bluuebunny/crossref_metadata_2025_split huggingface dataset:
Vaginal pH value can affect the susceptibility to human papillomavirus infection
Authors: Liu Yinxia , Li Zhengyu 
Published: February 2024

Abstract
Background
Cervical cancer is the fourth most common cancer among women, with persistent high-risk human papillomavirus (HPV) infection being responsible for its progression. In healthy, pre-menopausal women, the vaginal pH value is maintained at 3.8–4.5, but various factors can affect it. Previous studies have suggested the relationship between vaginal pH value and HPV infection. In this study, we aimed to explore the relationship between vaginal pH and susceptibility of HPV infection.

Methods
In our study, we retrospectively collected medical information from women who underwent leukorrhea examination at our hospital. We excluded women with infectious diseases or cancer, those who were pregnant or within 6 months post-delivery, and those without HPV test results within 6 months. The association between percentage of HPV infection and vaginal pH value was analyzed. Furthermore, we prepared HPV pseudovirus (PsVs) by co-transfecting structure plasmids and report plasmids in 293FT cells. In vitro, we changed the pH value of cell culture medium to investigate its influence on HPV PsVs infection. In vivo, we changed mouse’s vaginal pH value to investigate its influence on HPV PsVs infection.

Results
Our retrospective study included 3115 women aged 20–78, including 2531 women with HPV negative and 584 women with HPV positive. The percentages of both HPV infection and high-risk HPV infection were higher in women with a vaginal pH value ≥5.0 compared to those with a pH value < 5.0. In vitro, HPV PsVs infection rate was higher in cell culture medium of higher pH value, dominantly due to the influence of pH value on the stage of HPV PsVs adhering to cell surface. Neither of the cell surface HPV receptors Syndecan-1 nor integrin α6 was found to be changed obviously in different pH values. In vivo, more HPV PsVs were adhered to the mouse’s vaginal epithelial cells with the increase of the vaginal pH value.

Conclusions
Our study suggests a possible association between vaginal pH value and HPV infection. The pH value can influence the susceptibility of HPV PsVs infection by affecting the adhering of HPV PsVs to cells in vivo and in vitro. Additionally, the cell surface HPV receptors Syndecan-1 and Integrin α6 do not seem to be affected by pH value, and the specific mechanism needs to be further explored.
Development of mental health first-aid guidelines for psychosis: a Delphi expert consensus study in Argentina and Chile
Authors: Agrest Martín , Tapia-Munoz Thamara , Encina-Zúñiga Esteban , Vidal-Zamora Isidora , Geffner Norma , Ardila-Gómez Sara , Alvarado Rubén , Leiderman Eduardo A. , Reavley Nicola 
Published: February 2024

AbstractBackgroundPsychotic symptoms may be less common than anxiety or affective symptoms, but they are still frequent and typically highly debilitating. Community members can have a role in helping to identify, offer initial help and facilitate access to mental health services of individuals experiencing psychosis. Mental health first aid guidelines for helping a person experiencing psychosis have been developed for the global north. This study aimed to adapt the English- language guidelines for Chile and Argentina.MethodsA Delphi expert consensus study was conducted with two panels of experts, one of people with lived experience of psychosis (either their own or as a carer;n = 29) and another one of health professionals (n = 29). Overall, 249 survey items from the original English guidelines and 26 items suggested by the local team formed a total of 275 that were evaluated in the first round. Participants were invited to rate how essential or important those statements were for Chile and Argentina, and encouraged to suggest new statements if necessary. These were presented in a second round. Items with 80% of endorsement by both panels were included in the guidelines for Chile and Argentina.ResultsData were obtained over two survey rounds. Consensus was achieved on 244 statements, including 26 statements locally generated for the second round. Almost 20% of the English statements were not endorsed (n = 50), showing the applicability of the original guidelines but also the importance of culturally adapting them. Attributions and tasks expected to be delivered by first aiders were shrunk in favour of a greater involvement of mental health professionals. Self-help strategies were mostly not endorsed and as were items relating to respecting the person’s autonomy.ConclusionsWhile panellists agreed that first aiders should be aware of human rights principles, items based on recovery principles were only partially endorsed. Further research on the dissemination of these guidelines and development of a Mental Health First Aid training course for Chile and Argentina is still required.
A 10-step participatory program for developing, implementing, and evaluating physical activity promoting actions in nursing homes in Germany
Authors: Hahn Lea-Sofie , Thiel Ansgar , Dembeck Viola , Haigis Daniel , Matting Leon , Pomiersky Rebekka , Eschweiler Gerhard W. , Nieß Andreas M. , Sudeck Gorden , Frahsa Annika 
Published: February 2024

