bluuebunny/crossref_metadata_2025_split huggingface dataset:
Neuropathological lesions in intravenous BCG-stimulated K18-hACE2 mice challenged with SARS-CoV-2
Authors: Sánchez-Morales Lidia , Porras Néstor , García-Seco Teresa , Pérez-Sancho Marta , Cruz Fátima , Chinchilla Blanca , Barroso-Arévalo Sandra , Diaz-Frutos Marta , Buendía Aránzazu , Moreno Inmaculada , Briones Víctor , Risalde María de los Ángeles , de la Fuente José , Juste Ramón , Garrido Joseba , Balseiro Ana , Gortázar Christian , Rodríguez-Bertos Antonio , Domínguez Mercedes , Domínguez Lucas 
Published: May 2024

AbstractIn the wake of the COVID-19 pandemic caused by SARS-CoV-2, questions emerged about the potential effects of Bacillus Calmette-Guérin (BCG) vaccine on the immune response to SARS-CoV-2 infection, including the neurodegenerative diseases it may contribute to. To explore this, an experimental study was carried out in BCG-stimulated and non-stimulated k18-hACE2 mice challenged with SARS-CoV-2. Viral loads in tissues determined by RT-qPCR, histopathology in brain and lungs, immunohistochemical study in brain (IHC) as well as mortality rates, clinical signs and plasma inflammatory and coagulation biomarkers were assessed. Our results showed BCG-SARS-CoV-2 challenged mice presented higher viral loads in the brain and an increased frequency of neuroinvasion, with the greatest differences observed between groups at 3–4 days post-infection (dpi). Histopathological examination showed a higher severity of brain lesions in BCG-SARS-CoV-2 challenged mice, mainly consisting of neuroinflammation, increased glial cell population and neuronal degeneration, from 5 dpi onwards. This group also presented higher interstitial pneumonia and vascular thrombosis in lungs (3–4 dpi), BCG-SARS-CoV-2 mice showed higher values for TNF-α and D-dimer values, while iNOS values were higher in SARS-CoV-2 mice at 3–4 dpi. Results presented in this study indicate that BCG stimulation could have intensified the inflammatory and neurodegenerative lesions promoting virus neuroinvasion and dissemination in this experimental model. Although k18-hACE2 mice show higher hACE2 expression and neurodissemination, this study suggests that, although the benefits of BCG on enhancing heterologous protection against pathogens and tumour cells have been broadly demonstrated, potential adverse outcomes due to the non-specific effects of BCG should be considered.
Advances in solar pond technology and prospects of efficiency improvement methods
Authors: Mbelu Onyedika V. , Adeyinka Adekanmi M. , Yahya Daniel I. , Adediji Yaqub B. , Njoku Howard 
Published: May 2024

AbstractThe rising global energy demand necessitates innovative solutions for harnessing renewable energy sources. Solar ponds have received attention as they present a viable means to address this challenge by absorbing and storing solar radiation. This article provides a comprehensive review of solar pond technology, including its principles, applications, heat extraction mechanisms, and approaches to optimize performance, with special attention to the salt-gradient solar pond. Additionally, the article identifies challenges that currently hinder the large-scale adoption of solar pond technology and offers recommendations for future research. By providing a detailed analysis of the current trends and future research directions, this paper seeks to contribute to the ongoing efforts to improve these systems, exploring various approaches to increase their efficiency and make them more economical and environmentally sustainable.
Peer-Mediated Programs Amidst a Pandemic: Perspectives on Implementation, Impact, and Future Considerations
Authors: Pulido Stephanie , Matthews Amy , Owen-DeSchryver Jamie , Harr-Smith Lindsey , Carter Erik W. 
Published: May 2024

Abstract
Schoolwide peer-mediated programs have long been advocated as an avenue for promoting inclusion, friendship, and learning for students with autism and other developmental disabilities. Such interactive programs faced complexities amid the COVID-19 pandemic. We surveyed representatives of 91 elementary and secondary schools implementing a peer-mediated program called Peer to Peer (Ziegler et al., 2020). Participants described how the pandemic impacted program involvement, implementation, and inclusion across two school years. In open-ended questions, participants described program adaptations and how the pandemic deepened their commitment to inclusion. We discuss implications for research and practice aimed at strengthening peer-mediated programs to advance inclusion and belonging within—and after—a global pandemic.
Diabetes mellitus as a risk factor for severe dengue fever and West Nile fever: A meta-analysis
Authors: Lu Hong-Zheng , Xie Yu-Zhuang , Gao Chen , Wang Ying , Liu Ting-Ting , Wu Xing-Zhe , Dai Fang , Wang Duo-Quan , Deng Sheng-Qun 
Published: May 2024

