bluuebunny/crossref_metadata_2025_split huggingface dataset:
Infectious disease hotlines to provide advice to general practitioners: a prospective study
Authors: Sette Anna Luce , François Patrice , Lesprit Philippe , Vitrat Virginie , Rogeaux Olivier , Breugnon Emma , Baldeyrou Marion , Mondain Véronique , Issartel Bertrand , Kerneis Solen , Diamantis Sylvain , Poitrenaud Delphine , Boussat Bastien , Pavese Patricia 
Published: May 2023

AbstractBackgroundTelephone hotlines in infectious diseases (ID) are part of antimicrobial stewardship programs designed to provide support and expertise in ID and to control antibiotic resistance. The aim of the study was to characterize the activity of the ID hotlines and estimate their usefulness for general practitioners (GPs).MethodsThis was a multicenter prospective observational study in different French regions. ID teams involved in antimicrobial stewardship with a hotline for GPs were asked to record their advice from April 2019 to June 2022. In these regions, all GPs were informed of the ID hotline’s operating procedures. The main outcome was usage rate of the hotlines by GPs.ResultsTen volunteer ID teams collected 4138 requests for advice from 2171 GPs. The proportion of GPs using the hotline varied pronouncedly by region, from 54% in the Isere department, to less than 1% in departments with the lowest usage. These differences were associated with the number of physicians in ID teams and with the age of the hotline. These results highlighted the value of working time as a means of ensuring the permanence of expertise. The main reasons for calling were: a diagnostic question (44%); choice of antibiotic (31%). The ID specialist provided advice on antibiotic therapy (43%) or a proposal for specialized consultation or hospitalization (11%).ConclusionsID hotlines could help to strengthen cooperation between primary care and hospital medicine. However, the deployment and perpetuation of this activity require reflection concerning its institutional and financial support.
Family caregiver involvement and role in hospital at home for adults: the patients’ and family caregivers’ perspective - a Norwegian qualitative study
Authors: Karlsen Lillian , Mjølstad Bente Prytz , Løfaldli Bjarte Bye , Helvik Anne-Sofie 
Published: May 2023

Abstract
Background
Hospital at home (HaH) provides acute healthcare services in patients’ homes instead of traditional in-patient care. Research has reported positive outcomes for patients and reduced costs. Although HaH has developed into a global concept, we have little knowledge about the involvement and role of family caregivers (FCs) of adults. The aim of this study was to explore FC involvement and role during HaH treatment as perceived by patients and FCs in a Norwegian healthcare context.

Methods
A qualitative study was carried out among seven patients and nine FCs in Mid-Norway. The data was obtained through fifteen semi-structured interviews; fourteen were performed individually and one as duad interview. The age of the participants varied between 31 and 73 years, and mean age of 57 years. A hermeneutic phenomenological approach was used, and the analysis was performed according to Kvale and Brinkmann’s description of interpretation.

Results
We identified three main categories and seven subcategories regarding FC involvement and role in HaH: (1) Preparing for something new and unfamiliar, including the subcategories `Lack of involvement in the decision process` and `Information overload affecting caregiver readiness`, (2) Adjusting to a new everyday life at home, including the subcategories `The critical first days at home`, `Coherent care and support in a novel situation`, and `Prior established family roles influencing the new everyday life at home`, (3) FCs` role gradually diminishes and looking back, including the subcategories `A smooth transition to life beyond hospital at home` and `Finding meaning and motivation in providing care`.

Conclusions
FCs played an important role in HaH, although their tasks, involvement and effort varied across different phases during HaH treatment. The study findings contribute to a greater understanding of the dynamic nature of the caregiver experiences during HaH treatment, which can guide healthcare professionals on how they can provide timely and appropriate support to FCs in HaH over time. Such knowledge is important to decrease the risk of caregiver distress during HaH treatment. Further work, such as longitudinal studies, should be done to examine the course of caregiving in HaH over time to correct or support the phases described in this study.
Manufacture and evaluation of a HER2-positive breast cancer immunotoxin 4D5Fv-PE25
Authors: Peng Yanjie , Wu Zhengli , Pang Zheng , Zhang Lin , Song Dandan , Liu Fang , Li Yanhong , Lin Tongjun 
Published: May 2023