Abstract
Background
Since multidimensional barriers challenge nursing homes, a socio-ecological approach is needed for physical activity promotion in this setting. So far, little is known about how such an approach can be transferred into the successful development and implementation of PA-promoting actions together with stakeholders on-site. We aimed to investigate the actions and dimensions of PA-promoting actions and their sustainable implementation. To contribute to closing this gap, we present a 10-step program for co-developing and co-evaluating PA-promoting actions in nursing homes through an integrated counselling approach.

Methods
We used a multiple case study approach that built upon manifold data sources, collected in 7 nursing homes over 3 years between 2021 and 2023. We collected fieldnotes and photologs from 14 future workshops (2 per home); 7 evaluation workshops (1 per home); 36 individual counsellings (2 sessions per resident), as well as 87 implementation protocols (action type and frequency), 11 evaluation questionnaires (changes among resources, cooperations, and collaborations); 7 goal attainment scales and 18 individual activity schedules. In addition, we retrieved and documented progress information at regular intervals by phone or email.

Results
With staff, residents, relatives, and volunteers, we co-developed 112 ideas for PA promotion; from which 54 ideas were implemented and integrated into everyday life, differentiated into “activities of daily living,” “structured activities,” and “activity-friendly environments.”; 18 residents in 4 homes participated in individual counselling to develop individual activity schedules. Eighteen actions were rated as “(much) more successful than expected”; 10 “(much) worse than expected,” and 23 “as successful as expected.” Three actions were not evaluated.

Discussion
The participatory integrated counselling approach led to home-specific actions and promoted implementation into everyday life. The number and dimensions of actions implemented largely depended on the mission and vision of the respective home. The lack of staff could partially be compensated for by involving neighbourhoods, volunteers, and community organisations, such as local clubs.

Conclusion
To effectively promote PA in nursing homes, a tailored approach considering structural conditions, locations, volunteer engagement, and organisational visions is essential. Long-lasting partnerships and low-threshold opportunities prove promising. Future research should delve into structural-level change processes and outcomes in this context.
Allostatic load and chronic pain: a prospective finding from the national survey of midlife development in the United States, 2004–2014
Authors: Liang Yunlong , Booker Cara 
Published: February 2024

Abstract
Background
Previous research has demonstrated a correlation between chronic stress and chronic pain (CP). However, there have been few studies examining the prospective association of allostatic load (AL)—the biological processes related to stress—with CP.

Methods
We firstly conducted latent class analysis to identify phenotypes of AL using a community-dwelling sample, the Midlife in the United States. Multinomial logistic regression models were used to examine the prospective association between phenotypes of AL at MIDUS 2 biomarker project and the presence of CP, CP interference and the number of CP sites at MIDUS 3.

Results
Three phenotypes of AL, low biological dysregulation, parasympathetic dysregulation and metabolic dysregulation, were identified. Compared to low biological dysregulation group, participants experiencing metabolic dysregulation phenotype of AL at MIDUS 2 had higher risks of having high-interference CP (RRR = 2.00, 95% CI: 1.06, 3.79, P < 0.05) and 3 or more CP sites (RRR = 2.03, 95% CI: 1.08, 3.83, P < 0.05) at MIDUS 3.

