bluuebunny/crossref_metadata_2025_split huggingface dataset:
The role of traditional birth attendants and problem of integration with health facilities in remote rural community of West Omo Zone 2021: exploratory qualitative study
Authors: Kassie Aychew , Wale Alemnew , Girma Desalegn , Amsalu Hailemariam , yechale Mastewal 
Published: May 2022

Abstract
Background
Mothers in rural Ethiopian communities prefer giving birth at home. In developing countries, traditional birth attendants play an important role in reducing the maternal mortality rate. In Ethiopia, however, their role during pregnancy, childbirth, the postnatal period, and their integration with health professionals is not clearly defined. This study aimed to explore the role of traditional birth attendants in feto-maternal care during pregnancy, childbirth, and the postnatal period, and integration with health professionals in the West Omo Zone, southern Ethiopia.

Methods
A qualitative descriptive design was used with triangulation of methods and data sources. We conducted in-depth interviews with traditional birth attendants, key informant interviews with health care professionals and community or religious leaders, and two focus group discussions with multiparous pregnant women. Each interview and focus group discussion was tape-recorded and the data obtained were transcribed and translated into English for analysis. The analysis was done based on thematic analysis framework.

Results
Traditional birth attendants stated that they used herbal remedies to treat nausea and vomiting, decrease pain during labor, and increase pregnant women's desire to push. The absence of incentives for their work, shortage of logistics, and lack of training was mentioned as challenges to the continuity of their roles. All study participants explained the importance of training traditional birth attendants on maternal and child health in rural communities. However, health care professionals reported that few traditional birth attendants advised mothers about traditional practices such as milk tooth extraction and uvulectomy.

Conclusion and recommendation
Traditional birth attendants continued their roles despite the existing challenges. There was no integration between TBA and the formal health care system. The need for training traditional birth attendants has been emphasized by all study participants and its impact on reducing feto-maternal death was recognized by health care professionals. Therefore, the federal ministry of health should works better for the development of TBAs to scale up their skills across all regions in the country.
Invisible experts: a systematic review & thematic synthesis of informal carer experiences of inpatient mental health care
Authors: Abou Seif Nada , Wood Lisa , Morant Nicola 
Published: May 2022

Abstract
Background
The negative impact of caregiving on carers’ physical and psychological wellbeing is well documented. Carers of mental health inpatients have particularly negative experiences and largely report being dissatisfied with how they and their loved one are treated during inpatient care. It remains unclear why, despite policies intended to improve inpatient experiences. A comprehensive review of carers’ inpatient experiences is needed to understand carer needs. As such, we aimed to conduct a systematic review and thematic synthesis of carer experiences of inpatient mental health care.

Methods
We searched MEDLINE, PsycINFO, Embase and CINAHL for qualitative studies examining carer experiences of mental health inpatient care. Searches were supplemented by reference list screening and forward citation tracking of included studies. Results were synthesised using thematic synthesis. Our protocol was registered on PROSPERO (CRD42020197904) and our review followed Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines.

Findings
Twelve studies were included from 6 countries. Four themes were identified: the emotional journey of inpatient care; invisible experts; carer concerns about quality of care for their loved one; and relationships and partnership between carers, service users and staff.

Interpretation
Greater attention should be paid to ensure carers are well-supported, well-informed, and included in care. More emphasis must be placed on fostering positive relationships between carers, service users and staff and in facilitating continuity of care across inpatient and community services to provide carers with a sense of security and predictability. Further research is needed to explore differences in experiences based on carer and service user characteristics and global context, alongside co-production with carers to develop and evaluate future guidelines and policies.
Chemical composition, antibiofilm, cytotoxic, and anti-acetylcholinesterase activities of Myrtus communis L. leaves essential oil
Authors: Caputo Lucia , Capozzolo Francesca , Amato Giuseppe , De Feo Vincenzo , Fratianni Florinda , Vivenzio Giovanni , Nazzaro Filomena 
Published: May 2022

Abstract
Background
The potential of essential oils (EOs) and of their principal constituents for eradication of biofilm and at the same time the research of new potential acetylcholinesterase inhibitors is gaining increasing interest in last years. The aims of this study were to determine the chemical composition and to evaluate the antibacterial, cytotoxic, and anti-acetylcholinesterase properties of Myrtus communis leaves essential oil and its main constituents.

