bluuebunny/crossref_metadata_2025_split huggingface dataset:
Health system facilitators and barriers to the integration of mental health services into primary care in the Democratic Republic of the Congo: a multimethod study
Authors: Mukala Mayoyo Erick , Chenge Faustin , Sow Abdoulaye , Criel Bart , Michielsen Joris , Van den Broeck Kris , Coppieters Yves 
Published: June 2024

Abstract
Background
The integration of mental health into primary care—i.e., the process by which a range of essential mental health care and services are made available in existing multipurpose health care settings that did not previously provide them—can be facilitated or hindered by several health system factors that are still poorly understood. This study aimed to identify health system facilitators and barriers to the integration of mental health services into primary care in the Democratic Republic of the Congo (DRC) to improve the success rate of integration programs.

Methods
We conducted a multimethod, cross-sectional exploratory study. Stakeholders (managers, health service providers, service users, etc.) from sixteen of the twenty-six provinces of the DRC participated. We collected qualitative data through 31 individual, semistructured, face-to-face key informant interviews. We then collected quantitative data through a population-based survey of 413 respondents. We analyzed the interviews via thematic analysis, assigning verbatims to predefined themes and subthemes. For the survey responses, we performed descriptive analysis followed by binomial logistic regression to explore the associations between the variables of interest.

Results
Strong leadership commitment, positive attitudes toward mental health care, the availability of care protocols, mental health task sharing (p < 0.001), and sufficient numbers of primary care providers (PCPs) (p < 0.001) were identified as key health system facilitators of successful integration. However, barriers to integration are mainly related to a poor understanding of what integration is and what it is not, as well as to the poor functionality and performance of health facilities. In addition, stigma, low prioritization of mental health, lack of mental health referents, low retention rate of trained health professionals, lack of reporting tools, lack of standardized national guidelines for integration (p < 0.001), lack of funding (p < 0.001), shortage of mental health specialists to coach PCPs (p < 0.001), and lack of psychotropic medications (p < 0.001) were identified as health system barriers to integration.

Conclusion
Improving the functionality of primary care settings before integrating mental health care would be beneficial for greater success. In addition, addressing identified barriers, such as lack of funding and mental health-related stigma, requires multistakeholder action across all building blocks of the health system.
Utilisation of postnatal care services among maternal in Maeen District – Sana’a City, Yemen
Authors: Haza’a Abdulnasser A. , Odhah Marzoq A. , Al-Ahdal Saddam A. , Abol–Gaith Fawz M. , Ismail Nada A. , Al-Awar Mohammed S. , Al-Jaradi Abdulfatah S. , Eidah Wedian S. , Kaid Manar M. 
Published: June 2024

Abstract
Background
One of the most effective ways to reduce maternal and neonatal mortality is to improve mother and newborn health via the provision of appropriate postnatal care services by qualified healthcare providers. However, there is limited information on the use of postnatal care services in Yemen. This study aimed to determine the utilisation of postnatal care services among mothers in Yemen.

Methodology
A descriptive cross-sectional study was conducted in the Maeen District of Sana’a City, Yemen from December 2022 to January 2023. Convenience sampling was employed to recruit 321 participants. Semi-structured questionnaires were applied as the study tool in the face-to-face survey.

Result
Less than half (45.2%) of the study participants utilised postnatal care services in this study. The mode of delivery, place of delivery, and receiving information about postnatal care during antenatal visits were significantly associated with postnatal care service utilisation.

Conclusion
Less than half of the study participants were informed about postnatal care services, contributing to their low utilisation. Thus, it is vital to strengthen the provision of information, education, and communication with regard to postnatal care services among pregnant mothers visiting antenatal clinics.
Characterizing the utilization of doula support services among birthing people of color in the United States: a scoping review
Authors: Kang Emily , Stowe Nat’e , Burton Kelsey , Ritchwood Tiarney D. 
Published: June 2024

Abstract
Background
Birthing people of color experience disproportionately higher rates of infant and maternal mortality during pregnancy and birth compared to their white counterparts. The utilization of doula support services may lead to improvements in the birthing experiences of birthing people of color. Yet, the research in this area is sparse. Thus, the purpose of this review is to characterize the research on doula utilization among birthing people of color, identify gaps in the field, and provide recommendations for future research.