Conclusion
The findings indicate that focusing on mitigating the metabolic dysfunction phenotype of AL has the potential to be an efficacious strategy for alleviating future CP bodily widespreadness and high CP interference.
Psychometric evaluation of the Chinese version of the stressors in breast cancer scale: a translation and validation study
Authors: Hu Wenqi , Bao Jiahui , Yang Xiaolin , Ye Mao 
Published: February 2024

Abstract
Objective
To translate the Stressors in Breast Cancer Scale (SBCS) from English to Chinese and assess its psychometric properties.

Methods
The Brislin’s translation model was applied to perform forward translation, back translation, cross-cultural adaptation, Whereas the Chinese version of the SBCS was formed by conducting pre-testing. A cohort of 878 breast cancer patients participated in this methodological study. Content validity, construct validity, convergent validity, discriminant validity, and criterion-related validity were used to establish validity. Internal consistency reliability, split-half reliability, and test-retest reliability were used to establish reliability.

Results
The final scale contained five dimensions and 24 items, including interpersonal relationship and healthcare strains, worries and concerns about the future, physical appearance and sex strains, daily difficulties and health. The average content validity index of the scale was 0.975. The goodness-of-fit index (χ2/DF = 2.416, RMSEA = 0.057, GFI = 0.896, CFI = 0.947, IFI = 0.947, and TLI = 0.939) indicated that the model was well-fitted. The composite reliability (CR) of the dimensions ranged from 0.825 to 0.934, the average variance extracted (AVE) ranged from 0.539 to 0.712, and the correlation coefficients of each dimension with the other dimensions were less than the square root of the AVE for that dimension. The Criterion-related validity was 0.511. The Cronbach’s alpha was 0.938, and the dimensions ranged from 0.779 to 0.900. Split-half reliability was 0.853, with dimensions ranging from 0.761 to 0.892. Test-retest reliability was 0.855.

Conclusions
The Chinese version of the SBCS has good reliability and validity, which can be applied to the assessment of stressors in breast cancer patients in China.
Detecting high-risk neighborhoods and socioeconomic determinants for common oral diseases in Germany
Authors: Völker Sebastian , van der Zee-Neuen Antje , Rinnert Alexander , Hanneken Jessica , Johansson Tim 
Published: February 2024

Abstract
Background
Ideally, health services and interventions to improve dental health should be tailored to local target populations. But this is not the standard. Little is known about risk clusters in dental health care and their evaluation based on small-scale, spatial data, particularly among under-represented groups in health surveys. Our study aims to investigate the incidence rates of major oral diseases among privately insured and self-paying individuals in Germany, explore the spatial clustering of these diseases, and evaluate the influence of social determinants on oral disease risk clusters using advanced data analysis techniques, i.e. machine learning.

Methods
A retrospective cohort study was performed to calculate the age- and sex-standardized incidence rate of oral diseases in a study population of privately insured and self-pay patients in Germany who received dental treatment between 2016 and 2021. This was based on anonymized claims data from BFS health finance, Bertelsmann, Dortmund, Germany. The disease history of individuals was recorded and aggregated at the ZIP code 5 level (n = 8871).

Results
Statistically significant, spatially compact clusters and relative risks (RR) of incidence rates were identified. By linking disease and socioeconomic databases on the ZIP-5 level, local risk models for each disease were estimated based on spatial-neighborhood variables using different machine learning models. We found that dental diseases were spatially clustered among privately insured and self-payer patients in Germany. Incidence rates within clusters were significantly elevated compared to incidence rates outside clusters. The relative risks (RR) for a new dental disease in primary risk clusters were min = 1.3 (irreversible pulpitis; 95%-CI = 1.3–1.3) and max = 2.7 (periodontitis; 95%-CI = 2.6–2.8), depending on the disease. Despite some similarity in the importance of variables from machine learning models across different clusters, each cluster is unique and must be treated as such when addressing oral public health threats.