Background
Dengue fever (DF) and West Nile fever (WNF) have become endemic worldwide in the last two decades. Studies suggest that individuals with diabetes mellitus (DM) are at a higher risk of developing severe complications from these diseases. Identifying the factors associated with a severe clinical presentation is crucial, as prompt treatment is essential to prevent complications and fatalities. This article aims to summarize and assess the published evidence regarding the link between DM and the risk of severe clinical manifestations in cases of DF and WNF.

Methodology/Principal findings
A systematic search was conducted using the PubMed and Web of Science databases. 27 studies (19 on DF, 8 on WNF) involving 342,873 laboratory-confirmed patients were included in the analysis. The analysis showed that a diagnosis of DM was associated with an increased risk for severe clinical presentations of both DF (OR 3.39; 95% CI: 2.46, 4.68) and WNF (OR 2.89; 95% CI: 1.89, 4.41). DM also significantly increased the risk of death from both diseases (DF: OR 1.95; 95% CI: 1.09, 3.52; WNF: OR 1.74; 95% CI: 1.40, 2.17).

Conclusions/Significance
This study provides strong evidence supporting the association between DM and an increased risk of severe clinical manifestations in cases of DF and WNF. Diabetic individuals in DF or WNF endemic areas should be closely monitored when presenting with febrile symptoms due to their higher susceptibility to severe disease. Early detection and appropriate management strategies are crucial in reducing the morbidity and mortality rates associated with DF and WNF in diabetic patients. Tailored care and targeted public health interventions are needed to address this at-risk population. Further research is required to understand the underlying mechanisms and develop effective preventive and therapeutic approaches.
A systematic review of barriers and facilitators to antenatal screening for HIV, syphilis or hepatitis B in Asia: Perspectives of pregnant women, their relatives and health care providers
Authors: Sabin Lucie , Haghparast-Bidgoli Hassan , Miller Faith , Saville Naomi 
Published: May 2024

Background
Despite improvements, the prevalence of HIV, syphilis, and hepatitis B remains high in Asia. These sexually transmitted infections (STIs) can be transmitted from infected mothers to their children. Antenatal screening and treatment are effective interventions to prevent mother-to-child transmission (MTCT), but coverage of antenatal screening remains low. Understanding factors influencing antenatal screening is essential to increase its uptake and design effective interventions. This systematic literature review aims to investigate barriers and facilitators to antenatal screening for HIV, syphilis, and hepatitis B in Asia.

Methods
We conducted a systematic review by searching Ovid (MEDLINE, Embase, PsycINFO), Scopus, Global Index Medicus and Web of Science for published articles between January 2000 and June 2023, and screening abstracts and full articles. Eligible studies include peer-reviewed journal articles of quantitative, qualitative and mixed-method studies that explored factors influencing the use of antenatal screening for HIV, syphilis or hepatitis B in Asia. We extracted key information including study characteristics, sample, aim, identified barriers and facilitators to screening. We conducted a narrative synthesis to summarise the findings and presented barriers and facilitators following Andersen’s conceptual model.

Results
The literature search revealed 23 articles suitable for inclusion, 19 used quantitative methods, 3 qualitative and one mixed method. We found only three studies on syphilis screening and one on hepatitis B. The analysis demonstrates that antenatal screening for HIV in Asia is influenced by many barriers and facilitators including (1) predisposing characteristics of pregnant women (age, education level, knowledge) (2) enabling factors (wealth, place of residence, husband support, health facilities characteristics, health workers support and training) (3) need factors of pregnant women (risk perception, perceived benefits of screening).

