bluuebunny/crossref_metadata_2025_split huggingface dataset:
Cost-effectiveness of tenofovir prophylaxis during pregnancy for the elimination of mother-to-child transmission of the hepatitis B virus: real-world analysis from Thailand
Authors: Janekrongtham Chawisar , Punsuwan Niramon , Thitichai Phanthanee , Lertpiriyasuwat Cheewanan , Pan-ngum Wirichada , Poovorawan Kittiyod , Jantarapakde Jureeporn , Tangkijvanich Pisit 
Published: July 2023

ObjectiveDespite implementing hepatitis B immunoglobulin (HBIG) and vaccination, data suggest it would not be sufficient to reach the elimination targets. Tenofovir disoproxil fumarate (TDF) has been added to the Thai national standards of care for prevention of transmission of the hepatitis B virus during birth. To optimise national strategies in Thailand, we assessed TDF’s effectiveness for prevention of mother-to-child transmission and conducted cost-effectiveness analyses of different TDF-based strategies.Research design and methodsWe retrospectively reviewed medical records of mother and infant pairs whose mothers were positive for hepatitis B e-antigen (HBeAg) and received TDF to prevent maternal transmission of viral hepatitis B during 2018–2020. Based on the available data on transmission rate, we also applied a decision tree to estimate the cost-effectiveness of different TDF-based strategies to eligible mothers. These included: (1) HBIG for all hepatitis B virus (HBV) exposed infants; (2) HBIG for only infants of HBeAg-positive mothers (‘HBIG for e-positive’) and (3) without HBIG to infants (‘HBIG-free’). The incremental cost-effectiveness ratio between the different strategies and baseline intervention without TDF was calculated. The one-way sensitivity analysis was used to adjust prevalence of HBeAg-positive mothers, cost of HBIG, cost of TDF and transmission rate.ResultsOf 223 infants enrolled, 212 (95.0%) received HBIG, while 11 (5.0%) did not. None of the infants had chronic HBV infection. The most cost-saving intervention was ‘HBIG-free’ followed by ‘HBIG for e-positive’. The one-way sensitivity demonstrated that the results were reasonably robust to changes. The cost-saving was greater with a higher hepatitis B virus surface antigen (HBsAg) prevalence. The HBIG-free strategy remained best at 0%–1.4% transmission rates, meeting the additional target for eliminations.ConclusionThe study is the first cost-effectiveness analyses to provide evidence supporting an HBIG-free strategy in an antiviral era. This approach should be considered to prevent mother-to-child transmission in resource-constrained settings, particularly in countries with a high HBsAg prevalence.
Effectiveness of humanitarian health interventions: a systematic review of literature published between 2013 and 2021
Authors: Doocy Shannon , Lyles Emily , Tappis Hannah , Norton Alexandra 
Published: July 2023

ObjectivesTo provide a thorough mapping of the current quality and depth of evidence examining the effectiveness of health interventions in humanitarian settings in low and middle-income countries published in peer-reviewed journals since 2013.MethodsWe searched MEDLINE, Embase and Global Health for English language peer-reviewed literature published from May 2013 through April 2021 to analyse the strength of evidence on health interventions’ effectiveness in humanitarian settings in low and middle-income countries across nine thematic areas. Quality was assessed using standardised criteria and critical appraisal tools based on study design.ResultsA total of 269 publications were included in this review. The volume of publications increased since the first Elrha Humanitarian Health Evidence Review in 2013, but non-communicable diseases and water, sanitation and hygiene remain the areas with the most limited evidence base on intervention effectiveness in addition to injury and rehabilitation. Economic evaluations continued to constitute a small proportion (5%) of studies. Half of studies had unclear risk of bias, while 28% had low, 11% moderate and 11% high risk of bias. Despite increased diversity in studied interventions, variations across and within topics do not necessarily reflect the health issues of greatest concern or barriers to quality service delivery in humanitarian settings.ConclusionsDespite an increasing evidence base, the challenge of implementing high-quality and well-reported humanitarian health research persists as a critical concern. Improvements in reporting and intervention description are needed as are study designs that allow for attribution, standard indicators and longer term follow-up and outcome measures. There is a clear need to prioritise expansion of cross-cutting topics, namely health service delivery, health systems and cost-effectiveness.PROSPERO registration numberCRD42021254408.
Quality of life and relapse of Opioid Use Disorder: a scoping review protocol
Authors: Namatovu Angella , Akatusasira Rita , Kaggwa Mark Mohan 
Published: July 2023

