bluuebunny/crossref_metadata_2025_split huggingface dataset:
Indigenous herbal medicine use and its associated factors among pregnant women attending antenatal care at public health facilities in Dire Dawa, Ethiopia: a cross-sectional study
Authors: Mohammed Aminu , Amsalu Bezabih , Hailu Mickiale , Sintayehu Yitagesu , Weldeamanuel Tadesse , Belay Yalelet , Hassen Zeyniya , Dinkesa Tesema , Dechasa Natnael , Mengist Betelhem , Mengesha Teshale , Nuri Aliya , Getnet Tewodros , Manaye Yibekal , Aliyi Usso Ahmedin , Legesse Henok , Sertsu Addisu 
Published: June 2024

ObjectiveThe aim of this study was to investigate the prevalence of indigenous herbal medicine use and its associated factors among pregnant women attending antenatal care (ANC) at public health facilities in Dire Dawa, Ethiopia.DesignA facility-based cross-sectional study design.SettingThe study was conducted in seven public health facilities (one referral hospital, three urban and three rural health centres) in Dire Dawa, Ethiopia, from October to November 2022.Participants628 pregnant women of any gestational age who had been on ANC follow-up at selected public health facilities were included.Main outcome measuresPrevalence of indigenous herbal medicine (users vs non-users) and associated factors.ResultsThe study revealed that 47.8% (95% CI 43.8% to 51.6%) of pregnant women used herbal medicines. Lack of formal education (adjusted OR, AOR 5.47, 95% CI 2.40 to 12.46), primary level (AOR 4.74, 95% CI 2.15 to 10.44), housewives (AOR 4.15, 95% CI 1.83 to 9.37), number of ANC visits (AOR 2.58, 95% CI 1.27 to 5.25), insufficient knowledge (AOR 4.58, 95% CI 3.02 to 6.77) and favourable perception (AOR 2.54, 95% CI 1.71 to 3.77) were factors significantly associated with herbal medicine use. The most commonly used herbs were garden cress (Lepidium sativum) (32%), bitter leaf (Vernonia amygdalina) (25.2%), moringa (Moringa oleifera) (24.5%).Commonindications were related to gastrointestinal problems, blood pressure and sugar.ConclusionThe prevalence of herbal medicine use is high (one in two pregnant women) and significantly associated with education level, occupation, ANC visits, knowledge and perceptions. The study’s findings are helpful in advancing comprehension of herbal medicines using status, types and enforcing factors. It is essential that health facilities provide herbal counselling during ANC visits, and health regulatory bodies ought to raise awareness and implement interventions to lower the risks from over-the-counter herbal medicine use by pregnant women.
Longitudinal Resilience and Risk Factors in Pediatric Postoperative Pain (LORRIS): Protocol for a Prospective Longitudinal Swiss University Children’s Hospitals-Based Study
Authors: Hochreuter Jana , Dreher Thomas , Hasler Carol-Claudius , Canonica Sandro , Locher Cosima , Held Ulrike , Rabbitts Jennifer , Koechlin Helen 
Published: June 2024

IntroductionChronic postsurgical pain (CPSP) is defined as pain that persists after a surgical procedure and has a significant impact on quality of life. Previous studies show the importance of psychological factors in CPSP, yet the majority of studies focused solely on negative emotions. This longitudinal observational study aims to broaden this knowledge base by examining the role of emotional state, emotion variability, emotion regulation and emotion differentiation on the child and the parent level for the development CPSP, and to describe pain and emotion-related trajectories following surgery.Methods and analysisWe intend to include 280 children and adolescents aged 8–18 years with a planned orthopaedic surgery and their parents. A total of five assessment time points is planned: 3 weeks before surgery (baseline), 2 weeks after surgery (post) and 3 months (follow-up (FU) 1), 6 months and 12 months after surgery. At baseline and post only, children and parents are asked to complete a daily diary thrice a day for a week where they rate their current emotional state and their pain severity (children only). Emotional state ratings will be used to calculate indices of emotion variability, emotion regulation and emotion differentiation. Children and parents will complete questionnaires at each time point, including measures on quality of life, social support, sleep, and symptoms of anxiety and depression.To predict development of CPSP, generalised linear regression models will be used, resulting in ORs and 95% CIs. Pearson product-moment correlations between predictors and outcomes will be evaluated at each time point. The primary outcome of the prediction model is CPSP at FU1. For the trajectory analysis, the classification method K-means for longitudinal data will be used to determine clusters in the data.Ethics and disseminationThe Ethics Committee of the Canton of Zurich, Switzerland, has approved the study (ID: 2023-01475). Participants will be compensated, and a dissemination workshop will be held.Trial registration numberNCT05816174.
Development and validation of a supportive programme for family caregivers of children suffering from cystic fibrosis: protocol for a sequential exploratory mixed-methods study
Authors: Shadi Danial , Jabraeili Mahnaz , Hassankhani Hadi , Alhani Fatemeh , Bostanabad Mohammad Arshadi 
Published: June 2024

