bluuebunny/crossref_metadata_2025_split huggingface dataset:
"They see me as mentally ill": the stigmatization experiences of Chinese menopausal women in the family
Authors: Li Qiong , Gu Jintu , Huang Jianyuan , Zhao Pei , Luo Chenliang 
Published: April 2023

Abstract
Background
Menopausal women are regarded as “abnormal people” in China and are often discriminated against and ostracized, especially in the privacy of their homes. However, research on the stigmatization of menopausal women in China is limited. The aim of this study is to explore and describe the stigmatization experiences of Chinese menopausal women in the family and their feelings about these experiences.

Methods
A phenomenological qualitative research design involving in-depth semi-structured interviews was selected. Our data analysis adopted Colaizzi's methodology.

Results
Fourteen menopausal women participated in this study. Four themes and 12 subthemes emerged: (1) violent treatment (verbal and physical violence); (2) lack of attention and companionship (lack of understanding of physical and psychological suffering, neglect of the value of labour and difficulty finding someone to talk to and accompany them); (3) coping struggles (keeping quiet, fighting back, changing inappropriate perceptions and developing a menopausal transition management plan); and (4) despair (deep-rooted perceptions, restrictions on travel and consumption, and unknown "healing" times).

Conclusion
Our results suggest that Chinese menopausal women suffer physically and mentally within their families. The stigma of menopause is both a symptom of the broad societal lack of knowledge regarding menopause and a reflection of the patriarchal oppression of women in a specific cultural context. Accordingly, this study can help menopausal women and society in general better understand the former’s stigmatization experiences and amplify their inner voices. Moreover, it can serve as a reference for the formulation of menopause-related health policies in China and for advocating and promoting humanistic care for menopausal women.
Effectiveness and safety analysis of Danggui Shaoyao Powder for the treatment of non-alcoholic fatty liver disease: study protocol for a randomized, double-blind, placebo-controlled clinical trial
Authors: Huang Qian , An Ziming , Xin Xin , Sun Qinmei , Gao Siting , Lv Sheng , Xu Xiao , Yang Shuohui , Lu Fang , Yuan Jie , Zhao Yu , Hu Yiyang , Liu Ping , Feng Qin 
Published: April 2023

Abstract
Background
The incidence of non-alcoholic fatty liver disease (NAFLD) has been on the rise in recent years, and there are no effective drugs to treat NAFLD; therefore, effective prevention and treatment of NAFLD have become a new challenge. Danggui Shaoyao Powder (DGSY) is a classic prescription commonly used in clinical practice and has been shown to reduce hepatic steatosis in patients with NAFLD. In addition, previous studies have shown that DGSY can alleviate hepatic steatosis and inflammation in NAFLD mice. Although clinical practice and basic studies have shown that DGSY is effective in NAFLD, high levels of clinical evidence are lacking. Therefore, a standardized RCT study protocol is required to evaluate its clinical efficacy and safety.

Methods and analysis
This study will be a randomized, double-blind, placebo-controlled, and single-center trial. According to the random number table, NAFLD participants will be randomly divided into the DGSY or placebo group for 24 weeks. The follow-up period will be 6 weeks after drug withdrawal. The primary outcome is the relative change in MRI-proton density fat fraction (MRI-PDFF) from baseline to 24 weeks. Absolute changes in serum alanine aminotransferase (ALT), liver stiffness measurement (LSM), body mass index (BMI), blood lipid, blood glucose, and insulin resistance index will be selected as secondary outcomes to comprehensively evaluate the clinical efficacy of DGSY in the treatment of NAFLD. The safety of DGSY will be evaluated by renal function, routine blood and urine tests, and electrocardiogram.

Discussion
This study will provide evidence-based medical corroboration for the clinical application of DGSY and promote the development and application of this classic prescription.