Methods
Essential oil was obtained by hydrodistillation of M. communis L. leaves and was analyzed by GC and GC–MS. The antimicrobial activity was carried out against both gram-negative and gram-positive bacteria. The microdilution method was used to estimate the minimum inhibitory concentrations (MICs). Then, the capacity of essential oil and its main constituent to inhibit biofilm growth, with the method of O’Toole and Kolterand, and the metabolic activity of biofilm cells through the MTT colorimetric method were evaluated at different times. Moreover, was studied the potential cytotoxic activity against SH-SY5Y cell line with MTT assay and the anti-acetylcholinesterase activity using Ellman’s assay.

Results
Myrtenyl-acetate, 1,8 cineole, α-pinene, and linalool were the main components in the EO. The myrtle EO, at the minimum tested dose (0.4 mg/ml), inhibited S. aureus biofilm by 42.1% and was capable of inhibiting the biofilm cell metabolism in all tested strains, except Staphylococcus aureus. Moreover, the EO showed good cytotoxic and anti-acetylcholinesterase activities IC50 of 209.1 and 32.8 μg/ml, respectively.

Conclusions
The results suggest that myrtle EO and its main constituents could be used as possible products that could act against the resistant pathogenic species E. coli, P. aeruginosa, L. monocytogenes and S. aureus, on the other hand, as possible coadjutants in the treatment of neurological diseases.
Anti-inflammatory and anti-nociceptive effects of Cinnamon and Clove essential oils nanogels: an in vivo study
Authors: Esmaeili Fariba , Zahmatkeshan Masoumeh , Yousefpoor Yaser , Alipanah Hiva , Safari Ehsan , Osanloo Mahmoud 
Published: May 2022

Abstract
Background
Cinnamon (Cinnamomum zeylanicum) and Clove (Syzygium aromaticum) essential oils are two medicinally important plant-derived substances with a wide range of biological properties. Besides, nanoemulsion-based gels have been widely used to increase topical drug delivery and effectiveness.

Methods
This study aimed to explore the anti-inflammatory effect (paw edema test) and the anti-nociceptive effect (hot plate and formalin test) of nanoemulsion-based gels containing the essential oils in the animal model. Cinnamon and Clove essential oils nanoemulsions with droplet sizes of 28 ± 6 nm and 12 ± 3 nm were first prepared. By adding carboxymethylcellulose (3.5% w/v), the nanoemulsions were then gelified. Finally, the nanogels were characterized by ATR-FTIR analysis and were used as topical pre-treatment before induction of inflammation or pain in acute and chronic analgesic experimental studies.

Results
The paw edema and formalin findings showed that the nanogels formulations possess significant anti-nociceptive and anti-inflammatory effects.

Conclusion
The prepared nanogels could be considered as analgesic drugs for inhibiting the inflammation and pain of diseases.
A novel surgical technique for prevention of self-sucking in cattle and buffaloes: tongue piercing
Authors: Salman Yasser , Semieka Mohamed , Karmi Mohamed , Al-lethie Al-lethie A. 
Published: May 2022

Abstract
Background
Self-sucking is an abnormal behavior lead to important economic losses for dairy farms. The objective of this study was to evaluate tongue piercing as a novel technique to prevent self-sucking in cattle and buffaloes. The study was carried out on 26 cows and 4 buffaloes suffered from self-sucking. Tongue piercing was achieved by the application of an implant in the midline of the tongue and anterior to the frenulum linguae. With a follow up period of 6 months.

Results
This implant produced mechanical disruption of the affected animals ability to curl their tongues, in a U- shape manner, subsequently it was impossible for these animals to cup their tongues and suck its own teats. Slight swelling around the piercing site of the tongue was observed among all animals on the first 3 days after surgery. No other complications have been reported.