IntroductionFamilies with children who have cystic fibrosis (CF) face a multitude of challenges. They require complex and time-consuming daily care, various forms of knowledge and intricate care responsibilities. One of the most critical challenges that Iranian families of children with CF face is the lack of adequate support from health teams in the early stages of diagnosis, frequent hospitalisation and the postdischarge process. Unfortunately, limited studies have been conducted in this field, and the Iranian society lacks a comprehensive support programme for these families after leaving treatment centres or home care teams. Therefore, it is necessary to identify and redefine the needs of these families for better care and support in Iran.Methods and analysisA mixed-method research design with an exploratory sequential approach will be used in this study. The study consists of three stages: stage (1) the qualitative phase (conventional content analysis and scoping review); stage (2) the programme design phase (development of a support programme) and stage (3) the quantitative phase (validation of the programme through the Delphi method). In the first stage, data will be collected through interviews. Key concepts, evidence and gaps in research will also be identified, collected and analysed through a scoping review. In the second stage, a support programme will be designed based on the results of the content analysis of interviews and the findings from the scoping review. In the final phase, the study will aim to validate the designed programme through a Delphi study.Ethics and disseminationThis study formed part of a Ph.D. degree and was approved by the ethics committee of Tabriz University of Medical Sciences (IR.TBZMED.REC.1402.395). Informed consent will be obtained from all study participants. Findings will be published in a peer-reviewed journal.
Estimating the indirect economic burden of cancer in Jordan: a retrospective observational study
Authors: Rashdan Omar 
Published: June 2024

ObjectiveThe aim of this study is to estimate the indirect economic burden of 22 cancer types in Jordan using both the human capital approach (HCA) and the value of a statistical life year (VSLY) approach. Additionally, this study aims to forecast the burden of these cancers for the next 5 years while employing time series analysis.DesignRetrospective observational study with a time series analysis.ParticipantsDisability adjusted life years records from the IHME Global Burden Disease estimates 2019 data.Primary outcome measureIndirect economic burden of cancer in Jordan.ResultsThe mean total economic burden for all cancers is estimated to be $1.82 billion using HCA and $3.13 billion using VSLY approach. The cancers contributing most to the total burden are ‘tracheal, bronchus and lung cancer’ ($359.5 million HCA, $618.3 million VSLY), followed by ‘colon and rectum cancer’ ($300.6 million HCA, $517.1 million VSLY) and ‘breast cancer’ ($292.4 million HCA, $502.9 million VSLY). The indirect economic burden ranged from 1.4% to 2.1% of the gross domestic product (GDP) using the HCA, and from 2.3% to 3.6% of the GDP using the VSLY approach. The indirect economic burden is expected to reach 2.3 and 3.5 billion Intl$ by the year 2025 using the HCA and VSLY approach, respectively.ConclusionThe indirect economic burden of cancer in Jordan amounted to 1.4%–3.6% of total GDP, with tracheal, bronchus and lung cancer; colon and rectum cancer; and breast cancer contributing to over 50% of the total burden. This will help set national cancer spending priorities following Jordan’s economic modernisation vision with regard to maximising health economic outcomes.
Surgeons’ views of peer comparison and guideline-based feedback on postsurgery opioid prescriptions: a qualitative investigation
Authors: Martinez Meghan , Kirkegaard Allison , Bouskill Kathryn , Yan Xiaowei Sherry , Wagner Zachary , Watkins Katherine E 
Published: June 2024

Background
Excess opioid prescribing after surgery can lead to prolonged opioid use and diversion. We interviewed surgeons who were part of a three-group cluster-randomised controlled trial aimed at reducing prescribed opioid quantities after surgery via two versions of a monthly emailed behavioural ‘nudge’ (messages encouraging but not mandating compliance with social norms and clinical guidelines around prescribing) at the end of the implementation year in order to understand surgeons’ reasoning for changing or continuing their prescribing behaviour as a result of the intervention and the context for their rationale.