Trial registration
http://www.chictr.org.cn. Trial number: ChiCTR2000029144. Registered on 15 Jan 2020.
“But at home, with the midwife, you are a person”: experiences and impact of a new early postpartum home-based midwifery care model in the view of women in vulnerable family situations
Authors: Schwind Bettina , Zemp Elisabeth , Jafflin Kristen , Späth Anna , Barth Monika , Maigetter Karen , Merten Sonja , Kurth Elisabeth 
Published: April 2023

Abstract
Background
Postpartum home-based midwifery care is covered by basic health insurance in Switzerland for all families with newborns but must be self-organized. To ensure access for all, Familystart, a network of self-employed midwives, launched a new care model in 2012 by ensuring the transition from hospital to home through cooperation with maternity hospitals in the Basel area. It has particularly improved the access to follow-up care for families in vulnerable situations needing support beyond basic services. In 2018, the SORGSAM (Support at the Start of Life) project was initiated by Familystart to enhance parental resources for better postpartum health outcomes for mothers and children through offering improved assistance to psychosocially and economically disadvantaged families. First, midwives have access to first-line telephone support to discuss challenging situations and required actions. Second, the SORGSAM hardship fund provides financial compensation to midwives for services not covered by basic health insurance. Third, women receive financial emergency support from the hardship fund.

Aim
The aim was to explore how women living in vulnerable family situations experienced the new early postpartum home-based midwifery care model provided in the context of the SORGSAM project, and how they experienced its impact.

Methods
Findings are reported from the qualitative part of the mixed-methods evaluation of the SORGSAM project. They are based on the results of seven semi-structured interviews with women who, due to a vulnerable family postpartum situation at home, received the SORGSAM support. Data were analyzed following thematic analysis.

Results
Interviewed women experienced the early postpartum care at home, as “relieving and strengthening” in that midwives coordinated patient care that opened up access to appropriate community-based support services. The mothers expressed that they felt a reduction in stress, an increase in resilience, enhanced mothering skills, and greater parental resources. These were attributed to familiar and trusting relationships with their midwives where participants acknowledged deep gratitude.

Conclusion
The findings show the high acceptance of the new early postpartum midwifery care model. These indicate how such a care model can improve the well-being of women in vulnerable family situations and may prevent early chronic stress in children.
Three-dimensional transesophageal echocardiographic evaluation of pulmonary vein anatomy prior to cryoablation: validation with cardiac CT scan
Authors: Nagy Laszlo Tibor , Jenei Csaba , Papp Timea Bianka , Urbancsek Reka , Kolozsvari Rudolf , Racz Agnes , Raduly Arnold Peter , Veisz Richard , Csanadi Zoltan 
Published: April 2023

Abstract
Background
Anatomical characteristics of the left atrium and the pulmonary veins (PVs) may be relevant to the success rate of cryoballoon (CB)-ablation for atrial fibrillation (AF). Cardiac computed tomography (CCT) is considered as the gold standard for preablation imaging. Recently, three-dimensional transesophageal echocardiography (3DTOE) has been proposed for preprocedural assessment of cardiac structures relevant to CB-ablation. The accuracy of 3DTOE has not been validated by other imaging modalities.

Objective
We prospectively evaluated the feasibility and the accuracy of 3DTOE imaging for the assessment of left atrial and PV structures prior to pulmonary vein isolation (PVI). In addition, CCT was used to validate the measurements obtained with 3DTOE.

Methods
PV anatomy of 67 patients (59.7% men, mean age 58.5 ± 10.5 years) was assessed using both 3DTOE and CCT scan prior to PVI with the Arctic Front CB. The following parameters were measured bilaterally: PV ostium area (OA), the major and minor axis diameters of the ostium (a > b) and the width of the carina between the superior and the inferior PVs. In addition, the width of the left lateral ridge (LLR) between the left atrial appendage and the left superior PV. Evaluation of inter-technique agreement was based on linear regression with Pearson correlation coefficient (PCC) and Bland–Altman analysis of biases and limits of agreement.

