bluuebunny/crossref_metadata_2025_split huggingface dataset:
Obesity at age 20 and weight gain during adulthood increase risk of total and premature all-cause mortality: findings from women attending breast screening in Manchester
Authors: Pegington Mary , Harvie Michelle , Harkness Elaine F. , Brentnall Adam , Malcomson Lee , Southworth Jake , Fox Jill , Howell Anthony , Cuzick Jack , Evans D. Gareth 
Published: January 2023

Abstract
Background
Obesity in early adulthood is associated with lower breast cancer rates in later life. This could be interpreted as a positive reinforcement of excess weight amongst younger women however, the wider implications of higher weights are less well known. This study examined the association between both obesity in early adulthood and body mass index (BMI) change through adulthood, and all-cause mortality.

Methods
The Predicting Risk of Cancer At Screening (PROCAS) study recruited 57,902 women aged 46–73 years (median age 57.2, IQR 51.8–63.7 years) from the Greater Manchester National Health Service breast screening programme in North West England between 2009 and 2015. It was used to assess associations between BMI at 20 years and cohort entry with all-cause mortality ascertained via deaths recorded on the National Breast Screening System to June 2020. Hazard ratios were estimated using proportional hazards (Cox) regression adjusted for factors at entry to the cohort: age, deprivation, bilateral oophorectomy, hormone-replacement therapy, menopausal status, ethnicity, alcohol intake, physical activity, and BMI.

Results
The prevalence of overweight (25–30 kg/m2) and obesity (> 30 kg/m2) were 10.4% and 2.5% respectively at 20 years, increasing to 35.2% and 25.9% respectively at cohort entry. After a mean 8.7 years follow-up we observed that overweight (HR = 1.27, 95%CI = 1.10–1.47) and obesity (HR = 2.11, 95%CI = 1.67–2.66) at 20 years had a higher mortality rate compared with healthy weight. Women who were underweight/healthy weight at 20 years and gained weight to obesity at entry had a slightly increased mortality rate compared with women who were underweight/healthy weight at both time points (HR 1.16, 95%CI = 1.02–1.32). Women with overweight (HR = 1.36, 95%CI = 1.06–1.75) or obesity (HR = 1.90, 95%CI = 1.45–2.48) at both 20 years and entry had a higher mortality rate than women who were underweight/healthy weight at both points.

Conclusions
Women who self-reported overweight and obesity at 20 years had a shorter life expectancy in this cohort of women attending breast cancer screening. Weight gain from 20 years was common in this group. Girls and women should be supported to maintain a healthy weight throughout the lifespan to help increase life expectancy.
Trial registration number NCT04359420, retrospectively registered 24/04/2020.
Cultural beliefs, attitudes and perceptions of lactating mothers on exclusive breastfeeding in The Gambia: an ethnographic study
Authors: Sosseh Sering A. L. , Barrow Amadou , Lu Zxyyann Jane 
Published: January 2023

Abstract
Background
WHO/UNICEF recommends that women in resource-poor developing countries- like the Gambia, should exclusively breastfeed their infants for the first six months of their lives because of its health benefits to both mother and infant. The study aimed to explore the cultural beliefs, attitudes, and perceptions of lactating mothers towards exclusive breastfeeding in The Gambia.

Methods
This was a qualitative ethnographic study of culture-sharing groups of mothers with infants 4 to 6 months old. The study was conducted from July to October 2014 and data collection was done through a face-to-face, in-depth interview and moderate participant observation. The study recruited 22 breastfeeding mothers attending government health facilities in the Kanifing Municipality. The collected data were transcribed verbatim and analyzed through a constant comparison method generating six cultural themes, each with sub-themes.

Results
Baby’s welfare is traditionally based on the types of food mother’s eat. To this end, mothers reportedly shunned eating green leafy vegetables, liquid and hot foods for their infants’ wellbeing. Encounters such as weight loss, nipple inflammation, and backache, which mothers associated with hyper latching and sitting for prolonged breastfeeding, respectively, were among major undesirable physical effects revealed by the participants. Furthermore, the necessity of giving water to infants for their survival was illustrated as a barricade to exclusive breastfeeding practices. Likewise, the entrenched practice of giving charm water to instill the Islamic faith and shielding infants against evil spirits was another factor influencing exclusive breastfeeding practices. Finally, the belief that breast milk adequacy is based on breast size and nurturing men’s physical strength by starting prelacteal feeds early in infancy also contributes to the meek exclusive breastfeeding rate among mothers.