Methods
The study took place at a large healthcare system in northern California with surgeons from three surgical specialties—orthopaedics, obstetrics/gynaecology and general surgery. Following the intervention period, we conducted semistructured interviews with 36 surgeons who had participated in the trial, ensuring representation across trial arm, specialty and changes in prescribing quantities over the year. Interviews focused on reactions to the nudges, impacts of the nudges on prescribing behaviours and other factors impacting prescribing. Three study team members coded and analysed the transcribed interviews.

Results
Nudges were equally effective in reducing postsurgical opioid prescribing across surgical specialties and between intervention arms. Surgeons were generally receptive to the nudge intervention, noting that it reduced the size of their discharge opioid prescriptions by improving their awareness and intentionality around prescribing. Most were unaware that clinical guidelines around opioid prescribing existed. Some had reservations regarding the accuracy and context of information provided in the nudges, the prescription quantities encouraged by the nudges and feelings of being watched or admonished. A few described discussing the nudges with colleagues. Respondents emphasised that the prescribing behaviours are informed by individual clinical experience and patient-related and procedure-related factors.

Conclusions
Surgeons were open to learning about their prescribing behaviour through comparisons to guidelines or peer behaviour and incorporating this feedback as one of several factors that guide discharge opioid prescribing. Increasing awareness of clinical guidelines around opioid prescribing is important for curbing postsurgical opioid overprescribing.

Trial registration number

NCT05070338
.
Effects of antibiotics, hospitalisation and surgical complications on self-reported immunological vulnerability following paediatric open-heart surgery and thymectomy: a single-centre retrospective cohort study
Authors: Kesäläinen Anssi , Rantanen Rea , Honkila Minna , Helminen Merja , Rahkonen Otto , Kallio Merja , Ruuska Terhi , Kekäläinen Eliisa , Heinonen Santtu 
Published: June 2024

BackgroundPartial or complete thymectomy is routinely performed in paediatric open-heart surgeries when treating congenital heart defects. Whether or not thymectomised children require systematic immunological monitoring later in life is unknown. The objective of this study was to investigate the effects of preoperatively and postoperatively used antibiotics, hospitalisation and surgical complications on self-reported immunological vulnerability in paediatric patients with early thymectomy to better recognise the patients who could benefit from immunological follow-up in the future.MethodsWe conducted a retrospective cohort study, including 98 children and adolescents aged 1–15 years, who had undergone an open-heart surgery and thymectomy in infancy and who had previously answered a survey regarding different immune-mediated symptoms and diagnoses. We performed a comprehensive chart review of preoperative and postoperative factors from 1 year preceding and 1 year following the open-heart surgery and compared the participants who had self-reported symptoms of immunological vulnerability to those who had not.ResultsThe median age at primary open-heart surgery and thymectomy was 19.5 days in the overall study population (60% men, n=56) and thymectomies mainly partial (80%, n=78). Broad-spectrum antibiotics were more frequently used preoperatively in participants with self-reported immunological vulnerability (OR=3.05; 95% CI 1.01 to 9.23). This group also had greater overall use of antibiotics postoperatively (OR=3.21; 95% CI 1.33 to 7.76). These findings were more pronounced in the subgroup of neonatally operated children. There was no statistically significant difference in the duration of intensive care unit stay, hospitalisation time, prevalence of severe infections, surgical complications or glucocorticoid use between the main study groups.ConclusionAntimicrobial agents were more frequently used both preoperatively and postoperatively in thymectomised children with self-reported immunological vulnerability after thymectomy. Substantial use of antimicrobial agents early in life should be considered a potential risk factor for increased immunological vulnerability when evaluating the significance of immune-mediated symptom occurrence in thymectomised paediatric patients.
Dysregulation of CD4+and CD8+resident memory T, myeloid, and stromal cells in steroid-experienced, checkpoint inhibitor colitis
Authors: He Jun Yan , Kim Yang-Joon , Mennillo Elvira , Rusu Iulia , Bain Jared , Rao Arjun A , Andersen Christopher , Law Karen , Yang Hai , Tsui Jessica , Shen Alan , Davidson Brittany , Kushnoor Divyashree , Shi Yimin , Fan Frances , Cheung Alexander , Zhang Li , Fong Lawrence , Combes Alexis J , Pisco Angela O , Kattah Michael G , Oh David Y 
Published: June 2024

