiencing health-illness transition processes, particularly concerning adaptation to illness and continuity of care, in the context of healthcare. Studies within this scope carried out between 2013 and 2023 and written in Portuguese or English were identified. The articles were selected using the PRISMA methodology. The data were extracted to an instrument and then presented with a synthesizing approach supporting the interpretation of the results.

Results
Ninety-eight methodologically broad but predominantly qualitative articles were included in this review. Children with CCC have specific needs associated with complex and dynamic health-illness transitions with a multiple influence in their daily lives. Several facilitating factors (p.e. positive communication and a supportive therapeutic relationship with parents and professionals, as well as involvement in a collaborative approach to care), inhibiting factors (p.e. the complexity of the disease and therapeutic regime, as well as the inefficient organization and coordination of teams) and both positive (p.e. well-being and better quality of life) and negative response patterns (p.e. negative feelings about the chronic illness) were identified. Some interventions to support the transitional process also emerged from the literature. Pediatric palliative care is seen as a good practice and an integrative approach for these children and families.

Conclusion
Health professionals play a fundamental role in supporting the transitional process and promoting positive response patterns. More significant investment is needed at the clinical and academic levels regarding production and dissemination of knowledge in this area to ensure the awareness of children with CCC and that their needs are fully enhanced.

Review registration
https://doi.org/10.17605/OSF.IO/QRZC8.
Impact of the ActTeens Program on physical activity and fitness in adolescents: a cluster randomized controlled trial
Authors: Castilho dos Santos Géssika , de Souza Silva Thais Maria , da Silva Jadson Marcio , de Oliveira Barbosa Rodrigo , Kennedy Sarah G. , Lubans David R. , Stabelini Neto Antonio 
Published: July 2024

Abstract
Background
The aim of our study was to evaluate the impact of the ActTeens Program on physical activity and health-related physical fitness among adolescents in Brazil.

Methods
The “ActTeens Program” was conducted using a cluster-randomized controlled trial during 24-week school term. The sample consisted of 317 adolescents (52.7% girls; 13.61 ± 0.70 years) from four secondary schools that were randomly assigned to intervention group (N = 169) or control group (N = 148). This school-based physical activity (PA) intervention involved two components: (i) structured physical activity sessions delivered within physical education (PE) and (ii) healthy lifestyle guidance (mHealth). The primary outcome was PA assessed using Physical Activity Questionnaire for Adolescents (PAQ-A); secondary outcomes included muscular (MF) and cardiorespiratory fitness (CRF) assessed using 90-push-up, handgrip dynamometer, standing long jump, and 20 m PACER shuttle run test. Assessments were conducted at baseline, 12- and 24-week. Intervention effects were assessed using linear mixed models (LMM).

Results
For the primary outcome (PA), no significant group-by-time effects were observed for physical education based-PA (0.3 score; 95%CI: -0.1; 0.6; and − 0.01 score; 95%CI: -0.03; 0.03, at 12-wk and 24-wk respectively) and total PA (-0.02 score; 95%CI: -0.2; 0.2; and − 0.01score; 95%CI: -0.2; 0.2, at 12 and 24 weeks respectively). After 24 weeks, we observed a significant group by time effects for lower body muscular fitness (12.9 cm; 95%CI, 3.2 to 22.2).

Conclusion
The implementation of aerobic and muscle-strengthening exercises used in the ActTeens intervention did not lead to improvements in physical activity. The intervention resulted in improved lower body muscular fitness, however, we found no significant differences for upper body muscular and cardiorespiratory fitness.
Spatial and trend analysis of gestational syphilis cases in Brazil from 2011 to 2020: an ecological study
Authors: da Silva Thales Philipe Rodrigues , Schreck Rafaela Siqueira Costa , de Oliveira Débora Caixeta Bernardes , Mascarenhas Letícia Vieira , Luvisaro Bianca Maria Oliveira , Camargo Bárbara Tideman Sartório , Martins Eunice Francisca , de Freitas Giselle Lima , Matozinhos Fernanda Penido 
Published: July 2024

Abstract
Objectives
To analyze the rate of gestational syphilis (GS) based on temporal trends over 11 years, as well as the spatial distribution of GS in Brazil, based on the identification of spatial clusters.

Methodology
An ecological, using Brazil and its regions as an analysis unit, based on gestational syphilis data reported in the Notifiable Diseases Information System (SINAN), from 2011 to 2020. Thematic maps were built for spatial data analysis, and the Prais-Winsten autoregressive model was used to verify the trend. Spatial analysis identified the distribution of clusters (high-high; low-low; high-low and low-high) of distribution of GS across Brazilian municipalities, using a 5% significance level.