Results
Moderate positive correlation (PCC 0.5–0.7) was demonstrated between the two imaging methods for the right superior PV’s OA and both axis diameters, the width of the LLR and left superior PV (LSPV) minor axis diameter (b) with limits of agreement ˂50% and no significant biases. Low positive or negligible correlation (PCC < 0.5) was found for both inferior PV parameters.

Conclusions
Detailed assessment of the right superior PV parameters, LLR and LSPV b is feasible with 3DTOE prior to AF ablation. This 3DTOE measurements demonstrated a clinically acceptable inter-technique agreement with those obtained with CCT.

Graphical Abstract
Human dendritic cell maturation induced by amorphous silica nanoparticles is Syk-dependent and triggered by lipid raft aggregation
Authors: Guillet Éléonore , Brun Émilie , Ferard Céline , Hardonnière Kévin , Nabhan Myriam , Legrand François-Xavier , Pallardy Marc , Biola-Vidamment Armelle 
Published: April 2023

Abstract
Background
Synthetic amorphous silica nanoparticles (SAS-NPs) are widely employed in pharmaceutics, cosmetics, food and concretes. Workers and the general population are exposed daily via diverse routes of exposure. SAS-NPs are generally recognized as safe (GRAS) by the Food and Drug Administration, but because of their nanoscale size and extensive uses, a better assessment of their immunotoxicity is required. In the presence of immune “danger signals”, dendritic cells (DCs) undergo a maturation process resulting in their migration to regional lymph nodes where they activate naive T-cells. We have previously shown that fumed silica pyrogenic SAS-NPs promote the two first steps of the adaptative immune response by triggering DC maturation and T-lymphocyte response, suggesting that SAS-NPs could behave as immune “danger signals”. The present work aims to identify the mechanism and the signalling pathways involved in DC phenotype modifications provoked by pyrogenic SAS-NPs. As a pivotal intracellular signalling molecule whose phosphorylation is associated with DC maturation, we hypothesized that Spleen tyrosine kinase (Syk) may play a central role in SAS-NPs-induced DC response.

Results
In human monocyte-derived dendritic cells (moDCs) exposed to SAS-NPs, Syk inhibition prevented the induction of CD83 and CD86 marker expression. A significant decrease in T-cell proliferation and IFN-γ, IL-17F and IL-9 production was found in an allogeneic moDC:T-cell co-culture model. These results suggested that the activation of Syk was necessary for optimal co-stimulation of T-cells. Moreover, Syk phosphorylation, observed 30 min after SAS-NP exposure, occurred upstream of the c-Jun N-terminal kinase (JNK) Mitogen-activated protein kinases (MAPK) and was elicited by the Src family of protein tyrosine kinases. Our results also showed for the first time that SAS-NPs provoked aggregation of lipid rafts in moDCs and that MβCD-mediated raft destabilisation altered Syk activation.

Conclusions
We showed that SAS-NPs could act as an immune danger signal in DCs through a Syk-dependent pathway. Our findings revealed an original mechanism whereby the interaction of SAS-NPs with DC membranes promoted aggregation of lipid rafts, leading to a Src kinase-initiated activation loop triggering Syk activation and functional DC maturation.
Harm reduction and recovery services support (HRRSS) to mitigate the opioid overdose epidemic in a rural community
Authors: Heo Moonseong , Beachler Taylor , Sivaraj Laksika B. , Tsai Hui-Lin , Chea Ashlyn , Patel Avish , Litwin Alain H. , Zeller T. Aaron 
Published: April 2023

Abstract
Background
Rural areas in the United States (US) are ravaged by the opioid overdose epidemic. Oconee County, an entirely rural county in northwest South Carolina, is likewise severely affected. Lack of harm reduction and recovery resources (e.g., social capital) that could mitigate the worst outcomes may be exacerbating the problem. We aimed to identify demographic and other factors associated with support for harm reduction and recovery services in the community.