IntroductionQuality of life (QoL) greatly influences the outcomes of patients with mental illnesses and there is evidence that there is an association between QoL and the relapse of Opioid Use Disorder (OUD). However, no reviews elucidate the relationship between QoL and the relapse of OUD. This document provides a scoping review protocol that aims to systematically chart and synthesise the published, unpublished and grey literature about the relationship between QoL and relapse of OUD.Methods and analysisThe enhanced six-stage methodological framework for scoping reviews of Arksey and O’Malley will be used. The main research question guiding the review will be: What is the relationship between QoL and relapse of OUD? Peer-reviewed and non-peer-reviewed articles, reports, and policy documents will be eligible to be included in the review with no limits on publication date. PubMed, PsycINFO, Google Scholar, Scopus, OVID and Cochrane Library will be among the databases searched. We shall identify grey literature from Google Scholar, ProQuest database, Grey Source Index, Open Grey and OpenDOAR. The reporting of the review will follow the guidelines of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews. Criteria for evidence inclusion and exclusion will be used during literature screening and mapping.Ethics and disseminationPatients and the public will not be involved in the interpretations of the findings, therefore, we shall not seek approval from an ethics committee. Results will be disseminated through publication in a peer-reviewed, scientific journal, conference presentations.
Comprehensive assessment of resources for prevention and control of chronic and non-communicable diseases in China: a cross-sectional study
Authors: Yi Zhun , Xu Tingling , Yang Jing , Yu Shicheng , Zhou Maigeng , Li Han , Guo Jiahuan , Qian Jing , Dong Wenlan 
Published: July 2023

ObjectiveThis study aims to comprehensively evaluate the resources for prevention and control of chronic and non-communicable diseases (NCDs) in China to provide a reference basis for optimising the resource allocation for prevention and control of NCDs.MethodsChina Chronic Disease and Risk Factor Surveillance sites and National Demonstration Areas for Integrated Chronic and Non-communicable Disease Prevention and Control (NCDDA) were selected as investigation objects. In December 2021, the district (or county) resource allocation for NCD prevention and control was investigated through the NCDDA management information system. According to the index system of NCD prevention and control, 31 indicators of 6 dimensions were collected, and the weighted technique for order preference by similarity to an ideal solution, weighted rank-sum ratio and fuzzy comprehensive evaluation methods were used for comprehensive evaluation of resources for prevention and control of NCDs.ResultsThe 653 districts (or counties) in this study cover 22.96% of China’s districts (or counties). The top three weights were full-time staff for NCD prevention and control (0.1066), the amount of funds for NCD prevention and control (0.0967), and the coverage rate of districts (or counties) establishing chronic obstructive pulmonary disease surveillance information system (0.0886). The comprehensive evaluation results for the resources for prevention and control of NCDs by the three methods were basically the same. The results of fuzzy comprehensive evaluation showed that the resource allocation in urban areas (0.9268) was better than that in rural areas (0.3257), the one in eastern region (0.9016) was better than that in central (0.3844) and western regions (0.3868), and the one in NCDDA (0.9625) was better than that in non-NCDDA (0.2901).ConclusionThe resources in China for NCD prevention and control differ among different regions, which should be taken into account in future policymaking and resource allocation.
Factors influencing the implementation of shared decision-making in breast cancer care: protocol for a mixed-methods study
Authors: Bravo Paulina , Dois Angelina , Villarroel Luis , González-Agüero Marcela , Fernández-González Loreto , Sánchez César , Martinez Alejandra , Turén Valentina , Quezada Constanza , Guasalaga María Elisabeth , Härter Martin 
Published: July 2023