Conclusion
Tongue piercing is an effective, rapid, easy, minimally invasive technique to prevent self-sucking among cattle and buffaloes, moreover, the technique was more widely acceptable by the owners than other traditional and surgical methods.
NecroX-5 ameliorates bleomycin-induced pulmonary fibrosis via inhibiting NLRP3-mediated epithelial–mesenchymal transition
Authors: Min Li , Shu-Li Zhang , Feng Yuan , Han Hu , Shao-Jun Li , Sheng-Xiong Tong , Jia-Yu Tian , Xiang-Zhi Fang , Dan Feng 
Published: May 2022

Abstract
Background
Pulmonary fibrosis is a progressive and usually lethal pulmonary disease. Despite considerable research efforts, no effective therapeutic strategy for pulmonary fibrosis has been developed. NecroX-5 has been reported to possess anti-inflammatory, anti-oxidative and anti-tumor activities. In the present study, we aimed to determine whether NecroX-5 exhibits antifibrotic property in bleomycin (BLM)-induced pulmonary fibrosis.

Results
We found that pre-treatment with NecroX-5 alleviated inflammatory response, reduced oxidative stress, inhibited epithelial–mesenchymal transition (EMT), and ameliorated pulmonary fibrosis in vivo and in vitro. Our data further indicated that NecroX-5 substantially reduced activation of NLRP3 inflammasome and TGF-β1/Smad2/3 signaling in vivo and in vitro. Additionally, NLRP3 overexpression significantly reversed the protective effects of NecroX-5 in lung epithelial cells exposed to BLM.

Conclusions
Overall, our results demonstrate the potent antifibrotic properties of NecroX-5 and its therapeutic potential for pulmonary fibrosis.
A comprehensive analysis of potential gastric cancer prognostic biomarker ITGBL1 associated with immune infiltration and epithelial–mesenchymal transition
Authors: Wang Zhe , Fu Liu , Zhang Junjie , Ge Yanli , Guo Cheng , Wang Rui , Deng Min , Wang Qizhi , Wang Zhirong 
Published: May 2022

Abstract
Background
Integrin, beta-like 1 (ITGBL1) is involved in a variety of human malignancies. However, the information on the involvement of ITGBL1 in gastric carcinoma (GC) is limited. Hence, this study aimed further to explore the functions and mechanisms of ITGBL1 in GC.

Methods
First, multiple bioinformatics databases, including Oncomine, Tumor Immune Estimation Resource, UALCAN, and Kaplan–Meier Plotter, were used to predict the expression level and prognostic value of ITGBL1, as well as its association with immune infiltration and epithelial–mesenchymal transition (EMT) in GC. Quantitative reverse transcription–polymerase chain reaction and immunohistochemical analysis were used to detect the expression of ITGBL1 in both GC tissues and cells. Then, targeted silencing of ITGBL1 in GC cells was further used to examine the biological functions of ITGBL1.

Results
These databases revealed that ITGBL1 was overexpressed and affected the overall survival in GC. Besides, the expression of ITGBL1 positively correlated with immune-infiltrating cells and EMT-related markers. Subsequently, molecular biology experiments verified these predictions. In GC tissues and cells, ITGBL1 was notably overexpressed. Loss-of-function studies showed that the knockdown of ITGBL1 significantly suppressed migration and invasion but promoted apoptosis in MGC803 GC cells. Furthermore, the inhibition of ITGBL1 resulted in remarkably increased protein expression levels of cadherin 1, while the expression of Vimentin, Snail, and transforming growth factor-β1 was downregulated, indicating the initiation and progression of GC caused by ITGBL1 partly via inducing EMT.

Conclusions
To sum up, the findings indicated that ITGBL1 acted as a valuable oncogenic factor in GC.
Three-dimensional finite element analysis of the effect of alveolar cleft bone graft on the maxillofacial biomechanical stabilities of unilateral complete cleft lip and palate
Authors: Tian Tao , Huang Han-yao , Wang Wei , Shi Bing , Zheng Qian , Li Cheng-hao 
Published: May 2022

Abstract
Background
The objective is to clarify the effect of alveolar cleft bone graft on maxillofacial biomechanical stabilities, the key areas when bone grafting and in which should be supplemented with bone graft once bone resorption occurred in UCCLP (unilateral complete cleft lip and palate).

Methods
Maxillofacial CAD (computer aided design) models of non-bone graft and full maxilla cleft, full alveolar cleft bone graft, bone graft in other sites of the alveolar cleft were acquired by processing the UCCLP maxillofacial CT data in three-dimensional modeling software. The maxillofacial bone EQV (equivalent) stresses and bone suture EQV strains under occlusal states were obtained in the finite element analysis software.