Methods
The Oconee County Opioid Response Taskforce conducted a 46-item survey targeting a general population between May and June in 2022, which was mainly distributed through social media networks. The survey included demographic factors and assessed attitudes and beliefs toward individuals with opioid use disorder (OUD) and medications for OUD, and support for harm reduction and recovery services, such as syringe services programs and safe consumption sites. We developed a Harm Reduction and Recovery Support Score (HRRSS), a composite score of nine items ranging from 0 to 9 to measure level of support for placement of naloxone in public places and harm reduction and recovery service sites. Primary statistical analysis using general linear regression models tested significance of differences in HRRSS between groups defined by item responses adjusting for demographic factors.

Results
There were 338 survey responses: 67.5% were females, 52.1% were 55 years old or older, 87.3% were Whites, 83.1% were non-Hispanic, 53.0% were employed, and 53.8% had household income greater than US$50,000. The overall HRRSS was relatively low at a mean of 4.1 (SD = 2.3). Younger and employed respondents had significantly greater HRRSS. Among nine significant factors associated with HRRSS after adjusting for demographic factors, agreement that OUD is a disease had the greatest adjusted mean difference in HRSSS (adjusted diff = 1.22, 95% CI=(0.64, 1.80), p < 0.001), followed by effectiveness of medications for OUD (adjusted diff = 1.11, 95%CI=(0.50, 1.71), p < 0.001).

Conclusions
Low HRRSS indicates low levels of acceptance of harm reduction potentially impacting both intangible and tangible social capital as it relates to mitigation of the opioid overdose epidemic. Increasing community awareness of the disease model of OUD and the effectiveness of medications for OUD, especially among older and unemployed populations, could be a step toward improving community uptake of the harm reduction and recovery service resources critical to individual recovery efforts.
Elastin is responsible for the rigidity of the ligament under shear and rotational stress: a mathematical simulation study
Authors: Naya Yuki , Takanari Hiroki 
Published: April 2023

Abstract
Background
An accurate understanding of the mechanical response of ligaments is important for preventing their damage and rupture. To date, ligament mechanical responses are being primarily evaluated using simulations. However, many mathematical simulations construct models of uniform fibre bundles or sheets using merely collagen fibres and ignore the mechanical properties of other components such as elastin and crosslinkers. Here, we evaluated the effect of elastin-specific mechanical properties and content on the mechanical response of ligaments to stress using a simple mathematical model.

Methods
Based on multiphoton microscopic images of porcine knee collateral ligaments, we constructed a simple mathematical simulation model that individually includes the mechanical properties of collagen fibres and elastin (fibre model) and compared with another model that considers the ligament as a single sheet (sheet model). We also evaluated the mechanical response of the fibre model as a function of the elastin content, from 0 to 33.5%. Both ends of the ligament were fixed to a bone, and tensile, shear, and rotational stresses were applied to one of the bones to evaluate the magnitude and distribution of the stress applied to the collagen and elastin at each load.

Results
Uniform stress was applied to the entire ligament in the sheet model, whereas in the fibre model, strong stress was applied at the junction between collagen fibres and elastin. Even in the same fibre model, as the elastin content increased from 0 to 14.4%, the maximum stress and displacement applied to the collagen fibres during shear stress decreased by 65% and 89%, respectively. The slope of the stress–strain relationship at 14.4% elastin was 6.5 times greater under shear stress than that of the model with 0% elastin. A positive correlation was found between the stress required to rotate the bones at both ends of the ligament at the same angle and elastin content.

Conclusions
The fibre model, which includes the mechanical properties of elastin, can provide a more precise evaluation of the stress distribution and mechanical response. Elastin is responsible for ligament rigidity during shear and rotational stress.
Mid term freedom from atrial fibrillation following hybrid ablation, a systematic review and meta analysis
Authors: Eranki Aditya , Wilson-Smith Ashley , Flynn Campbell , Williams Michael , Manganas Con 
Published: April 2023

Abstract
Introduction
Atrial Fibrillation (AF) is a common tachyarrhythmia affecting 33 million people worldwide. Hybrid AF ablation utilises a surgical (epicardial) ablation followed by an endocardial catheter-based ablation. The aim of this systematic review and meta-analysis is to summarize the literature reporting mid-term freedom from AF following hybrid ablation.