Abstract
Background
Human epidermal growth factor receptor 2 (HER2) positive breast cancer is an aggressive subtype, accounting for around 20% of all breast cancers. The development of HER2-targeted therapy has substantially improved patient outcomes. Nevertheless, the increasing rate of side effects and resistance to targeted drugs limit their efficacy in clinical practice. In this study, we designed and synthesized a new immunotoxin, 4D5Fv-PE25, which targets HER2-positive breast cancer, and evaluated its effectiveness in vitro and in vivo.

Results
The 4D5Fv-PE25 was expressed in high-density Escherichia coli (E. coli.) using the fermentor method and refined via hydrophobicity, ion exchange, and filtration chromatography, achieving a 56.06% recovery rate. Additionally, the semi-manufactured product with 96% purity was prepared into freeze-dried powder by the lyophilized process. Flow cytometry was used to detect the expression of HER2 in SK-BR-3, BT-474, MDA-MB-231, and MDA-MB-468 breast cancer cell lines. The 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyl tetrazolium bromide (MTT) method was used for cytotoxicity assay, and the half-maximal inhibitory concentration (IC50) of 4D5Fv-PE25 lyophilized products to HER2-positive cell line SK-BR-3 was 12.53 ng/mL. The 4D5Fv-PE25 was injected into xenograft tumor mice via the tail vein on the 1st, 4th, and 8th day, it indicated that the growth of tumor volume was effectively inhibited for 24 days, although the 4D5Fv-PE25 was metabolized within 60 min by measuring the release of 3 H-Thymidine radiation.

Conclusion
we succeeded in producing the 4D5Fv-PE25 freeze-dried powder using the prokaryotic expression method, and it could be employed as a potential drug for treating HER2-positive breast cancer.

Graphical abstract
Realising radical potential: building community power in primary health care through Participatory Action Research
Authors: Mabetha Denny , Ojewola Temitope , van der Merwe Maria , Mabika Reflect , Goosen Gerhard , Sigudla Jerry , Hove Jennifer , Witter Sophie , D’Ambruoso Lucia ,   On behalf in collab the Verbal Autopsy with Participatory Action Research (VAPAR)/Wits/Mpumalanga Department of Health Learning Platform
Published: May 2023

AbstractBackgroundWhile community participation is an established pro-equity approach in Primary Health Care (PHC), it can take many forms, and the central category of power is under-theorised. The objectives were to (a) conduct theory-informed analysis of community power-building in PHC in a setting of structural deprivation and (b) develop practical guidance to support participation as a sustainable PHC component.MethodsStakeholders representing rural communities, government departments and non-governmental organisations engaged through a participatory action research (PAR) process in a rural sub-district in South Africa. Three reiterative cycles of evidence generation, analysis, action, and reflection were progressed. Local health concerns were raised and framed by community stakeholders, who generated new data and evidence with researchers. Dialogue was then initiated between communities and the authorities, with local action plans coproduced, implemented, and monitored. Throughout, efforts were made to shift and share power, and to adapt the process to improve practical, local relevance. We analysed participant and researcher reflections, project documents, and other project data using power-building and power-limiting frameworks.ResultsCo-constructing evidence among community stakeholders in safe spaces for dialogue and cooperative action-learning built collective capabilities. The authorities embraced the platform as a space to safely engage with communities and the process was taken up in the district health system. Responding to COVID-19, the process was collectively re-designed to include a training package for community health workers (CHWs) in rapid PAR. New skills and competencies, new community and facility-based alliances and explicit recognition of CHW roles, value, and contribution at higher levels of the system were reported following the adaptations. The process was subsequently scaled across the sub-district.ConclusionsCommunity power-building in rural PHC was multidimensional, non-linear, and deeply relational. Collective mindsets and capabilities for joint action and learning were built through a pragmatic, cooperative, adaptive process, creating spaces where people could produce and use evidence to make decisions. Impacts were seen in demand for implementation outside the study setting. We offer a practice framework to expand community power in PHC: (1) prioritising community capability-building, (2) navigating social and institutional contexts, and (3) developing and sustaining authentic learning spaces.
Menstruation and social inequities in Spain: a cross-sectional online survey-based study
Authors: Medina-Perucha Laura , López-Jiménez Tomàs , Jacques-Aviñó Constanza , Holst Anna Sofie , Valls-Llobet Carme , Munrós-Feliu Jordina , Martínez-Bueno Cristina , Pinzón-Sanabria Diana , Vicente-Hernández Mª Mercedes , Berenguera Anna 
Published: May 2023