Results
Gestational syphilis experienced a considerable increase in cases during the studied period, with a peak of 37,436 cases in 2018. The spatial distribution of the disease is heterogeneous in the country. A growing trend was observed in all states of Brazil, except for Espírito Santo, where it remained stationary, with a monthly variation of 10.32%.

Conclusion
The spatial and temporal trend analysis point to syphilis as an important public health problem. The numbers are alarming and show the urgent need for measures to prevent and control syphilis during pregnancy.
A Persian validation of the burnout assessment tool
Authors: Kalani Simindokht , Esfahani Mahla Dashti , Khanlari Payam 
Published: July 2024

Abstract
Background
Burnout is an increasing public health concern. Its prevalence has extended across diverse professions globally, posing significant challenges to individuals, organizations, and society. This phenomenon has undermined employee well-being, productivity, and organizational effectiveness, making it a critical concern in contemporary work environments. The present study aimed to examine the adaptation and assess the validity of the Persian version of the Burnout Assessment Tool (BAT).

Methods
The adaptation process included the translation and back-translation of the BAT. Data were collected on a sample of 580 teachers using the convenience sampling. The BAT-Persian and Utrecht Work Engagement Scale were administered to collect the data. The reliability, factorial structure of the BAT-C and BAT-S, and the convergent and discriminant validity of BAT-C and work engagement were explored.

Results
Confirmatory factor analysis supported a four-factor structure for the core dimensions (BAT-C; exhaustion, mental distance, emotional impairment, cognitive impairment), and a two-factor structure for the secondary dimensions (BAT-S; psychological distress, psychosomatic complaints). In the second-order model, the item loadings on the four factors of BAT-C ranged from 0.35 to 0.85, and on two factors of BAT-S ranged from 0.63 to 0.89. The Persian versions of the BAT-C and BAT-S showed good internal consistency (respectively, α = 0.95 and 0.90). Additional evidence supports the convergent and discriminant validity of the BAT-GR. the BAT‐C and its scales were negatively correlated with work engagement and dimensions (i.e., vigor, dedication, and absorption). Moreover, the BAT‐S and its scales negatively correlated with work engagement and dimensions.

Conclusions
This study provided evidence that the Iranian version of BAT represents a reliable and valid tool for measuring burnout in the work context. A reliable and valid tool for assessing burnout in the Iranian workplace enables early detection of employee distress, allowing for timely intervention and support. This means that identifying the signs and symptoms of burnout in the early stages can prevent more severe consequences such as absenteeism, reduced productivity, or turnover.
A two-pronged approach to understanding reciprocity and mental health relationship in developing countries: evidence from young informal construction workers in Nigeria
Authors: Oladosu Ayomide Oluwaseyi , Chanimbe Timothy 
Published: July 2024

Abstract
Background
Mental health problems disproportionately affect young people in developing countries. However, there is limited research on help-seeking behaviours and the social support systems that improve mental wellbeing among vulnerable youth populations.

Objective
This mixed-methods study aimed to examine the relationship between social support reciprocity and mental health among young informal construction workers in Nigeria, a population at high-risk for occupational and socioeconomic stressors.

Methods
A cross-sectional survey was administered to 686 informal workers to measure reciprocity, mental health-related quality of life, and covariates. In-depth interviews with 32 participants provided qualitative context.

Results
Quantitative analyses showed 25% of participants reported poor mental health. Reciprocity positively predicted mental health after controlling for covariates. Qualitative findings revealed reciprocity occurs directly between individuals as well as indirectly through trade unions and religious groups. Indirect exchanges through groups helped address limitations of direct support due to limited resources.

Conclusions
This study fills important gaps in understanding how social relationships impact mental health in developing country contexts. Findings emphasize the role of collective action and community-based support systems in promoting mental wellbeing among vulnerable populations. Insights can inform culturally relevant, systems-level mental health interventions.
Athletes’ medical preventive behaviors: the case of oral health and ultraendurance trail runners
Authors: Doré Amélie , Jacq Romain , Bas Anne-Charlotte 
Published: July 2024