Methods
Utilizing PRISMA guidelines, we conducted a scoping review, searching PubMed, PsycINFO, CINAHL, and Google Scholar for peer-reviewed articles published between January 1, 2016, to July 3, 2022.

Results
Twenty-five articles met inclusion criteria. We identified the three themes characterizing included studies: (1) how doulas support (HDS) their clients, (2) doula support outcomes (DSO), and (3) considerations for implementing doula support services (CIDS). Despite doulas being described as agents of empowerment, and providing social support, education, and advocacy, birthing people of color reported low utilization of doula support services and findings regarding their effectiveness in improving birthing outcomes were mixed.

Conclusions
While some studies suggest that doulas may offer important services to birthing people of color, doulas are largely under-utilized, with many birthing people reporting low knowledge of their potential roles during the pre- and post-partum periods. Moreover, few studies were designed to assess intervention effects, limiting our ability to draw firm conclusions. Birthing people of color are at elevated risk for maternal mortality. As such, interventions are needed to support this population and improve outcomes. Our review suggests that, while doulas have the potential to make important contributions to the birthing support team, they are underutilized, and intervention studies are needed to enable estimates of their true effectiveness.
IPF-related new macrophage subpopulations and diagnostic biomarker identification - combine machine learning with single-cell analysis
Authors: Zhang Hao , Yang Yuwei , Cao Yan , Guan Jingzhi 
Published: June 2024

AbstractsIdiopathic pulmonary fibrosis (IPF) is a chronic disease of unknown etiology that lacks a specific treatment. In IPF, macrophages play a key regulatory role as a major component of the lung immune system, especially during inflammation and fibrosis. However, our understanding of the cellular heterogeneity and molecular characterization of macrophages in IPF, as well as their relevance in the clinical setting, is relatively limited. In this study, we analyzed in-depth single-cell transcriptome sequencing (scRNA-seq) data from lung tissues of IPF patients, identified macrophage subpopulations in IPF, and probed their molecular characteristics and biological functions. hdWGCNA identified co-expressed gene modules of a subpopulation of IPF-associated macrophages (IPF-MΦ), and probed the IPF-MΦ by a machine-learning approach. hdWGCNA identified a subpopulation of IPF-associated macrophage subpopulations and probed the IPF-MΦ signature gene (IRMG) for its prognostic value, and a prediction model was developed on this basis. In addition, IPF-MΦ was obtained after recluster analysis of macrophages in IPF lung tissues. Coexpressed gene modules of IPF-MΦ were identified by hdWGCNA. Then, a machine learning approach was utilized to reveal the characteristic genes of IPF-MΦ, and a prediction model was built on this basis. In addition, we discovered a type of macrophage unique to IPF lung tissue named ATP5-MΦ. Its characteristic gene encodes a subunit of the mitochondrial ATP synthase complex, which is closely related to oxidative phosphorylation and proton transmembrane transport, suggesting that ATP5-MΦ may have higher ATP synthesis capacity in IPF lung tissue. This study provides new insights into the pathogenesis of IPF and provides a basis for evaluating disease prognosis and predictive medicine in IPF patients.
Graphical Abstract
Phenotyping grapevine resistance to downy mildew: deep learning as a promising tool to assess sporulation and necrosis
Authors: Macia Felicià Maviane , Possamai Tyrone , Dorne Marie-Annick , Lacombe Marie-Céline , Duchêne Eric , Merdinoglu Didier , Peeters Nemo , Rousseau David , Wiedemann-Merdinoglu Sabine 
Published: June 2024

Abstract
Background
Downy mildew is a plant disease that affects all cultivated European grapevine varieties. The disease is caused by the oomycete Plasmopara viticola. The current strategy to control this threat relies on repeated applications of fungicides. The most eco-friendly and sustainable alternative solution would be to use bred-resistant varieties. During breeding programs, some wild Vitis species have been used as resistance sources to introduce resistance loci in Vitis vinifera varieties. To ensure the durability of resistance, resistant varieties are built on combinations of these loci, some of which are unfortunately already overcome by virulent pathogen strains. The development of a high-throughput machine learning phenotyping method is now essential for identifying new resistance loci.