Results
Under corresponding occlusal states, the EQV stresses of maxilla, pterygoid process of sphenoid bone on the corresponding side and anterior alveolar arch on the non-cleft side were higher than other maxillofacial bones, the EQV strains of nasomaxillary, zygomaticomaxillary and pterygomaxillary suture on the corresponding side were higher than other maxillofacial bone sutures. The mean EQV strains of nasal raphe, the maximum EQV stresses of posterior alveolar arch on the non-cleft side, the mean and maximum EQV strains of nasomaxillary suture on the non-cleft side in full alveolar cleft bone graft model were all significantly lower than those in non-bone graft model. The mean EQV stresses of bilateral anterior alveolar arches, the maximum EQV stresses of maxilla and its alveolar arch on the cleft side in the model with bone graft in lower 1/3 of the alveolar cleft were significantly higher than those in full alveolar cleft bone graft model.

Conclusions
For UCCLP, bilateral maxillae, pterygoid processes of sphenoid bones and bilateral nasomaxillary, zygomaticomaxillary, pterygomaxillary sutures, anterior alveolar arch on the non-cleft side are the main occlusal load-bearing structures before and after alveolar cleft bone graft. Alveolar cleft bone graft mainly affects biomechanical stabilities of nasal raphe and posterior alveolar arch, nasomaxillary suture on the non-cleft side. The areas near nasal floor and in the middle of the alveolar cleft are the key sites when bone grafting, and should be supplemented with bone graft when the bone resorbed in these areas.
Real-world study of multiple naloxone administration for opioid overdose reversal among bystanders
Authors: Abdelal Randa , Raja Banerjee A. , Carlberg-Racich Suzanne , Darwaza Neyla , Ito Diane , Shoaff Jessica , Epstein Josh 
Published: May 2022

Abstract
Background
The increasing prevalence of highly potent, illicitly manufactured fentanyl and its analogues (IMF) in the USA is exacerbating the opioid epidemic which has worsened during the COVID-19 pandemic. Narcan® (naloxone HCl) Nasal Spray has been approved by the US Food and Drug Administration as a treatment for opioid-related overdoses. Due to the high potency of IMF, multiple naloxone administrations (MNA) may be needed per overdose event. It is essential to determine the patterns of naloxone use, including MNA, and preferences among bystanders who have used naloxone for opioid overdose reversal.

Methods
A cross-sectional web-based survey was administered to 125 adult US residents who administered 4 mg Narcan® Nasal Spray during an opioid overdose in the past year. The survey asked about the most recent overdose event, the use of Narcan® during the event and the associated withdrawal symptoms, and participant preferences regarding dosages of naloxone nasal spray. An open-ended voice survey was completed by 35 participants.

Results
Participants were mostly female (70%) and white (78%), while reported overdose events most frequently occurred in people who were males (54%) and white (86%). Most events (95%) were successfully reversed, with 78% using ≥ 2 doses and 30% using ≥ 3 doses of Narcan® Nasal Spray. Over 90% were worried that 1 Narcan® box may not be enough for a successful future reversal. Reported withdrawal symptoms were similar in overdose events where 1 versus ≥ 2 sprays were given. Eighty-six percent of participants reported more confidence in an 8 mg versus a 4 mg naloxone nasal spray and 77% reported a stronger preference for 8 mg over 4 mg.

Conclusions
MNA occurred in most overdose events, often involving more sprays than are provided in one Narcan® nasal spray box, and participants predominantly expressed having a stronger preference for and confidence in an 8 mg compared to a 4 mg nasal spray. This suggests the need and desire for a higher dose naloxone nasal spray formulation option. Given that bystanders may be the first to administer naloxone to someone experiencing an opioid overdose, ensuring access to an adequate naloxone supply is critical in addressing the opioid overdose epidemic.
Effective protection of ZF2001 against the SARS-CoV-2 Delta variant in lethal K18-hACE2 mice
Authors: Bian Lianlian , Bai Yu , Gao Fan , Liu Mingchen , He Qian , Wu Xing , Mao Qunying , Xu Miao , Liang Zhenglun 
Published: May 2022