AbstractUltra-endurance runners are particularly exposed to caries risk factors due to the continuous intake of sugars in liquid or sticky forms during long-distance exercise. The risk of caries increases due to a failure to perform oral hygiene during races. Ultra-endurance runners had good oral health status despite these particularities. Our hypothesis is that high compliance with preventive oral health recommendations (toothbrushing and preventive or regular dental visits) counterbalance the risks associated with their exposure to caries. We aimed to gain a better understanding of preventive dental behaviors in ultra-endurance runners. We then studied the determinants of two major recommendations: (1) visiting a dentist for preventive check-ups and (2) visiting a dentist during the year. 37% of the total sample reported patterns of both preventive dental visits and recent visits. Early visits (ORa = 4.8***), good oral health (ORa = 8.8**) and tooth brushing (ORa = 2.2**) were associated with preventive dental visits, but there was no significant influence of snacking or weekly work hours. The ultra-endurance race frequency was associated with early dental visits despite equal needs. Most risk-control behaviors were associated with each other, indicating that they are all-or-nothing behaviors. Individual prevention strategies implemented at the dental office may not be as effective as they predominantly target individuals who are already aware of and interested in preventive care. Instead, developing targeted primary prevention strategies that are accessible at race venues, such as stands, villages, or food supply points, could be more effective.
Integrated network pharmacology and metabolomics to reveal the mechanism of Pinellia ternata inhibiting non-small cell lung cancer cells
Authors: Feng Fan , Hu Ping , Peng Lei , Xu Lisheng , Chen Jun , Chen Qiong , Zhang Xingtao , Tao Xingkui 
Published: July 2024

AbstractLung cancer is a malignant tumor with highly heterogeneous characteristics. A classic Chinese medicine, Pinellia ternata (PT), was shown to exert therapeutic effects on lung cancer cells. However, its chemical and pharmacological profiles are not yet understood. In the present study, we aimed to reveal the mechanism of PT in treating lung cancer cells through metabolomics and network pharmacology. Metabolomic analysis of two strains of lung cancer cells treated with Pinellia ternata extracts (PTE) was used to identify differentially abundant metabolites, and the metabolic pathways associated with the DEGs were identified by MetaboAnalyst. Then, network pharmacology was applied to identify potential targets against PTE-induced lung cancer cells. The integrated network of metabolomics and network pharmacology was constructed based on Cytoscape. PTE obviously inhibited the proliferation, migration and invasion of A549 and NCI-H460 cells. The results of the cellular metabolomics analysis showed that 30 metabolites were differentially expressed in the lung cancer cells of the experimental and control groups. Through pathway enrichment analysis, 5 metabolites were found to be involved in purine metabolism, riboflavin metabolism and the pentose phosphate pathway, including D-ribose 5-phosphate, xanthosine, 5-amino-4-imidazolecarboxyamide, flavin mononucleotide (FMN) and flavin adenine dinucleotide (FAD). Combined with network pharmacology, 11 bioactive compounds were found in PT, and networks of bioactive compound–target gene–metabolic enzyme–metabolite interactions were constructed. In conclusion, this study revealed the complicated mechanisms of PT against lung cancer. Our work provides a novel paradigm for identifying the potential mechanisms underlying the pharmacological effects of natural compounds.
Healthcare workers’ views on decentralized primary health care management in Lesotho: a qualitative study
Authors: Birru Ermyas , Ndayizigiye Melino , Wanje George , Marole Tholoana , Smith Patrick D. , Koto Masebeo , McBain Ryan , Hirschhorn Lisa R. , Mokoena Mathabang , Michaelis Annie , Curtain Joel , Dally Emily , Andom Afom T. , Mukherjee Joia 
Published: July 2024

Abstract
Background
Lesotho experienced high rates of maternal (566/100,000 live births) and under-five mortality (72.9/1000 live births). A 2013 national assessment found centralized healthcare management in Ministry of Health led to fragmented, ineffective district health team management. Launched in 2014 through collaboration between the Ministry of Health and Partners In Health, Lesotho’s Primary Health Care Reform (LPHCR) aimed to improve service quality and quantity by decentralizing healthcare management to the district level. We conducted a qualitative study to explore health workers’ perceptions regarding the effectiveness of LPHCR in enhancing the primary health care system.

Methods
We conducted 21 semi-structured key informant interviews (KII) with healthcare workers and Ministry of Health officials purposively sampled from various levels of Lesotho’s health system, including the central Ministry of Health, district health management teams, health centers, and community health worker programs in four pilot districts of the LPHCR initiative. The World Health Organization’s health systems building blocks framework was used to guide data collection and analysis. Interviews assessed health care workers’ perspectives on the impact of the LPHCR initiative on the six-health system building blocks: service delivery, health information systems, access to essential medicines, health workforce, financing, and leadership/governance. Data were analyzed using directed content analysis.

Results
Participants described benefits of decentralization, including improved efficiency in service delivery, enhanced accountability and responsiveness, increased community participation, improved data availability, and better resource allocation. Participants highlighted how the reform resulted in more efficient procurement and distribution processes and increased recognition and status in part due to the empowerment of district health management teams. However, participants also identified limited decentralization of financial decision-making and encountered barriers to successful implementation, such as staff shortages, inadequate management of the village health worker program, and a lack of clear communication regarding autonomy in utilizing and mobilizing donor funds.