BackgroundColitis caused by checkpoint inhibitors (CPI) is frequent and is treated with empiric steroids, but CPI colitis mechanisms in steroid-experienced or refractory disease are unclear.MethodsUsing colon biopsies and blood from predominantly steroid-experienced CPI colitis patients, we performed multiplexed single-cell transcriptomics and proteomics to nominate contributing populations.ResultsCPI colitis biopsies showed enrichment of CD4+resident memory (RM) T cells in addition to CD8+RM and cytotoxic CD8+T cells. Matching T cell receptor (TCR) clonotypes suggested that both RMs are progenitors that yield cytotoxic effectors. Activated, CD38+HLA-DR+CD4+RM and cytotoxic CD8+T cells were enriched in steroid-experienced and a validation data set of steroid-naïve CPI colitis, underscoring their pathogenic potential across steroid exposure. Distinct from ulcerative colitis, CPI colitis exhibited perturbed stromal metabolism (NAD+, tryptophan) impacting epithelial survival and inflammation. Endothelial cells in CPI colitis after anti-TNF and anti-cytotoxic T-lymphocyte-associated antigen 4 (anti-CTLA-4) upregulated the integrin α4β7 ligand molecular vascular addressin cell adhesion molecule 1 (MAdCAM-1), which may preferentially respond to vedolizumab (anti-α4β7).ConclusionsThese findings nominate CD4+RM and MAdCAM-1+endothelial cells for targeting in specific subsets of CPI colitis patients.
In the fight against HIV/AIDS: the arduous implementation of government-funded pre-exposure prophylaxis programme in Taiwan
Authors: Huang Hsun Yin , Huang Jyun Rong , Chan Pei Chun , Lee Chia Chi 
Published: June 2024

Introduction
The government-funded pre-exposure prophylaxis (PrEP) programme was targeted to those aged under 30 years or serodiscordant couples and implemented in September 2018–October 2020 in Taiwan. The study aimed to examine the effectiveness of the programme and the relationship between sexually transmitted disease (STD) and HIV seroconversion.

Methods
This study was a retrospective cohort analysis with questionnaires designed for participants who joined the aforementioned programme in the PrEP-designated hospitals. The questionnaires included sociodemographic factors, sexual risk behaviours, number and types of sexual partners, and usage of narcotics filled in at the beginning of the programme and every 3 months. The McNemar test was used for the paired questionnaire analysis. The HIV seroconversion status among STD-notified patients nationwide was confirmed by using the data linkage method, followed up until October 2021 with stratification of PrEP programme participation or not.

Results
The programme recruited 2155 people. 11 participants (0.5%) had seroconversion within the programme, while 26 (1.2%) had seroconversion after withdrawing from the programme. Overall, 1892 subjects with repeated questionnaires were included in the analysis for behaviour changes with median follow-up of 289 days. After joining the programme, 94.7% of them claimed that they had sexual behaviours: the rate of those who had condomless sex rose to 5.5% (p<0.001) and the rate of those who used narcotics decreased to 2% (p<0.001), compared with their response in the pre-questionnaire. Notably, the frequency of non-use of narcotics in recent 3 months increased from 16.9% to 38.4% in the pre-questionnaire and post-questionnaire responses, among the 177 who had claimed narcotics usage in recent 12 months (p=0.003). More HIV seroconversion was found among patients with STD who did not join the programme than those who joined the programme (8.7% vs 4.9%, p=0.031).

Conclusions
The government-funded programme showed HIV case reduction and positive changes in health behaviours except for condomless sex which had increased prevalence. The reduction of HIV cases was also observed among people with STD. More resources should be allocated to the PrEP programme.
3D imaging application to the study of the early Neolithic ceramic complex: the decorated pottery of Rio Tana (Abruzzi, Italy)
Authors: Petrinelli Pannocchia Cristiana , Vassanelli Alice , Terranova Agnese , Potenziani Marco , Pingi Paolo , Callieri Marco , Cignoni Paolo 
Published: June 2024