Conclusions
Our study analyzed the incidence of major oral diseases in Germany and employed spatial methods to identify and characterize high-risk clusters for targeted interventions. We found that private claims data, combined with a network-based, data-driven approach, can effectively pinpoint areas and factors relevant to oral healthcare, including socioeconomic determinants like income and occupational status. The methodology presented here enables the identification of disease clusters of greatest demand, which would allow implementing more targeted approaches and improve access to quality care where they can have the most impact.
The experience of patients with hematological malignancy in their terminal stage: a phenomenological study from Jordan’s perspective
Authors: Alnaeem Mohammad M. , Shehadeh Anas , Nashwan Abdulqadir J. 
Published: February 2024

Abstract
Background
Patients diagnosed with hematological malignancies residing in low-middle-income countries undergo significant physical and psychological stressors. Despite this, only 16% of them receive proper care during the terminal stages. It is therefore crucial to gain insight into the unique experiences of this population.

Aim
To have a better understanding of the needs and experiences of adult patients with advanced hematological malignancy by exploring their perspectives.

Methods
A qualitative interpretive design was employed to collect and analyze data using a phenomenological approach. The study involved in-depth interviews with ten participants aged between 49 and 65 years, utilizing a semi-structured approach.

Results
Two primary themes emerged from the participants’ experiences of reaching the terminal stage of illness: “Pain, Suffering, and Distress” and “Spiritual Coping.” The first theme encompassed physical and emotional pain, suffering, and distress, while the second theme was centered on the participants’ spiritual coping mechanisms. These coping mechanisms included seeking comfort in religious practices, relying on spiritual support from family and friends, and finding solace in their beliefs and faith.

Conclusion
Patients with hematological malignancies in the terminal stages of their disease experience severe pain, considerable physical and psychosocial suffering, and spiritual distress. While they require support to cope with their daily struggles, their experiences often go unnoticed, leading to disappointment and loss of dignity. Patients mainly rely on their spirituality to cope with their situations. Healthcare providers must acknowledge these patients’ needs and provide more holistic and effective care.
Examining the pedagogical practices that support cultural proficiency development in graduate health science students
Authors: Speer Julie E. , Conley Quincy 
Published: February 2024

Abstract
Background
Health disparities are often a function of systemic discrimination and healthcare providers’ biases. In recognition of this, health science programs have begun to offer training to foster cultural proficiency (CP) in future professionals. However, there is not yet consensus about the best ways to integrate CP into didactic and clinical education, and little is known about the role of clinical rotations in fostering CP.

Methods
Here, a mixed-methods approach was used to survey students (n = 131) from a private all-graduate level osteopathic health sciences university to gain insight into the training approaches students encountered related to CP and how these may vary as a function of academic progression. The research survey included instruments designed to quantify students’ implicit associations, beliefs, and experiences related to the CP training they encountered through the use of validated instruments, including Implicit Association Tests and the Ethnocultural Empathy Inventory, and custom-designed questions.

Results
The data revealed that most students (73%) had received CP training during graduate school which primarily occurred via discussions, lectures, and readings; however, the duration and students’ perception of the training varied substantially (e.g., training range = 1–100 hours). In addition, while students largely indicated that they valued CP and sought to provide empathetic care to their patients, they also expressed personal understandings of CP that often fell short of advocacy and addressing personal and societal biases. The results further suggested that clinical rotations may help students attenuate implicit biases but did not appear to be synergistic with pre-clinical courses in fostering other CP knowledge, skills, and attitudes.

Conclusions
These findings highlight the need to utilize evidence-based pedagogical practices to design intentional, integrated, and holistic CP training throughout health science programs that employ an intersectional lens and empowers learners to serve as advocates for their patients and address systemic challenges.
Motivational drivers for health professionals in a large quality improvement collaborative project in Brazil: a qualitative study
Authors: da Silva Eliane Pereira , Saturno-Hernández Pedro Jesus , de Freitas Marise Reis , da Silva Gama Zenewton André 
Published: February 2024

Abstract
Background
The success of collaborative quality improvement (QI) projects in healthcare depends on the context and engagement of health teams; however, the factors that modulate teams’ motivation to participate in these projects are still unclear. The objective of the current study was to explore the barriers to and facilitators of motivation; the perspective was health professionals in a large project aiming to implement evidence-based infection prevention practices in intensive care units of Brazilian hospitals.