Abstract
Background
Available research suggests that menstrual inequity has an impact on (menstrual) health outcomes and emotional wellbeing. It is also a significant barrier to achieve social and gender equity and compromises human rights and social justice. The aim of this study was to describe menstrual inequities and their associations with sociodemographic factors, among women and people who menstruate (PWM) aged 18–55 in Spain.

Methods
A cross-sectional survey-based study was conducted in Spain between March and July 2021. Descriptive statistical analyses and multivariate logistic regression models were performed.

Results
A total of 22,823 women and PWM were included in the analyses (Mean age = 33.2, SD = 8.7). Over half of the participants had accessed healthcare services for menstruation (61.9%). The odds for accessing menstrual-related services were significantly higher among participants with university education (aOR: 1.48, 95% CI, 1.13–1.95). Also, 57.8% reported having had partial or no menstrual education pre-menarche, with odds being higher among participants born in non-European or Latin American countries (aOR: 0.58, 95% CI, 0.36–0.93). Lifetime self-reported menstrual poverty was between 22.2–39.9%. Main risk factors for menstrual poverty were identifying as non-binary (aOR: 1.67, 95% CI, 1.32–2.11), being born in non-European or Latin American countries (aOR: 2.74, 95% CI, 1.77–4.24), and not having a permit to reside in Spain (aOR: 4.27, 95% CI, 1.94–9.38). Completed university education (aOR: 0.61, 95% CI, 0.44–0.84) and no financial hardship < 12 months (aOR: 0.06, 95% CI, 0.06–0.07) were protective factors for menstrual poverty. Besides, 75.2% reported having overused menstrual products due to lack of access to adequate menstrual management facilities. Menstrual-related discrimination was reported by 44.5% of the participants. Non-binary participants (aOR: 1.88, 95% CI, 1.52–2.33) and those who did not have a permit to reside in Spain (aOR: 2.11, 95% CI, 1.10-4.03) had higher odds of reporting menstrual-related discrimination. Work and education absenteeism were reported by 20.3% and 62.7% of the participants, respectively.

Conclusions
Our study suggests that menstrual inequities affect a high number of women and PWM in Spain, especially those more socioeconomically deprived, vulnerabilised migrant populations and non-binary and trans menstruators. Findings from this study can be valuable to inform future research and menstrual inequity policies.
Association of visceral adiposity index with asymptomatic intracranial arterial stenosis: a population-based study in Shandong, China
Authors: Zhao Weihua , Ma Xiaotong , Ju Jiachen , Zhao Yuanyuan , Wang Xiang , Li Shan , Sui Yanling , Sun Qinjian 
Published: May 2023