Conclusion
This study could be a gazette piece for effective policy making and enhance nurses’ cultural sensitivity while caring for lactating mothers. Cultural meanings of health care behaviors in lactating mothers challenge universally applying guidelines of exclusive breastfeeding to all societies. The study findings could benefit healthcare providers in informing policies and designing culturally adaptive and acceptable community-based breastfeeding intervention programs in resource-limited settings.
Disruptions of sexually transmitted and blood borne infections testing services during the COVID-19 pandemic: accounts of service providers in Ontario, Canada
Authors: Ryu Heeho , Blaque Ezra , Stewart Mackenzie , Anand Praney , Gómez-Ramírez Oralia , MacKinnon Kinnon R. , Worthington Catherine , Gilbert Mark , Grace Daniel 
Published: January 2023

Abstract
Background
Since the onset of the COVID-19 pandemic in March 2020 in Canada, the availability of sexual health services including sexually transmitted and blood-borne infection (STBBI) testing has been negatively impacted in the province of Ontario due to their designation as “non-essential” health services. As a result, many individuals wanting to access sexual healthcare continued to have unmet sexual health needs throughout the pandemic. In response to this, sexual health service providers have adopted alternative models of testing, such as virtual interventions and self-sampling/testing. Our objective was to investigate service providers’ experiences of disruptions to STBBI testing during the COVID-19 pandemic in Ontario, Canada, and their acceptability of alternative testing services.

Methods
Between October 2020-February 2021, we conducted semi-structured virtual focus groups (3) and in-depth interviews (11) with a diverse group of sexual health service providers (n = 18) including frontline workers, public health workers, sexual health nurses, physicians, and sexual health educators across Ontario. As part of a larger community-based research study, data collection and analysis were led by three Peer Researchers and a Community Advisory Board was consulted throughout the research process. Transcripts were transcribed verbatim and analysed with NVivo software following grounded theory.

Results
Service providers identified the reallocation of public health resources and staff toward COVID-19 management, and closures, reduced hours, and lower in-person capacities at sexual health clinics as the causes for a sharp decline in access to sexual health testing services. Virtual and self-sampling interventions for STBBI testing were adopted to increase service capacity while reducing risks of COVID-19 transmission. Participants suggested that alternative models of testing were more convenient, accessible, safe, comfortable, cost-effective, and less onerous compared to traditional clinic-based models, and that they helped fill the gaps in testing caused by the pandemic.

Conclusions
Acceptability of virtual and self-sampling interventions for STBBI testing was high among service providers, and their lived experiences of implementing such services demonstrated their feasibility in the context of Ontario. There is a need to approach sexual health services as an essential part of healthcare and to sustain sexual health services that meet the needs of diverse individuals.
Recognising the importance of chronic lung disease: a consensus statement from the Global Alliance for Chronic Diseases (Lung Diseases group)
Authors: Gould Gillian Sandra , Hurst John R. , Trofor Antigona , Alison Jennifer A. , Fox Gregory , Kulkarni Muralidhar M. , Wheelock Craig E. , Clarke Marilyn , Kumar Ratika 
Published: January 2023

Abstract
Background
Chronic respiratory diseases are disorders of the airways and other structures of the lung, and include chronic obstructive pulmonary disease (COPD), lung cancer, asthma, bronchiectasis, interstitial lung diseases, occupational lung diseases and pulmonary hypertension. Through this article we take a broad view of chronic lung disease while highlighting (1) the complex interactions of lung diseases with environmental factors (e.g. climate change, smoking and vaping) and multimorbidity and (2) proposed areas to strengthen for better global patient outcomes.