Conclusion
Knowledge of identified barriers to antenatal screening may support implementation of appropriate interventions to prevent MTCT and help countries achieve Sustainable Development Goals’ targets for HIV and STIs.
The association between caesarean section delivery and obesity at age 17 years. Evidence from a longitudinal cohort study in the United Kingdom
Authors: O. Gorman Tessa , Maher Gillian M. , Al Khalaf Sukainah , Khashan Ali S. 
Published: May 2024

Background
Childhood and adolescent obesity are major, preventable public health concerns. Studies to date are inconclusive regarding an association between caesarean section (CS) delivery and offspring obesity, with fewer studies conducted in late adolescence. This study examined the association between CS delivery, with a specific focus on planned CS, and induction of labour and adolescent body mass index (BMI) and body fat percentage (BF%) at age 17 years.

Methods
Data on 8,880 mother-child pairs from the United Kingdom Millennium Cohort Study were analysed. The exposures were mode of delivery (normal vaginal delivery (VD) (reference), assisted VD, planned CS and emergency CS) and mode of delivery by induction of labour status. Crude and adjusted binary logistic regression and linear regression models were fitted examining BMI and BF% at age 17 years respectively, adjusting for several potential confounders.

Results
Adolescents born by CS did not have an elevated BMI or BF% compared to those born by normal VD. The fully adjusted results for overweight and obesity in children born by planned CS, compared to VD, were 1.05 (95% CI: 0.86–1.28) and 0.94 (95% CI: 0.72–1.23), respectively. The results were similar for the associations between CS and BF%, and between induction of labour and BMI.

Conclusion
Overall, this large longitudinal study did not support an association between CS or induction of labour and overweight, obesity or BF%. It is possible that previously reported associations are due to residual or unmeasured confounding and/or underlying indications for CS delivery.
Vitamin C and E antioxidant supplementation may significantly reduce pain symptoms in endometriosis: A systematic review and meta-analysis of randomized controlled trials
Authors: Bayu Patrick , Wibisono Jacobus Jeno 
Published: May 2024

Background
The primary challenge encountered by individuals diagnosed with endometriosis is the experience of pain. Emerging research indicates that oxidative stress is implicated in the initiation of pain associated with endometriosis. Vitamins C and E are known for their antioxidative properties. The primary objective of this study is to assess the efficacy of antioxidant supplementation, consisting of these vitamins, in the management of pain associated with endometriosis.

Methods
A comprehensive search was conducted on the ClinicalTrials.gov, Scopus, Europe PMC, and Medline databases up until August 23rd, 2023, utilizing a combination of relevant keywords. This review incorporates literature that examines the relationship between antioxidant supplementation and pain in endometriosis. We employed fixed-effect models to analyze the risk ratio (RR) and present the outcomes together with their corresponding 95% confidence intervals (CI).

Results
A total of five RCTs were incorporated. The results of our meta-analysis indicated that antioxidant supplementation with vitamin C and E combination was associated with higher proportion of endometriosis patients reporting reduced chronic pelvic pain (RR 7.30; 95%CI: 3.27–16.31, p<0.00001, I2 = 0%), alleviations of dysmenorrhea (RR 1.96; 95%CI: 1.25–3.07, p = 0.003, I2 = 39%), and dyspareunia (RR 5.08; 95%CI: 2.10–12.26, p = 0.0003, I2 = 0%) than patients only receiving placebo.

Conclusions
This study suggests the potential ability of vitamin C and E in alleviating pain symptoms experienced by individuals with endometriosis.
Coverage, spatial distribution and determinants of childhood inactivated poliovirus vaccine immunization in Ethiopia
Authors: Tamir Tadesse Tarik , Workneh Belayneh Shetie , Mekonen Enyew Getaneh , Zegeye Alebachew Ferede 
Published: May 2024

Introduction
Polio eradication is a current and common strategy throughout the globe. The study of the newly introduced inactivated poliovirus vaccine provides a grasp on the current status of immunization and identifies any disparities in the implementation of the vaccine throughout Ethiopia. Thus, this study aimed to demonstrate the spatial distribution, coverage, and determinants of inactivated poliovirus vaccine immunization in Ethiopia.

Method
Spatial distribution and determinants of inactivated poliovirus vaccine immunization in Ethiopia were conducted using Ethiopian mini-demographic and health survey 2019 data. A total of 2,056 weighted children aged 12 to 35 months were included in the analysis. The association between the outcome and explanatory variables was determined by commuting the adjusted odds ratio at a 95% confidence interval. The p-value of less than 0.05 was used to declare factors as significantly associated with the inactivated poliovirus vaccine immunization.