Methods
An electronic search of databases was performed to identify all relevant studies providing mid-term (2 year) outcomes following hybrid ablation for AF. The primary study outcome was to assess the mid-term freedom from AF following hybrid ablation, utilising the metaprop function on Stata® (Version 17.0, StataCorp, Texas, USA). Subgroup analysis was performed to assess the impact of various operative characteristics on mid-term freedom from AF. The secondary outcomes assessed mortality and procedural complication rate.

Results
The search strategy identified 16 studies qualifying for inclusion in this meta-analysis, with 1242 patients in total. The majority of papers were retrospective cohort studies (15) and one study was a randomized control trial (RCT). The mean follow up was 31.5 ± 8.4 months. Following hybrid ablation, the overall mid-term freedom from AF was 74.6% and 65.4% for patients off antiarrhythmic drugs (AAD). Actuarial freedom from AF was 78.2%, 74.2% and 73.6% at 1, 2 and 3 years respectively. No significant differences in mid-term freedom from AF based epicardial lesion set (box vs pulmonary vein isolation) or Left atrial appendage/Ganglionated Plexus/Ligament of Marshall ablation or staged vs concomitant procedures. There were 12 deaths overall following the hybrid procedure with a pooled complication rate of 5.53%.

Conclusion
Hybrid AF ablation offers promising mid-term freedom from AF reported at a mean follow-up of 31.5 months. The overall complication rate remains low. Further analysis of high-quality studies with randomized data and long-term follow up will help verify these results.
Community mental health care network: an evaluative approach in a Brazilian state
Authors: Coelho Vívian Andrade Araújo , da Gama Carlos Alberto Pegolo , Andrade Leonardo Isolani e , Silva Mariana Arantes e , Guimarães Denise Alves , de Azevedo Guimarães Eliete Albano , Modena Celina Maria 
Published: April 2023

AbstractIn recent decades, public policies of the Unified Health System (SUS) in Brazil have structured a community mental health care network (RAPS) based on various community actions and services. This study carried out evaluative research on the implementation of the structure and process dimensions of this care network in Minas Gerais, the second most populous state of Brazil, generating indicators that can enhance the strategic management of the public health system in the strengthening the psychosocial care in the state. The application of a multidimensional instrument, previously validated (IMAI-RAPS), in 795 of the 853 municipalities in Minas Gerais was carried out between June and August 2020. Regarding the structural dimension, we noticed an adequate implementation of services like ‘Family Health Strategy,’ ‘Expanded Family Health Center,’ and ‘Psychosocial Care Centers’ but a lack of ‘Beds in General Hospitals’ destinated to mental health care, ‘Unified Electronic Medical Records’ and ‘Mental Health Training Activities for Professionals.’ In the process dimension, adequate implementation of actions such as ‘Multidisciplinary and Joint Care,’ ‘Assistance to Common Mental Disorders by Primary Health Care,’ ‘Management of Psychiatric Crises in Psychosocial Care Centers,’ ‘Offer of Health Promotion Actions,’ and ‘Discussion of Cases by Mental Health Teams’ point to a form of work consistent with the guidelines. However, we detected difficulties in the implementation of ‘Psychosocial Rehabilitation Actions,’ ‘Productive Inclusion,’ ‘User Protagonism,’ ‘Network Integration,’ and practical activities for the effectiveness of collaborative care. We found a better implementation of the mental health care network in more populous, demographically dense, and socioeconomically developed cities, which shows the importance of regional sharing of services that are not possible for small cities. The evaluation practices of mental health care networks are scarce throughout the Brazilian territory, a fact also found in Minas Gerais, highlighting the need for its expansion not only in the scientific sphere but also in the daily life of the various levels of management.