Conclusion
We suggest new directions for the research agenda in high-priority populations and those experiencing health disparities. We call for lung disease to be made a research priority with greater funding allocation globally.
Independent effects of the triglyceride-glucose index on all-cause mortality in critically ill patients with coronary heart disease: analysis of the MIMIC-III database
Authors: Zhang Rongting , Shi Shanshan , Chen Weihua , Wang Yani , Lin Xueqin , Zhao Yukun , Liao Lihua , Guo Qian , Zhang Xiaoying , Li Weiguo , Zhang Kaijun , Liao Ying , Fang Yong 
Published: January 2023

Abstract
Background
The triglyceride-glucose (TyG) index is a reliable alternative biomarker of insulin resistance (IR). However, whether the TyG index has prognostic value in critically ill patients with coronary heart disease (CHD) remains unclear.

Methods
Participants from the Medical Information Mart for Intensive Care III (MIMIC-III) were grouped into quartiles according to the TyG index. The primary outcome was in-hospital all-cause mortality. Cox proportional hazards models were constructed to examine the association between TyG index and all-cause mortality in critically ill patients with CHD. A restricted cubic splines model was used to examine the associations between the TyG index and outcomes.

Results
A total of 1,618 patients (65.14% men) were included. The hospital mortality and intensive care unit (ICU) mortality rate were 9.64% and 7.60%, respectively. Multivariable Cox proportional hazards analyses indicated that the TyG index was independently associated with an elevated risk of hospital mortality (HR, 1.71 [95% CI 1.25–2.33] P = 0.001) and ICU mortality (HR, 1.50 [95% CI 1.07–2.10] P = 0.019). The restricted cubic splines regression model revealed that the risk of hospital mortality and ICU mortality increased linearly with increasing TyG index (P for non-linearity = 0.467 and P for non-linearity = 0.764).

Conclusions
The TyG index was a strong independent predictor of greater mortality in critically ill patients with CHD. Larger prospective studies are required to confirm these findings.
Heat shock protein 27 deficiency promotes ferrous ion absorption and enhances acyl-Coenzyme A synthetase long-chain family member 4 stability to promote glioblastoma cell ferroptosis
Authors: Zhang Kai , Wu Yue , Chen Guangliang , Wang Hao , Liu Yongsheng , Zhou Youxin 
Published: January 2023

Abstract
Background
Glioblastoma is one of the malignant tumors of the central nervous system with high lethality, high disability and low survival rate. Effective induction of its death is one of the existing challenges. In recent studies, heat shock protein 27 (HSP27) has been shown to be associated with ferroptosis; therefore, targeting HSP27 may be a potential therapeutic approach for GBM.

Methods
Immunohistochemistry and western blot analysis were used to detect the expression of HSP27 in GBM tissues. CCK8, plate clone formation assay, EdU proliferation assay for cell proliferation ability, PI, LDH release assay for cell viability. Reactive oxygen, iron levels, and mitochondrial potential for HSP27 silencing were assayed for ferrotosis in vitro. Western blotting and IP were used to verify the relationship between HSP27 and ACSL4. The effect of knockdown of HSP27 on tumor growth capacity was assessed in an intracranial xenograft model.

Results
HSP27 was significantly highly expressed in GBM. In vitro experiments, knockdown of HSP27 significantly induced ferroptosis in GBM cells. IP and western blot demonstrated a sumo-ization link between HSP27 and ACSL4. In vivo experiments, HSP27 deficiency retarded tumor growth rate by promoting ferroptosis.

Conclusions
HSP27 deficiency promotes GBM ferroptosis. Targeting HSP27 may serve as a new direction for GBM treatment.
Challenges and recommendations to increasing the use of exome sequencing and whole genome sequencing for diagnosing rare diseases in Brazil: an expert perspective
Authors: Félix Têmis Maria , Fischinger Moura de Souza Carolina , Oliveira João Bosco , Rico-Restrepo Mariana , Zanoteli Edmar , Zatz Mayana , Giugliani Roberto 
Published: January 2023