IntroductionChile is committed to actively involving patients in their healthcare. However, little is known about how this is translated into clinical encounters. Breast cancer (BC) is the first cause of cancer-related death in Chilean women. National policy guarantees standard care, and treatment decisions should be made along this process that can have long-term consequences for women. So, BC is a particularly well-suited case study to understand the complexity of patient participation in decision-making.ObjectiveTo identify the factors that affect the active involvement of patients in the BC treatment decision-making process, considering the perspectives and practices of health professionals and women facing the disease.Method and analysisWe will conduct a mixed-method study through a convergent parallel design in three stages: (1) A qualitative study: non-participant observation of the tumour board (TB) meetings; semi-structured interviews with key informants from TBs; documentary analyses; semi-structured interviews with women facing BC; and non-participant observations of clinical encounters; (2) a cross-sectional study with 445 women facing BC stages I–III from three hospitals in Santiago, Chile. We will measure the level of expected participation, experienced participation, decisional conflict, quality of life (QoL) and satisfaction with healthcare. Descriptive analysis will be performed, and multivariable binary logistic regression models will be adjusted to identify factors associated with high levels of QoL or satisfaction; (3) an integration study will bring together the data through a joint display technique.Ethics and disseminationThe study has been conceived and will be conducted according to international and local agreements for ethical research. Ethical approval has been granted by two Ethics Committees in Chile.The results will be disseminated to scientific and lay audiences (publications in scientific journals and conferences, seminars and a website for plain language dissemination).
Alanyl-glutamine supplementation forClostridioides difficileinfection treatment (ACT): a double-blind randomised controlled trial study protocol
Authors: Warren Cirle A , Shin Jae Hyun , Bansal Ekta N , Costa Deiziane V D S , Wang Xin Qun , Wu Martin , Swann Jonathan R , Behm Brian W , Targonski Paul V , Archbald-Pannone Laurie 
Published: July 2023

IntroductionClostridioides difficileis the leading cause of healthcare-associated infections in the USA, with an estimated 1 billion dollars in excess cost to the healthcare system annually.C. difficileinfection (CDI) has high recurrence rate, up to 25% after first episode and up to 60% for succeeding episodes. Preliminary in vitro and in vivo studies indicate that alanyl-glutamine (AQ) may be beneficial in treating CDI by its effect on restoring intestinal integrity in the epithelial barrier, ameliorating inflammation and decreasing relapse.Methods and analysisThis study is a randomised, placebo-controlled, double-blind, phase II clinical trial. The trial is designed to determine optimal dose and safety of oral AQ at 4, 24 and 44 g doses administered daily for 10 days concurrent with standard treatment of non-severe or severe uncomplicated CDI in persons age 18 and older. The primary outcome of interest is CDI recurrence during 60 days post-treatment follow-up, with the secondary outcome of mortality during 60 days post-treatment follow-up. Exploratory analysis will be done to determine the impact of AQ supplementation on intestinal and systemic inflammation, as well as intestinal microbial and metabolic profiles.Ethics and disseminationThe study has received University of Virginia Institutional Review Board approval (HSR200046, Protocol v9, April 2023). Findings will be disseminated via conference presentations, lectures and peer-reviewed publications.Trial registration numberNCT04305769.
The Transcriptional and Epigenetic Landscape of Cancer Cell Lineage Plasticity
Authors: Davies Alastair , Zoubeidi Amina , Beltran Himisha , Selth Luke A. 
Published: July 2023

Abstract

Lineage plasticity, a process whereby cells change their phenotype to take on a different molecular and/or histologic identity, is a key driver of cancer progression and therapy resistance. Although underlying genetic changes within the tumor can enhance lineage plasticity, it is predominantly a dynamic process controlled by transcriptional and epigenetic dysregulation. This review explores the transcriptional and epigenetic regulators of lineage plasticity and their interplay with other features of malignancy, such as dysregulated metabolism, the tumor microenvironment, and immune evasion. We also discuss strategies for the detection and treatment of highly plastic tumors.