Conclusion
Our study findings indicate that the implementation of decentralized primary health care management in Lesotho was associated a positive impact on health system building blocks related to primary health care. However, it is crucial to address the implementation challenges identified by healthcare workers to optimize the benefits of decentralized healthcare management.
ESRP1-mediated biogenesis of circPTPN12 inhibits hepatocellular carcinoma progression by PDLIM2/ NF-κB pathway
Authors: Ji Yang , Ni Chuangye , Shen Yanjun , Xu Zhenggang , Tang Lei , Yu Fei , Zhu Lingbang , Lu Hao , Zhang Chuanyong , Yang Shikun , Wang Xuehao 
Published: July 2024

Abstract
Background
Emerging evidence indicates the pivotal involvement of circular RNAs (circRNAs) in cancer initiation and progression. Understanding the functions and underlying mechanisms of circRNAs in tumor development holds promise for uncovering novel diagnostic indicators and therapeutic targets. In this study, our focus was to elucidate the function and regulatory mechanism of hsa-circ-0003764 in hepatocellular carcinoma (HCC).

Methods
A newly discovered hsa-circ-0003764 (circPTPN12) was identified from the circbase database. QRT-PCR analysis was utilized to assess the expression levels of hsa-circ-0003764 in both HCC tissues and cells. We conducted in vitro and in vivo experiments to examine the impact of circPTPN12 on the proliferation and apoptosis of HCC cells. Additionally, RNA-sequencing, RNA immunoprecipitation, biotin-coupled probe pull-down assays, and FISH were employed to confirm and establish the relationship between hsa-circ-0003764, PDLIM2, OTUD6B, P65, and ESRP1.

Results
In HCC, the downregulation of circPTPN12 was associated with an unfavorable prognosis. CircPTPN12 exhibited suppressive effects on the proliferation of HCC cells both in vitro and in vivo. Mechanistically, RNA sequencing assays unveiled the NF-κB signaling pathway as a targeted pathway of circPTPN12. Functionally, circPTPN12 was found to interact with the PDZ domain of PDLIM2, facilitating the ubiquitination of P65. Furthermore, circPTPN12 bolstered the assembly of the PDLIM2/OTUD6B complex by promoting the deubiquitination of PDLIM2. ESRP1 was identified to bind to pre-PTPN12, thereby fostering the generation of circPTPN12.

Conclusions
Collectively, our findings indicate the involvement of circPTPN12 in modulating PDLIM2 function, influencing HCC progression. The identified ESRP1/circPTPN12/PDLIM2/NF-κB axis shows promise as a novel therapeutic target in the context of HCC.

Graphical Abstract
Diagnosis, treatment and management of lipodystrophy: the physician perspective on the patient journey
Authors: Patni Nivedita , Chard Craig , Araújo-Vilar David , Phillips Helen , Magee David A. , Akinci Baris 
Published: July 2024

Abstract
Background
Lipodystrophy syndromes are a heterogeneous group of rare, life-limiting diseases characterized by a selective loss of adipose tissue and severe metabolic complications. There is a paucity of information describing the experiences and challenges faced by physicians who have seen and treated patients with lipodystrophy. This study aimed to provide a better understanding of the physician’s perspective regarding the patient journey in lipodystrophy, including diagnosis, the burden of disease, and treatment approaches.

Methods
Thirty-three physicians from six countries who had seen or treated patients with lipodystrophy were interviewed using a semi-structured questionnaire. Interviews were transcribed, anonymized, and analyzed for themes and trends. Four main themes were developed: (1) the diagnostic journey in lipodystrophy including the disease features or ‘triggers’ that result in the onward referral of patients to specialist medical centers with experience in managing lipodystrophy; (2) the impact of lipodystrophy on patient quality of life (QoL); (3) the use of standard therapies and leptin replacement therapy (metreleptin) in lipodystrophy, and (4) barriers to metreleptin use.

Results
Participants reported that, due to their rarity and phenotypic heterogeneity, lipodystrophy cases are frequently unrecognized, leading to delays in diagnosis and medical intervention. Early consultation with multidisciplinary specialist medical teams was recommended for suspected lipodystrophy cases. The development and progression of metabolic complications were identified as key triggers for the referral of patients to specialist centers for follow-up care. Participants emphasized the impact of lipodystrophy on patient QoL, including effects on mental health and self-image. Although participants routinely used standard medical therapies to treat specific metabolic complications associated with lipodystrophy, it was acknowledged that metreleptin was typically required in patients with congenital generalized lipodystrophy and in some acquired generalized and partial lipodystrophy cases. A lack of experience among some participants and restrictions to access remained as barriers to metreleptin use.

Conclusions
To our knowledge, this is one of the first studies describing the qualitative experiences of physicians regarding the diagnosis and management of lipodystrophy. Other physician-centered studies may help increase the awareness of lipodystrophy among the wider medical community and support clinical approaches to this rare disease.