AbstractEarly diagnosis of genetic rare diseases is an unmet need in Brazil, where an estimated 10–13 million people live with these conditions. Increased use of chromosome microarray assays, exome sequencing, and whole genome sequencing as first-tier testing techniques in suitable indications can shorten the diagnostic odyssey, eliminate unnecessary tests, procedures, and treatments, and lower healthcare expenditures. A selected panel of Brazilian experts in fields related to rare diseases was provided with a series of relevant questions to address before a multi-day conference. Within this conference, each narrative was discussed and edited through numerous rounds of discussion until agreement was achieved. The widespread adoption of exome sequencing and whole genome sequencing in Brazil is limited by various factors: cost and lack of funding, reimbursement, awareness and education, specialist shortages, and policy issues. To reduce the burden of rare diseases and increase early diagnosis, the Brazilian healthcare authorities/government must address the barriers to equitable access to early diagnostic methods for these conditions. Recommendations are provided, including broadening approved testing indications, increasing awareness and education efforts, increasing specialist training opportunities, and ensuring sufficient funding for genetic testing.
Temporal variation of the temperature-mortality association in Spain: a nationwide analysis
Authors: Ordanovich Dariya , Tobías Aurelio , Ramiro Diego 
Published: January 2023

Abstract
Background
Although adaptation to continuously rising ambient temperatures is an emerging topic and has been widely studied at a global scale, detailed analysis of the joint indicators for long-term adaptation in Spain are scarce. This study aims to explore temporal variations of the minimum mortality temperature and mortality burden from heat and cold between 1979 and 2018.

Methods
We collected individual all-cause mortality and climate reanalysis data for 4 decades at a daily time step. To estimate the temperature-mortality association for each decade, we fitted a quasi-Poisson time-series regression model using a distributed lag non-linear model with 21 days of lag, controlling for trends and day of the week. We also calculated attributable mortality fractions by age and sex for heat and cold, defined as temperatures above and below the optimum temperature, which corresponds to the minimum mortality in each period.

Results
We analysed over 14 million deaths registered in Spain between 1979 and 2018. The optimum temperature estimated at a nationwide scale declined from 21 °C in 1979–1988 to 16 °C in 1999–2008, and raised to 18 °C in 2009–2018. The mortality burden from moderate cold showed a 3-fold reduction down to 2.4% in 2009–2018. Since 1988–1999, the mortality risk attributable to moderate (extreme) heat reduced from 0.9% (0.8%) to 0.6% (0.5%). The mortality risk due to heat in women was almost 2 times larger than in men, and did not decrease over time.

Conclusion
Despite the progressively warmer temperatures in Spain, we observed a persistent flattening of the exposure-response curves, which marked an expansion of the uncertainty range of the optimal temperatures. Adaptation has been produced to some extent in a non-uniform manner with a substantial decrease in cold-related mortality, while for heat it became more apparent in the most recent decade only.
Identifying drivers of increasing opioid overdose deaths among black individuals: a qualitative model drawing on experience of peers and community health workers
Authors: Banks Devin E. , Duello Alex , Paschke Maria E. , Grigsby Sheila R. , Winograd Rachel P. 
Published: January 2023

Abstract
Background
Black individuals in the USA face disproportionate increases in rates of fatal opioid overdose despite federal efforts to mitigate the opioid crisis. The aim of this study was to examine what drives increases in opioid overdose death among Black Americans based on the experience of key stakeholders.

Methods
Focus groups were conducted with stakeholders providing substance use prevention services in Black communities in St. Louis, MO (n = 14). One focus group included peer advocates and volunteers conducting outreach-based services and one included active community health workers. Focus groups were held at community partner organizations familiar to participants. Data collection was facilitated by an interview guide with open-ended prompts. Focus groups were audio recorded and professionally transcribed. Transcripts were analyzed using grounded theory to abstract line-by-line codes into higher order themes and interpret their associations.

Results
A core theme was identified from participants’ narratives suggesting that opioid overdose death among Black individuals is driven by unmet needs for safety, security, stability, and survival (The 4Ss). A lack of The 4Ss was reflective of structural disinvestment and healthcare and social service barriers perpetuated by systemic racism. Participants unmet 4S needs are associated with health and social consequences that perpetuate overdose and detrimentally impact recovery efforts. Participants identified cultural and relationship-based strategies that may address The 4Ss and mitigate overdose in Black communities.