Significance:
Lineage plasticity is a hallmark of cancer and a critical facilitator of other oncogenic features such as metastasis, therapy resistance, dysregulated metabolism, and immune evasion. It is essential that the molecular mechanisms of lineage plasticity are elucidated to enable the development of strategies to effectively target this phenomenon. In this review, we describe key transcriptional and epigenetic regulators of cancer cell plasticity, in the process highlighting therapeutic approaches that may be harnessed for patient benefit.
Effects of Social Anxiety and Subjective Well-Being on Problematic Mobile Social Media Use in First-Year University Students: The Mediating Role of Self-Esteem
Authors: Luo Xiao 
Published: July 2023

Background: Problematic mobile social media use may impact college students’ physical and mental health. This study aimed to elucidate the impact of social anxiety and subjective well-being on problematic mobile social media use and the mediating role of self-esteem in this relationship. Methods: A total of 387 first-year university students (39.8% females, 60.2% males; mean age = 18.74 years) were enrolled in this study and completed self-report measures of social anxiety, subjective well-being, self-esteem and problematic mobile social media use. A structural equation model was constructed and tested by AMOS 23.0 software. Results: (1) Social anxiety not only had a direct effect on problematic mobile social media use, but also had an indirect effect on problematic mobile social media use via self-esteem. (2) Subjective well-being was positively and significantly associated with self-esteem, as well as problematic mobile social media use. (3) Self-esteem played a suppressing role between subjective well-being and problematic mobile social media use. Conclusions: It is necessary to help college students reduce their social anxiety and increase their subjective happiness through appropriate ways, as this plays an important role in increasing self-esteem and reducing their problematic mobile social media use.
Effectiveness of Nurse-led Lifestyle Modification Intervention on Obesity Among Young Women in India
Authors: Shaji Princey , Singh Maharaj , Sahu Bharti , Arulappan Judie 
Published: July 2023

Background Obesity management in young women necessitates interventions that include dietary modification and physical exercise. High-intensity lifestyle modification is effective in managing obesity in young women. Objectives The study determined the effectiveness of a nurse-led lifestyle modification intervention (NLLMI) on obesity among young women in India. Methods The study adopted a quasi-experimental pre- and post-interventional control group research design. The study was conducted among obese young women in the communities of Jabalpur, Madhya Pradesh, India. The participants were selected using convenient sampling technique. The sample included 150 women in the study group and 150 in the control group. The NLLMI comprising of exercises and dietary modifications were taught to the participants for 30 min three times a week for 24 weeks. Thereafter, they were encouraged to follow the diet and perform the exercises on their own for the next 12 weeks. Practice diary was maintained by the participants and they were encouraged to continue the intervention through the phone. The participants in the control group did not engage in the NLLMI until the post-test. However, they did receive the same NLLMI after the trial was over. Results There was a high statistically significant difference ( p = 0.001) between the study group and the control group the after 12th and 24th weeks of NLLMI. The study group had a significant reduction in BMI after the intervention. Conclusions Young obese women may benefit from a NLLMI if they regularly follow the healthy eating habits and physical exercise.
Incidence and risk factors associated with negative postoperative behavioral changes in children undergoing painless gastroscopy
Authors: YanYing Pu , ShenLing Liu , XiaoHan Peng , YunBo Xu , Xin Tan , GuoYan Li , Yan Cheng , Lei Huang 
Published: July 2023