Methods
This qualitative study was based on content analysis of semistructured in-depth interviews held with health professionals who participated in a collaborative QI project named “Improving patient safety on a large scale in Brazil”. In accordance with the principle of saturation, we selected a final sample of 12 hospitals located throughout the five regions of Brazil that have implemented QI; then, we conducted videoconference interviews with 28 health professionals from those hospitals. We encoded the interview data with NVivo software, and the interrelations among the data were assessed with the COM-B model.

Results
The key barriers identified were belief that improvement increases workload, lack of knowledge about quality improvement, resistance to change, minimal involvement of physicians, lack of supplies, lack support from senior managers and work overload. The primary driver of motivation was tangible outcomes, as evidenced by a decrease in infections. Additionally, factors such as the active participation of senior managers, teamwork, learning in practice and understanding the reason for changes played significant roles in fostering motivation.

Conclusion
The motivation of health professionals to participate in collaborative QI projects is driven by a variety of barriers and facilitators. The interactions between the senior manager, quality improvement teams, and healthcare professionals generate attitudes that modulate motivation. Thus, these aspects should be considered during the implementation of such projects. Future research could explore the cost-effectiveness of motivational approaches.
Protective role of arachidonic acid against diabetic myocardial ischemic injury: a translational study of pigs, rats, and humans
Authors: Lv Yunhui , Li Kai , Wang Shuo , Wang Xiaokang , Yue Guangxin , Zhang Yangyang , Lv Xin , Zhao Ping , Wang Shiping , Zhang Qi , Li Qiuju , Zhu Jinyan , Li Jubo , Peng Peng , Li Yue , Luo Jiafei , Zhang Xue , Yang Jianzhong , Zhang Baojie , Wang Xuemin , Zhang Min , Shen Chen , Wang Xin , Wang Miao , Ye Zhen , Cui Yongchun 
Published: February 2024

Abstract
Aim
Patients with diabetes mellitus have poor prognosis after myocardial ischemic injury. However, the mechanism is unclear and there are no related therapies. We aimed to identify regulators of diabetic myocardial ischemic injury.

Methods and results
Mass spectrometry-based, non-targeted metabolomic approach was used to profile coronary sinus blood from diabetic and non-diabetic Bama-mini pigs at 0.5-h post coronary artery ligation. Six metabolites had a |log2 (Fold Change)|> 1.3. Among them, the most changed is arachidonic acid (AA), levels of which were 32 times lower in diabetic pigs than in non-diabetic pigs. The AA-derived products, PGI2 and 6-keto-PGF1α, were also significantly reduced. AA treatment of cultured cardiomyocytes protected against cell death by 30% at 48 h of high glucose and oxygen deprivation, which coincided with increased mitophagic activity (as indicated by increased LC3II/LC3I, decreased p62 and increased parkin & PINK1), improved mitochondrial renewal (upregulation of Drp1 and FIS1), reduced ROS generation and increased ATP production. These cardioprotective effects were abolished by PINK1(a crucial mitophagy protein) knockdown or the autophagy inhibitor 3-Methyladenine. The protective effect of AA was also inhibited by indomethacin and Cay10441, a prostacyclin receptor antagonist. Furthermore, diabetic Sprague Dawley rats were subjected to coronary ligation for 40 min and AA treatment (10 mg/day per animal gavaged) decreased myocardial infarct size, cell apoptosis index, inflammatory cytokines and improved heart function. Scanning electron microscopy showed more intact mitochondria in the border zone of infarcted myocardium in AA treated rats. Lastly, diabetic patients after myocardial infarction had lower plasma levels of AA and 6-keto-PGF1α and reduced cardiac ejection fraction, compared with non-diabetic patients after myocardial infarction. Plasma AA level was inversely correlated with fasting blood glucose.

Conclusions
AA protects against diabetic ischemic myocardial damage by promoting mitochondrial autophagy and renewal, which is related to AA derived PGI2 signaling. AA may represent a new strategy to treat diabetic myocardial ischemic injury.