Results
Images of grapevine leaf discs infected with P. viticola were annotated with OIV 452–1 values, a standard scale, traditionally used by experts to assess resistance visually. This descriptor takes two variables into account the complete phenotype of the symptom: sporulation and necrosis. This annotated dataset was used to train neural networks. Various encoders were used to incorporate prior knowledge of the scale’s ordinality. The best results were obtained with the Swin transformer encoder which achieved an accuracy of 81.7%. Finally, from a biological point of view, the model described the studied trait and identified differences between genotypes in agreement with human observers, with an accuracy of 97% but at a high-throughput 650% faster than that of humans.

Conclusion
This work provides a fast, full pipeline for image processing, including machine learning, to describe the symptoms of grapevine leaf discs infected with P. viticola using the OIV 452–1, a two-symptom standard scale that considers sporulation and necrosis. If symptoms are frequently assessed by visual observation, which is time-consuming, low-throughput, tedious, and expert dependent, the method developed sweeps away all these constraints. This method could be extended to other pathosystems studied on leaf discs where disease symptoms are scored with ordinal scales.
Awareness and practical evaluation of correct use of iron chelators; a study to track the ambiguities of thalassemia patients on their medications in Iran
Authors: Mousavi Mina Saddat , Mohammadnezhad Ghader , Yaghmaei Farideh , Azarkeivan Azita , Esmaily Hadi 
Published: June 2024

Abstract
Purpose
This study aimed to evaluate the knowledge, attitude, and practice toward iron chelating agents (ICAs) in Iranian thalassemia major patients.

Methods
A total of 101 patients with thalassemia major were involved in this cross-sectional survey. A deep medication review was done, and participants’ knowledge, attitude, and practice were evaluated by a validated instrument based on a 20-scoring system.

Results
Statistical analyses showed 52 patients (51.5%) had a poor knowledge level (scores < 10) about their medications, 37 (36.6%) had a moderate level (scores 10–15), and 12 (11.9%) had a satisfactory level (scores > 15). Seventy-seven (76.2%) patients have positive beliefs regarding the dependence of their current health status on taking iron chelators, and 63 (62.4%) believed that they would become very ill without taking medication. The results also showed that the mean practice score in patients who received deferoxamine was 5.81 ± 3.50; in the patients who received deferiprone and those who received deferasirox, the mean scores were 7.36 ± 5.15 and 14.94 ± 4.14. Also, the knowledge and practice level had a direct linear correlation based on the regression analyses (P < 0.001).

Conclusion
In conclusion, results of the present research suggests that the patients’ knowledge about the administration, adverse events, and necessity of ICAs was not satisfactory. Improving the knowledge of thalassemia patients toward their medicines through educational interventions is highly recommended to improve their practice level.
Measurement and conceptualization of male involvement in family planning: a bibliometric analysis of Africa-based studies
Authors: Oni Tosin Olajide , Petlele Rebaone , Banjo Olufunmilayo Olufunmilola , Bankole Akinrinola , Akinyemi Akanni Ibukun 
Published: June 2024

Abstract
Background
Male involvement in Family Planning (FP) is an exercise of men’s sexual and reproductive health rights. However, the measurement of male involvement has been highly inconsistent and too discretional in FP studies. As a result, we used bibliometric tools to analyze the existing measures of male involvement in FP and recommend modifications for standard measures.

Methods
Using developed search terms, we searched for research articles ever published on male involvement in FP from Scopus, Web of Science, and PubMed databases. The search results were filtered for studies that focused on Africa. A total of 152 research articles were selected after the screening, and bibliometric analysis was performed in R.

Results
Results showed that 54% of the studies measured male involvement through approval for FP, while 46.7% measured it through the attitude of males to FP. About 31% measured male involvement through input in deciding FP method, while others measured it through inputs in the choice of FP service center (13.6%), attendance at FP clinic/service center (17.8%), and monetary provision for FP services/materials (12.4%). About 82.2% of the studies used primary data, though the majority (61.2%) obtained information on male involvement from women alone. Only about one in five studies (19.1%) got responses from males and females, with fewer focusing on males alone.