AbstractBackground and objectiveThe visceral adiposity index (VAI), as a composite indictor to evaluate visceral adipose function, has been demonstrated to be correlated with atherosclerosis. The study objective was to explore the association between asymptomatic intracranial arterial stenosis (aICAS) and VAI in Chinese rural dwellers.MethodsThe cross-sectional study consisted of 1942 participants  ≥ 40 years old who were living in Pingyin County, Shandong Province and free from history of clinical stroke and transient ischemic attack. The aICAS in the study was diagnosed by transcranial doppler ultrasound combined with magnetic resonance angiography. The multivariate logistic regression models were deployed to explore the correlation of VAI with aICAS, and receiver operating characteristic (ROC) curve were plotted to compare the performance of models.ResultsThe participants with aICAS comparing to those without had a significantly higher VAI. After adjusting for confounding factors including age, hypertension, DM, sex, drinking habit, LDL-C, hsCRP, and smoking habit, the VAI-Tertile 3 (vs. VAI-Tertile 1) was positively associated with aICAS (OR, 2.15; 95% CI, 1.25–3.65;P = 0.005). The VAI-Tertile 3 was still markedly associated with aICAS among the underweight and normal weight (BMI ≤ 23.9 kg/m2) participants (OR, 3.17; 95% CI, 1.15–8.71;P = 0.026) with an AUC = 0.684. A similar relationship between VAI and aICAS was obtained among the participants with no abdominal obesity (WHR < 1, OR, 2.03; 95% CI, 1.14–3.62;P = 0.017).ConclusionsThe possible correlation between VAI and aICAS was found to be positive for the first time among Chinese rural residents over 40 years old. A higher VAI was found to be significantly associated with aICAS among the participants who were underweight or normal weight, and these results may provide additional risk stratification information for aICAS.
Targeting the hallmarks of aging to improve influenza vaccine responses in older adults
Authors: Cadar Andreia N. , Martin Dominique E. , Bartley Jenna M. 
Published: May 2023

AbstractAge-related declines in immune response pose a challenge in combating diseases later in life. Influenza (flu) infection remains a significant burden on older populations and often results in catastrophic disability in those who survive infection. Despite having vaccines designed specifically for older adults, the burden of flu remains high and overall flu vaccine efficacy remains inadequate in this population. Recent geroscience research has highlighted the utility in targeting biological aging to improve multiple age-related declines. Indeed, the response to vaccination is highly coordinated, and diminished responses in older adults are likely not due to a singular deficit, but rather a multitude of age-related declines. In this review we highlight deficits in the aged vaccine responses and potential geroscience guided approaches to overcome these deficits. More specifically, we propose that alternative vaccine platforms and interventions that target the hallmarks of aging, including inflammation, cellular senescence, microbiome disturbances, and mitochondrial dysfunction, may improve vaccine responses and overall immunological resilience in older adults. Elucidating novel interventions and approaches that enhance immunological protection from vaccination is crucial to minimize the disproportionate effect of flu and other infectious diseases on older adults.
Validation of the relative biological effectiveness of active-energy scanning carbon-ion radiotherapy on a commercial treatment planning system with a microdosimetic kinetic model
Authors: Wang Weiwei , Sun Wei , Shen Hao , Zhao Jingfang 
Published: May 2023

Abstract
Background
The study objective was to validate the relative biological effectiveness (RBE) calculated by the modified microdosimetric kinetic model in RayStation (Ray-MKM) for active-energy scanning carbon-ion radiotherapy.

Methods
The Ray-MKM was benchmarked using a spread-out Bragg-peak (SOBP) plan, which was suggested in literature from the National Institute of Radiobiological Science (NIRS) in Japan. The residual RBE differences from the MKM at NIRS (NIRS-MKM) were derived using several SOBP plans with different ranges, SOBP widths, and prescriptions. To investigate the origins of the differences, we compared the saturation-corrected dose-mean specific energy $$Z_{1D}^{*}$$

Z

1
D

∗

of the aforementioned SOBPs. Furthermore, we converted the RBE-weighted doses with the Ray-MKM to those with local effect model I (LEM doses). The purpose was to investigate whether the Ray-MKM could reproduce the RBE-weighted conversion study.

Results
The benchmark determined the value of the clinical dose scaling factor, $$F_{clin}$$

F

clin

, as 2.40. The target mean RBE deviations between the Ray-MKM and NIRS-MKM were median: 0.6 (minimum: 0.0 to maximum: 1.69) %. The $$Z_{1D}^{*}$$

Z

1
D

∗

difference in-depth led to the RBE difference in-depth and was remarkable at the distal end. The converted LEM doses from the Ray-MKM doses were comparable (the deviation being − 1.8–0.7%) to existing literature.