Result
The weighted national coverage of inactivated poliovirus vaccine immunization in Ethiopia was 51.58% at a 95% confidence interval (49.42, 53.74). While the rates of inactivated poliovirus vaccine immunization were observed to be greater in Addis Ababa, Tigiray, Amahara, and Benishangul Gumuz provinces and lower in the Somali, Afar, and SNNPR provinces of Ethiopia, Antenatal care follow-up, place of delivery, place of residence, and region were significantly associated with inactivated poliovirus immunization in Ethiopia.

Conclusion
The distribution of inactivated poliovirus immunization was spatially variable across Ethiopia. Only about half of the children aged twelve to thirty-five months received the inactivated poliovirus vaccine in the country. The factors, both at the individual and community level, were significantly associated with inactivated poliovirus immunization. Therefore, policies and strategies could benefit from considering antenatal care follow-up, place of delivery, place of residence, and region while implementing inactivated poliovirus vaccine immunization.
Leading from the bottom: The clinical leaders roles in an HIV primary care facility in Eldoret, Kenya
Authors: Cherop Felishana , Wachira Juddy , Bagire Vincent , Korir Michael 
Published: May 2024

Background
Clinical leaders in health systems play critical roles in making decisions that impact patient care and health system performance. Current literature has focused on the importance of clinical leaders’ roles in healthcare settings and has not addressed the leadership aspect that clinical leaders engage in day-to-day decision-making in HIV facilities while providing HIV patient care. Therefore, identifying the leadership roles that wclinical leaders perform at HIV primary facilities is of critical importance.

Purpose
The study explored the views of healthcare providers working in AMPATH-MTRH HIV facility on what they perceived as the roles of clinical leaders at the HIV primary care facility.

Methods
We conducted a qualitative exploratory study between December 2019 to May 2020, involving in-depth interviews with (n = 22) healthcare providers working in AMPATH-MTRH HIV facility, who were purposively and conveniently sampled to participate in in-depth interviews to explore perceptions regarding the leadership roles of clinical leaders. The collected data were analyzed thematically and Nvivo vs.12 software was used for data management.

Results
The following themes were identified from the analysis regarding perceived clinical leaders’ roles in an HIV primary care facility: 1) Strategic roles: providing direction and guidance, ensuring goals and objectives of the department are achieved within the set timelines, planning, and budgeting for adequate resources to support patient HIV care 2) Interconnecting health systems levels and supervisory oversight roles: a link between management, staff, and patients, solving problems, organizing and attending departmental meetings, facilitate staff training, accountable, collaborating with other departments and leaders, defines and assigns responsibilities, ensure quality patient service, coordination, and management of daily activities 3) Research roles: data collation, analysis, generation, review and reporting to the management.

Conclusion
Clinical leaders in the HIV care system perform leadership roles that are characterized by strategic, middle-level, supervisorial and research which reflects the model of the leadership and management style of the HIV care system. The understanding of these roles contributes valuable insights to HIV leaders and managers to recognize the important contribution of clinical leaders and consider reviewing Standard Operating Procedures to include these leadership roles and strengthen their capacity to maximize clinicians’ contribution to improve HIV care and enhance responsive health systems.
The MISOPRED score: Development and validation of a clinical scoring system to predict the effectiveness of Misoprostol treatment for early pregnancy loss
Authors: Bar-Noy Tomer , Limonad Ofer , Gandelsman Erika , Shrim Alon , Sharabi Hila , Zarecki Raphy , Hallak Mordechai , Bruchim Ilan 
Published: May 2024

Background
Misoprostol treatment for early pregnancy loss has varied success demonstrated in previous studies. Incorporating predictors in a single clinical scoring system would be highly beneficial in clinical practice.

Objective
To develop and evaluate the accuracy of a scoring system to predict misoprostol treatment outcomes for managing early pregnancy loss.

Study design
Retrospective cohort and validation study.