Conclusion
Most studies have measured male involvement in FP through expressed or perceived approval for FP. However, these do not sufficiently capture male involvement and do not reflect women’s autonomy. Other more encompassing measures of male involvement, which would reflect the amount of intimacy among heterosexual partners, depict the extent of the exercise of person-centered rights, and encourage the collection of union-specific data, are recommended.
Emission characterizations and environmental impacts of off-road vehicles
Authors: Li Hsing-Wang , Lai Chia-Hsiang , Chen Ku-Fan , Lin Yi-Ching , Chien Po-Yen , Chen Wei-Hsiang , Chen Kang-Shin , Peng Yen-Ping 
Published: June 2024

AbstractThis study measured particulate matter (PM) and gaseous pollutants in the exhaust of off-road vehicles (excavators, bulldozers) during idling and working. The fingerprint of metals in PM and the emission factors of off-road vehicles were investigated. The concentrations of total PM (TPM), PM10, and PM2.5 were 14–251, 12–181, and 10–163 mg m−3, respectively, for two kinds of off-road vehicles. PM10 occupied 60–70% of TPM, while PM2.5 accounted for 80–90%of PM10. The calculated emission factors were 0.64–0.94, 0.53–0.79, and 0.32–0.49 g BHP−1 h−1 for TPM, PM10, and PM2.5, respectively. Metallic elements of PM were analyzed in order to evaluate the carcinogenic and non-carcinogenic risks. The results showed that the emission of total metallic elements from the excavator and two bulldozers are 2.7 and 7.9–22.6 mg m−3, respectively, and the dominant components are Zn, Fe, and Al. The total carcinogenic risk of Cd and Pb decreased from 9.4 × 10−8 to 1.3 × 10−8 with increasing the distance from 0 to 150 m away from the three off-road vehicles (one excavator, and two bulldozers). The non-carcinogenic risk of both Cd and Pb is lower than the limits (hazard index = 1), which is considered acceptable.
Flexural strengthening of LWRC beams using RSHCC reinforced with glass fiber textile mesh
Authors: Issa Mohamed E. , El-Shafey Nasser F. , Baraghith Ahmed T. , Balat Ehab N. 
Published: June 2024

AbstractThis study aims to explore the flexural behavior of crushed clay brick (CCB) lightweight concrete (LWC) beams strengthened with rubberized strain-hardening cementitious composite reinforced with glass fiber textile mesh layers (GFTM-RSHCC) at the tension side. For this purpose, an experimental investigation consisting of seven simply supported beams, including one un-strengthened specimen, was produced and tested using a monotonic 4-point loading scheme. All specimens had a 120 × 250 mm cross-section, a total length of 2400 mm, and a loaded span of 2200 mm. The studied parameters were the number of GFTM inside the RSHCC (1, 2, or 3) and the thickness of GFTM-RSHCC layer (30 or 40 mm). All the following aspects were tracked: crack pattern, ultimate load, mid-span defection, and ductility. The results show that increasing the number of layers of GFTM and the thickness of RSHCC generally leads to an increase in the ultimate loads and ductility, up to 68% and 83%, respectively, compared to the control beam. Finally, a proposed equation considering the contribution of the GFTM-RSHCC layer was developed to predict the flexural capacity of the strengthened beams. The proposed equation showed good agreement with the experimental results.
ImmunoSarc II master trial (phase II of sunitinib and nivolumab): Results from the dedifferentiated chondrosarcoma (DDCS) cohort—A GEIS, ISG and UCL study.
Authors: Strauss Sandra J. , Hindi Nadia , Palmerini Emanuela , Martínez-Trufero Javier , Lopez-Pousa Antonio , Carrasco-Garcia Irene , Gonzalez-Billalabeitia Enrique , Moura David Silva , Ramos Rafael , Tirabosco Roberto , Gutierrez Antonio , Martin Broto Javier 
Published: June 2024