Conclusion
This study validated the Ray-MKM based on our active-energy scanning carbon-ion beam via phantom studies. The Ray-MKM could generate similar RBEs as the NIRS-MKM after benchmarking. Analysis based on $$Z_{1D}^{*}$$

Z

1
D

∗

indicated that the different beam qualities and fragment spectra caused the RBE differences. Since the absolute dose differences at the distal end were small, we neglected them. Furthermore, each centre may determine its centre-specific $$F_{clin}$$

F

clin

based on this approach.
Remote blood pressure monitoring in high risk pregnancy — study protocol for a randomised controlled trial (REMOTE CONTROL trial)
Authors: Rajkumar Theepika , Freyne Jill , Varnfield Marlien , Lawson Kenny , Butten Kaley , Shanmugalingam Renuka , Hennessy Annemarie , Makris Angela 
Published: May 2023

Abstract
Background
Pregnant women at high risk for developing a hypertensive disorder of pregnancy require frequent antenatal assessments, especially of their blood pressure. This expends significant resources for both the patient and healthcare system. An alternative to in-clinic assessments is a remote blood pressure monitoring strategy, in which patients self-record their blood pressure at home using a validated blood pressure machine. This has the potential to be cost-effective, increase patient satisfaction, and reduce outpatient visits, and has had widespread uptake recently given the increased need for remote care during the ongoing COVID-19 pandemic. However robust evidence supporting this approach over a traditional face-to-face approach is lacking, and the impact on maternal and foetal outcomes has not yet been reported. Thus, there is an urgent need to assess the efficacy of remote monitoring in pregnant women at high risk of developing a hypertensive disorder of pregnancy.

Methods
The REMOTE CONTROL trial is a pragmatic, unblinded, randomised controlled trial, which aims to compare remote blood pressure monitoring in high-risk pregnant women with conventional face-to-face clinic monitoring, in a 1:1 allocation ratio. The study will recruit patients across 3 metropolitan Australian teaching hospitals and will evaluate the safety, cost-effectiveness, impact on healthcare utilisation and end-user satisfaction of remote blood pressure monitoring.

Discussion
Remote blood pressure monitoring is garnering interest worldwide and has been increasingly implemented following the COVID-19 pandemic. However, robust data regarding its safety for maternofoetal outcomes is lacking. The REMOTE CONTROL trial is amongst the first randomised controlled trials currently underway, powered to evaluate maternal and foetal outcomes. If proven to be as safe as conventional clinic monitoring, major potential benefits include reducing clinic visits, waiting times, travel costs, and improving delivery of care to vulnerable populations in rural and remote communities.

Trial registration
The trial has been prospectively registered with the Australian and New Zealand Clinical Trials Registry (ACTRN12620001049965p, on October 11th, 2020).
Enhancing the extended value chain of the aromatic plant sector in Italy: a multiple correspondence analysis based on stakeholders’ opinions
Authors: Di Vita Giuseppe , Spina Daniela , De Cianni Rachele , Carbone Roberto , D’Amico Mario , Zanchini Raffaele 
Published: May 2023

AbstractThe aim of the study has been to understand the stakeholders’ stance, with respect to the different stages of Porter’s value chain, to learn what activities could create the most value to the future competitiveness of the Italian aromatic sector. The main challenges faced by stakeholders and possible future strategies have been investigated. A survey, consisting of four subsequent phases: creation of a focus group, identification of actors and experts, gathering of data, and processing of the data using descriptive statistics and Multiple Correspondence Analysis (MCA), has been performed. The stakeholders agreed that the Italian aromatic sector needs to enhance its value chain, but there is a polarisation of importance especially towards processors and retailers. Processors consider operations and outbound logistics as the most relevant primary activities, while retailers consider marketing and sales. Firm infrastructure and technology development are the more relevant support activities for retailers, while human resource management for processors. Farmers are apprehensive of imports, while processors agree that priority should be given to the bargaining power of retailers. Training of professionals emerges as an important future strategy to improve the extended value chain of the sector. The article investigates the extended value chain of the aromatic plant sector, according to Porter's model, in combination with a multivariate explorative tool (MCA). The results represent preliminary insights that can be used to diversify the role and sensitivity of different stakeholders, with respect to supply chain competitiveness and innovation.