Conclusions
Key stakeholders working in local communities to address racial inequities in opioid overdose highlighted the importance of upstream interventions that promote basic socioeconomic needs. Local outreach efforts utilizing peer services can provide culturally congruent interventions and promote harm reduction in Black communities traditionally underserved by US health and social systems.
COVID-19 vaccination does not affect male sexual functions
Authors: Mehta Poonam , Chakraborty Arijit , Andrabi Syed Waseem , Sharma Bhawani , Kumar Rakesh , Bhaskar L. V. K. S. , Rajender Singh 
Published: January 2023

Abstract
Background
COVID-19 infection has been linked with erectile dysfunction, which has also raised apprehensions about the impact of COVID-19 vaccination on male sexual functions. The purpose of this study was to investigate the impact of COVID-19 vaccination on male sexual functions, such as erectile function, orgasmic function, sexual desire, intercourse satisfaction, and overall satisfaction.

Methods
We used International Index of Erectile Function (IIEF) questionnaire for data collection. Mixed methods were adopted for this study, which consisted of Google online form distribution and the distribution of hard copies of the form to those who were not internet friendly. All data were entered in a spreadsheet and scores were assigned to each response according to the standard scores given in the IIEF questionnaire. Fifteen questions, one corresponding to each question in the IIEF questionnaire, were included to assess the impact of COVID-19 vaccination on each sexual function.

Results
In the first part of analysis, we calculated sexual function scores and men reporting low sexual function scores (~ 15%) were excluded, providing us with 465 individuals for further analysis. Regarding the impact of COVID-19 vaccination on male sexual functions, 71% individuals reported no impact, 3% reported a decline, 2.7% reported an improvement, and 23.3% could not assess the impact. We also performed analysis on the basis of age-groups of the participants and the duration after vaccination, finding that there was no impact irrespective of the age of subjects or the length of period after vaccination.

Conclusions
COVID-19 vaccination does not affect male sexual functions, including erectile function, orgasmic function, sexual desire, intercourse satisfaction, and overall sexual satisfaction.
Features of peritoneal dendritic cells in the development of endometriosis
Authors: Qiaomei Zheng , Ping Wu , Yanjing Zhao , Jinhua Wang , Shaozhan Chen , Lihong Chen 
Published: January 2023

Abstract
Background
Emerging evidence of immunological dysfunction have been described in endometriosis. Dendritic cells (DCs), one of the main antigen-presenting cells, are specialized in the initiation and modulation of the adaptive immune response. Emerging studies demonstrated both endometrial and circulating differences in DCs populations in women with endometriosis. However, the role and mechanism of peritoneal DCs in endometriosis is still unclear. The present study was undertaken to explore the features of peritoneal DCs in the pathogenesis of endometriosis. This study is beneficial to further clarify the cause of endometriosis and provide a new insight into the medical treatment for endometriosis.

Methods
The study included 12 women with endometriosis and 11 women without endometriosis. The C57BL6 mouse model of endometriosis was established by intraperitoneal injection of endometrial segments. The peritoneal DCs of endometriosis patients and mouse models were analyzed by fluorescence associated cell sorting (FACS) examination.

Results
Increased cell density of peritoneal DCs were observed in endometriosis patients. Moreover, the proportion of mature DCs (mDCs, CD80highCD1alow cells) in the peritoneal DCs was lower whereas the proportion of immature DCs (iDCs, CD80lowCD1ahigh cells) was increased in endometriosis patients. Similarly, the cell density of peritoneal DCs in murine models increased immediately after the injection of endometrial tissues and reached the highest level at 14 days. In addition, the proportion of mDCs (CD11chighCD80high cells) in the peritoneal DCs decreased immediately after the injection of endometrial tissues and then increased with the time until 42 days, but still lower than the control group. In contrast, the proportion of iDCs (CD11chighCD80low cells) in the peritoneal DCs showed the opposite dynamic changes. However, after treated with LPS, the mDCs proportion was significantly increased, leading to lower volume and weight of the endometriosis lesions.

Conclusions
Increased level of peritoneal DCs facilitated the pathogenesis of endometriosis lesions, especially in the early stage of the disease. Furthermore, peritoneal DCs maturation played an important role in the development of endometriosis.