11506 Background: Dedifferentiated chondrosarcoma (DDCS) is a rare aggressive CS subtype with a dismal prognosis and no standard of care systemic therapy. For those with advanced, metastatic disease, retrospective chemotherapy studies demonstrate short-term median progression-free survival (PFS) of around 3 to 5.5 months. Benefit from checkpoint and tyrosine kinase inhibitors has been reported, however clinical trial data is scarce, and endpoints are not well defined, thus benchmarking outcomes is challenging. The IMMUNOSARC I master-trial exploring sunitinib plus nivolumab in multiple sarcoma subtypes, detected potential activity in DDCS leading to a specific cohort within the phase II trial IMMUNOSARC II (NCT03277924). Methods: Patients (pts) with ECOG 0-1, centrally confirmed and progressive, measurable DDCS were eligible and treated with sunitinib 37.5 mg/d for 14 days (induction phase), followed by 25 mg/d, in combination with nivolumab 240 mg every 2 weeks until progressive disease (PD) or intolerance. Imaging assessments were performed every 8 weeks. Main endpoint was 6-m PFSR with one-arm survival design (type I error α 0.05, power 0.90, H0 40%, H1 70%) and a Brookmeyer-Crowley like test was assumed with at least 14 of 23 pts required without progression at 6 months. Results: Between December 2019 and October 2023, 24 pts with a median age of 60 years (38-76) were enrolled in 7 centres. Sixteen pts (66%), were male. Pts had received a median of 1 (0-2) prior lines of therapy. In total, 23 pts were evaluable with a median follow-up of 20.1 months (95%CI: 11.6-28.6). Median PFS, according to local site assessment, was 5.6 months (95%CI: 4.5-6.7); the 6m-PFSR was 10 of 23 pts (46%); (95%CI: 23-66) and median overall survival 10.3 months (95%CI: 6.7-13.9). In 19 pts with RECIST measurable response, 5 pts (26.3%) achieved a partial response; 10 (52.6%) stable disease and 4 (21.1%) PD. End-of-treatment reasons were PD in 21 pts (87%), toxicity 1 pt (4.2%) with two pts (8.4%) ongoing. For safety population, the most relevant study drug-related G3-4 toxicities were neutropenia (20.9%), anemia (16.7%), and increased ALT (12.5%). Conclusions: Sunitinib and nivolumab demonstrated encouraging activity in advanced DDCS that did not meet the primary endpoint, but compares favourably with previous analyses of cytotoxic and targeted therapy. The combination is worthy of further exploration in conjunction with reaching a consensus on clinically meaningful endpoints in this challenging population. Translational studies to identify potential predictive biomarkers are ongoing. Clinical trial information: NCT03277924 .
Phase II trial, multicenter, first line paclitaxel-avelumab treatment for inoperable angiosarcoma.
Authors: Kim Hye Ryeon , Kim Miso , Kim Jeong Eun , Kim Hyojeong , Kim Yu Jung , Kang Myoung Joo , Park Kwonoh , Bae Woo Kyun , Hong Jung Yong , Oh Sung Yong 
Published: June 2024

11512 Background: Angiosarcomas are very rare tumors of vascular or lymphatic origin characterized by a clinical heterogeneity in terms of presentation and behavior. It can occur in any site of body but most commonly originate in the skin of head and neck and in breast area. Many patients could not receive surgical resection due to its location and/or rapid progression, even who had localized disease. Moreover, conventional cytotoxic chemotherapy has shown limited effect in angiosarcoma. Here, we conduct a prospective, phase II study to evaluate the efficacy and toxicities of paclitaxel plus avelumab as the first line therapy for unresectable angiosarcoma. Methods: Patients with unresectable locally advanced or metastatic angiosarcoma, who had not received systemic treatment, were enrolled. Paclitaxel (80 mg/m2) was intravenously infused on days 1, 8, and 15 of every 28-days cycle, and avelumab (10mg/kg) was intravenously infused biweekly. The treatment was continued until disease progression or unacceptable toxicity, or withdrawal of consent, whichever occurred first. The primary endpoint was the objective response rate (ORR), and the secondary endpoint was overall survival (OS), progression free survival (PFS), and safety profiles. Results: A total 32 patients (21 male, 11 female) were finally enrolled, and the median age was 63.5 (range, 27 to 82). The ORR was 50.0% (n = 16), including one complete response. Median OS and PFS were 14.5 (95% CI, 9.4 to 24.6) and 6.0 (95% CI, 5.4 to 9.5) months, respectively. Among patients who received at least one dose of treatment (n = 33), adverse events (AEs) of any grade were reported in 90.9% (n = 30), and severe AEs were in 12.1% (n = 4), including one death. The most common hematologic/non-hematologic AEs were neutropenia (n = 13, 39.4%) and pain (n = 12, 36.4%), respectively. Febrile neutropenia, neutropenia, and aspiration were reported in two patients (6.1%) each. Conclusions: Avelumab plus paclitaxel for patients with inoperable angiosarcoma, was effective and has tolerable safety profile. Additional translation studies and phase III studies are needed to clearly identify effectiveness and safety. Clinical trial information: NCT03512834 . [Table: see text]