AbstractObjectiveTo investigate the incidence of and risk factors associated with negative postoperative behavioral changes (NPOBCs) in children undergoing painless gastroscopy.MethodsInclusion criteria: ASA I–II and outpatients aged 6–12 years undergoing painless gastroscopy. Exclusion criteria: history of surgery or anesthesia, children with developmental or intellectual abnormalities, refusal to participate, preoperative abdominal pain score > 3 points, history of chronic abdominal pain of > 3 months duration, and serious intraoperative complications. On the 1st, 14th, and 30th day after the gastroscopy, the Post Hospitalization Behavior Questionnaire for Ambulatory Surgery (PHBQ-AS) was used to assess NPOBCs in children.ResultsA total of 1,670 children were included in this prospective observational cohort study. The incidence rates of NPOBCs were 14.13%, 4.55%, and 2.14% on the 1st, 14th, and 30th day after gastroscopy, respectively. The risk factors for the first day were female sex (OR 1.34, 95% CI 1.00–1.79), parental anxiety (OR 2.23, 95% CI 1.75–3.12), and severe anxiety in children (OR 2.83, 95% CI 1.96–4.07). The risk factors on the 14th day were parental anxiety (OR 3.71, 95% CI 2.19–6.29), a parental educational level above high school (OR 1.65, 95% CI 1.00–2.70), and severe anxiety in children (OR 11.87, 95% CI 5.85–24.07). The risk factors on the 30th day were female sex (OR 2.99, 95% CI 1.41–6.34), being an only child (OR 4.42, 95% CI 2.18–8.95), a parental educational level above high school (OR 2.66, 95% CI 1.27 NPOBCs 5.56), and severe anxiety in children (OR 6.84, 95% CI 2.84–16.49).ConclusionIn children undergoing painless gastroscopy, the incidence rates of NPOBCs on the 1st, 14th, and 30th day were 14.13%, 4.55%, and 2.14%, respectively. The risk factors for NPOBCs were severe anxiety in children, female sex, parental anxiety, and a parental educational level above high school. In particular, severe preoperative anxiety in children was a persistent risk factor for NPOBCs within 30 days.
Comparing physical activity prescription with verbal advice for general practice patients with cardiovascular risk factors: results from the PEPPER randomised controlled trial
Authors: Bellanger William , Peurois Matthieu , Connan Laurent , Navasiolava Nastassia , Missud David , Py Thibaut , Bègue Cyril 
Published: July 2023

Abstract
Background
Regular physical activity improves health and quality of life for people with cardiovascular risk factors. However, few studies have demonstrated the applicability of strategies in health care to promote physical activity.

Objective
To evaluate if a written physical activity prescription combined with pedometer increases physical activity over one year compared with verbal advice in patients with cardiovascular disease risk in primary care.

Methods
The randomised-controlled, interventional, 12-month PEPPER study recruited patients aged 35 to 74 years, having quarterly followed-ups for hypertension, dyslipidaemia, or diabetes, and judged insufficiently active. Seventeen practices randomised patients into either the experimental group, who received a written, personalised prescription for daily step numbers, pedometer and logbook, or control group, who received verbal advice to do at least 15 min of rapid walking or equivalent daily. The primary outcome was the change in total weekly energy expenditure measured using an accelerometer at 3 months. The secondary outcomes were changes in step count, physical activity levels, quality of life, perceived obstacles to physical activity, and biomedical indicators at 3 and 12 months.

Results
One hundred and twenty-one participants were randomised. Although, weekly energy expenditure did not differ between the prescription and verbal instruction group, the estimated time spent doing moderate-intensity activity was significantly higher in the prescription group than the verbal group by an average of four minutes/week (p = 0.018)(95% CI [0.7 – 7.4]) reaching 48 min after 12 months (95% CI: 8 – 89). Similarly, this was associated with a clinically, higher average step number of 5256 steps/week increase over a year (95% CI: 660 – 9852). Among the most sedentary subgroup, walking less than 5000 steps/day at baseline, an 8868 steps/week (95% CI [2988 – 14700]) increase was observed in the prescription group.

Conclusion
Prescribing physical activity did not significantly modify total weekly energy expenditure, but slightly increased moderate-intensity activity duration and step counts, particularly among the most sedentary participants. Prescribing personalised physical activity goals encourages sedentary patients to engage in physical activity.

Trial registration
The PEPPER trial is registered in the US National Institutes of Health Clinical Trials Registry under number NCT02317003 (15/12/2014).