AbstractTo investigate the protective efficacy and mechanism of ZF2001 (a protein subunit vaccine with conditional approval in China) to SARS-CoV-2 Delta variant-induced severe pneumonia, the lethal challenge model of K18-hACE2 transgenic mice was used in this study. An inactivated-virus vaccine at the research and development stage (abbreviated as RDINA) was compared to ZF2001. We found that ZF2001 and RDINA could provide the protective effect against Delta variant-induced severe cases, as measured by the improved survival rates, the reduced virus loads, the alleviated lung histopathology and the high neutralizing antibody geomean titers, compared to aluminum adjuvant group. To prevent and control Omicron or other variant epidemics, further improvements in vaccine design and compatibilities with the novel adjuvant are required to achieve better immunogenicity.
Evaluating an e-learning program to strengthen the capacity of humanitarian workers in the MENA region: the Humanitarian Leadership Diploma
Authors: Saleh Shadi , Brome Dayana , Mansour Rania , Daou Tracy , Chamas Amar , Naal Hady 
Published: May 2022

AbstractBackgroundThe Middle East and North Africa (MENA) region is consistently plagued with humanitarian crises while having little response capacity. Despite their obvious growing need, there exist limited educational opportunities for humanitarian workers to develop their capacity in humanitarian topics. The present study evaluates an online training program, the Humanitarian Leadership Diploma (HLD), which targeted humanitarian workers across the MENA region.MethodsA mixed-methods design was used, comprising short and long-term quantitative and qualitative data, targeting individual and organizational-level outcomes. A total of 28 humanitarian workers across the MENA region enrolled in the program starting September 2019 until October 2020, 18 of which completed the full diploma. Short-term quantitative data such as knowledge assessments, course evaluations, and reflective commentaries were collected from all learners, whereas long-term qualitative data was collected only from those who completed the full diploma and from peers at their organizations, 6 months after completion. Data was triangulated, analyzed using qualitative content analysis, and reported as themes.ResultsThe program was overall successful given multiple factors reported by participants such as enhanced knowledge, high satisfaction, and improved practice, with some important challenges being identified. Themes under the strengths category related to (1) online learning, (2) significance of diploma, (3) course content, (4) instructors, (5) transfer of learning into practice, and (6) personal development. Themes under the challenges category related to (1) barriers to applying changes in behavior and performance, (2) engagement and interaction, and (3) pedagogical approach.ConclusionThis is one of very few evaluations of locally developed and delivered online learning programs for humanitarian actors in the MENA region. The findings are especially important as they may inform researchers and humanitarian actors looking to design and deliver similar programs in the MENA region or other fragile settings. Key recommendations are discussed in the manuscript, and include to combine synchronous and asynchronous approaches, design concise course materials, limit theoretical pedagogical approaches, ensure topics are contextualized to the region, and consider continuous engagement strategies for learners.
Feasibility properties of the EQ-5D-3L and 5L in the general population: evidence from the GP Patient Survey on the impact of age
Authors: Marten Ole , Greiner Wolfgang 
Published: May 2022

Abstract
Background
There is evidence to suggest that the proportion of missing values is slightly higher in the older population resulting in lower completion rates of the EQ-5D. However, existing studies rarely provide a within-sample comparison of feasibility properties across age groups to quantify this difference. Hence, this study examines feasibility properties of the EQ-5D-3L and 5L in the general population and explores the impact of age on the completion of EQ-5D instruments.

Methods
We pool five waves from the English GP Patient Survey, where respondents self-report their health in either EQ-5D-3L or 5L. Descriptive analysis was undertaken to analyse the distribution and proportion of missing values and completion rates stratified by age and EQ-5D version; logistic regression models were specified to quantify the impact of age, gender and potential long-term conditions on the completion of each of the EQ-5D instruments.

Results
The total sample comprises ~ 4.36 million observations, of which 2.88 million respondents report their health in 5L and 1.47 million in 3L, respectively. Respondents over 64 years have slightly more missing values in each dimension than younger respondents. The highest share was observed for the oldest age group in the dimension anxiety/depression (3L 9.1% vs. 5L 7.6%), but was otherwise below 5%. Consequently, completion rates (observed and predicted) decreased with older age and at a higher rate after the age of 64; this was more pronounced for the 3L.

Conclusion
Evidence from our study suggests that both the EQ-5D-3L and 5L have good feasibility properties. In comparison to younger populations there appears to be a higher proportion of respondents with incomplete responses beyond the age of 64 years. Overall, the 5L version compares more favourably in terms of missing values, completion rates as well as with regard to the expected probability of an incomplete descriptive system.