Methods
Patients discharged from the gynecologic emergency department from 2013 to 2016, diagnosed with early pregnancy loss, who were treated with 800 mcg misoprostol, administrated vaginally were included. All were sonographically reevaluated within 48–72 hours. Patients in whom the gestational sac was not expelled or with endometrial lining >30 mm were offered a repeat dose and returned for reevaluation after seven days. A successful response was defined as complete expulsion. Clinical data were reviewed to identify predictors for successful responses. The scoring system was then retrospectively evaluated on a second cohort to evaluate its accuracy. Multivariate logistic regression was performed to identify factors most predictive of treatment response.

Results
The development cohort included 126 patients. Six factors were found to be most predictive of misoprostol treatment effectiveness: nulliparity, prior complete spontaneous abortion, gestational age, vaginal bleeding, abdominal pain, and mean sac diameter, yielding a score of 0–8 (the MISOPRED score), where 8 represents the highest-likelihood of success. The score was validated retrospectively with 119 participants. Successful response in the group with the lowest likelihood score (score 0–3) was 9%, compared with 82% in the highest likelihood score group (score 7–8). Using the MISOPRED score, approximately 15% of patients previously planned to receive misoprostol treatment can be referred for surgical management.

Conclusions
MISOPRED score can be utilized as an adjunct tool for clinical decision-making in cases of Early pregnancy loss. To our knowledge, this is the first scoring system suggested to predict the success rate in these cases.
Unmet need for family planning and associated factors among currently married women in Nepal: A further analysis of Nepal Demographic and Health Survey—2022
Authors: K. C. Saugat Pratap , Adhikari Bikram , Pandey Achyut Raj , Pandey Merina , Kakchapati Sampurna , Giri Santosh , Sharma Shreeman , Lamichhane Bipul , Gautam Ghanshyam , Joshi Deepak , Dulal Bishnu Prasad , Regmi Shophika , Baral Sushil Chandra 
Published: May 2024

Introduction
Family planning (FP) is crucial for improving maternal and newborn health outcomes, promoting gender equality, and reducing poverty. Unmet FP needs persist globally, especially in South Asia and Sub-Saharan Africa leading to unintended pregnancies, unsafe abortions, and maternal fatalities. This study aims to identify the determinants of unmet needs for FP from a nationally representative survey.

Methods
We analyzed the data of 11,180 currently married women from nationally representative Nepal Health Demographic Survey 2022. We conducted weighted analysis in R statistical software to account complex survey design and non-response rate. We conducted univariate and multivariable binary and multinomial logistic regression to assess association of unmet need for FP with independent variables including place of residence, province, ecological belt, ethnicity, religion, current age, participant’s and husband’s education, occupation, wealth quintile, parity, desire for child, and media exposure.

Results
The total unmet FP need was 20.8% (95%CI: 19.7, 21.9) accounting 13.4% (95%CI: 12.5, 14.4) for unmet need for limiting and 7.4% (95%CI: 6.8, 8.0) for unmet for spacing. Lower odds of total unmet need for FP were present in 20–34 years and 35–49 years compared to <20 years, women belonging to Madhesi ethnic group (AOR: 0.78; 95%CI: 0.64, 0.95) compared to Brahmin/Chhetri, women from richest (AOR: 0.69; 95%CI: 0.56, 0.84), richer (AOR: 0.82; 95%CI: 0.68, 0.97) and middle wealth quintile (AOR: 0.82; 95%CI:0.70, 0.98) groups compared poorest wealth quintile group and women belonging to rural area (AOR: 0.89; 95%CI: 0.80, 0.99) compared to urban area. Higher odds of unmet need for FP were present among women with basic (AOR: 1.34; 95%CI: 1.17, 1.54), and secondary level (AOR: 1.32; 95%CI: 1.12, 1.56) education compared to women without education, among women from Madhesh (AOR: 1.56; 95%CI: 1.22, 1.98), Gandaki (AOR: 2.11; 95%CI: 1.66, 2.68), Lumbini (AOR: 1.97; 95%CI: 1.61, 2.42) and Sudurpashchim province (AOR: 1.64; 95%CI: 1.27, 2.10) compared to Koshi province and among women whose husband education was basic level (AOR:1.37; 95%CI: 1.15, 1.63), or secondary level (AOR: 1.32; 95%CI: 1.09, 1.60) education.

Conclusion
Nepal faces relatively high unmet FP needs across various socio-demographic strata. Addressing these needs requires targeted interventions focusing on age, ethnicity, religion, education, and socio-economic factors to ensure universal access to FP services.