AbstractThis study aims to demonstrate the potential of 3D analysis in the study of prehistoric ceramic complexes. Due to the production systems used, prehistoric pottery decorations can vary significantly. Examining the frequency of various decorative methods used at different sites may help identify areas potentially connected to specific traditional elements. However, this is usually a cumbersome and time-consuming task. 3D digital methodologies can bring several advantages in the interpretation of ceramic decoration, providing new tools that can improve analytical skills, speed up the decision process, and support the researcher’s conclusions. This work focuses on the application of these methodologies to the study of decorated ceramics from the Neolithic site of Rio Tana (Abruzzo, central Italy): firstly, a pottery complex from this site has been 3D digitised; then, an interactive and web-based 3D visualisation system has been developed to enable access and study of these digital data. By comparing archaeological data with experimental data, in parallel with the analysis of 3D models’ surfaces, it has been possible to better define the technique employed and quickly identify the type of tool used to create the ceramic decorations. Furthermore, the web-based system made it possible to share and disseminate the digital dataset with the community, creating the conditions to make it easier to compare the frequency of different decoration methods and tools used at Rio Tana with other sites.
Mapping the elemental distribution in archaeological findings through advanced Neutron Resonance Transmission Imaging
Authors: Marcucci Giulia , Scherillo Antonella , Riccardi Maria Pia , Cucini Costanza , Lemasson Quentin , Di Martino Daniela 
Published: June 2024

AbstractThis work highlights recent application of energy-selective neutron imaging at the ISIS Neutron and Muon Source, specifically focusing on the development of Neutron Resonance Transmission Imaging (NRTI) at the INES instrument. NRTI is a nuclear technique based on resonant neutron absorption reaction, which combines the sensitivity to elemental and isotopic composition with detailed morphological information, using the epithermal portion of the neutron flux available on the INES instrument at the ISIS facility. Unlike standard neutron radiography and tomography methods, NRTI preserves detailed time and energy information for each detector pixel, enabling enhanced visualisation of elemental distribution inside an object’s volume, with the potential for quantitative elemental analysis. These features combined with the non-destructiveness of NRTI make the method promising for applications in the field of Cultural Heritage, especially when it is employed in a multi-technique approach to provide complementary information about the composition and the crystalline structure of archaeological artefacts. A study related to Heritage Science is presented to demonstrate the effectiveness of NRTI in non-destructive investigations of inhomogeneous artefacts, specifically focusing on the excavation finds related to the first evidence of ancient brass production in Milan, Italy, during Roman times.
Intelligent Miniplatform for On-Site Monitoring of Water Samples and Pharmaceutical Production of Ointments Based on Betamethasone and Gentamicin as Active Pharmaceutical Ingredients
Authors: Tuchiu Bianca-Maria , Stefan-van Staden Raluca-Ioana , van Staden Jacobus (Koos) Frederick 
Published: June 2024

Betamethasone and gentamicin combination is commonly used in various dermatological conditions. In addition to the topical dosage forms in which this combination can be found, it can also accidentally end up in surface water following removal by washing. For this reason, a disposable miniplatform was constructed by modifying a boron-doped diamond screen printed electrode with calix[4]arene-25,26,27,28-tetrol. Wide linear ranges and low limits of quantification (LOQ) were achieved for both analytes: 1.0 × 10−16–1.0 × 10−2 mol l‒1 and a LOQ of 1.0 × 10−16 mol l‒1 for betamethasone, and 1.0 × 10−17–1.0 × 10−2 mol l‒1 and a LOQ of 1.0 × 10−17 mol l‒1 for gentamicin. The platform was tested on real samples, obtaining recovery values close to 100% and relative standard deviation values below 0.03%. Additionally, a comparison is provided between the proposed approach and existing electrochemical sensors to emphasize the achieved results.
The Cell Cycle: a Key to Unlock EZH2-targeted Therapy Resistance
Authors: Paolini Rachel L. , Souroullas George P. 
Published: June 2024

Summary:
In this issue, a study by Kazansky and colleagues explored resistance mechanisms after EZH2 inhibition in malignant rhabdoid tumors (MRT) and epithelioid sarcomas (ES). The study identified genetic alterations in EZH2 itself, along with alterations that converge on RB1-E2F–mediated cell-cycle control, and demonstrated that inhibition of cell-cycle kinases, such as Aurora Kinase B (AURKB) could bypass EZH2 inhibitor resistance to enhance treatment efficacy.
See related article by Kazansky et al., p. 965 (6).