bluuebunny/crossref_metadata_2025_split huggingface dataset:
How do naloxone-based interventions work to reduce overdose deaths: a realist review
Authors: Miller Nicole M. , Waterhouse-Bradley Bethany , Campbell Claire , Shorter Gillian W. 
Published: February 2022

Abstract
Background
Naloxone-based interventions as part of health systems can reverse an opioid overdose. Previous systematic reviews have identified the effectiveness of naloxone; however, the role of context and mechanisms for its use has not been explored. This realist systematic review aims to identify a theory of how naloxone works based on the contexts and mechanisms that contribute to the success of the intervention for improved outcomes.

Methods
Pre-registered at PROSPERO, this realist review followed RAMESES standards of reporting. Keywords included 'naloxone' and ' opioid overdose'. All study designs were included. Data extraction using 55 relevant outputs based on realist logic produced evidence of two middle-range theories: Naloxone Bystander Intervention Theory and Skills Transfer Theory.

Results
Harm reduction and/or low threshold contexts provide a non-judgemental approach which support in-group norms of helping and empower the social identity of the trained and untrained bystander. This context also creates the conditions necessary for skills transfer and diffusion of the intervention into social networks. Stigma and negative attitudes held by first responders and stakeholders involved in the implementation process, such as police or GPs, can prohibit the bystander response by inducing fear in responding. This interferes with skills transfer, naloxone use and carriage of naloxone kits.

Conclusions
The findings provide theoretically informed guidance regarding the harm reduction contexts that are essential for the successful implementation of naloxone-based interventions. Peer-to-peer models of training are helpful as it reinforces social identity and successful skills transfer between bystanders. Health systems may want to assess the prevalence of, and take steps to reduce opioid-related stigma with key stakeholders in contexts using a low threshold training approach to build an environment to support positive naloxone outcomes.

Trial Registration

PROSPERO 2019 CRD42019141003.
Intimate partner violence and unmet need for family planning in Afghan women: the implication for policy and practice
Authors: Dadras Omid , Nakayama Takeo , Kihara Masahiro , Ono-Kihara Masako , Dadras Fateme 
Published: February 2022

Abstract
Background
Intimate Partner Violence (IPV) is a serious public health issue and has been linked to a range of adverse health outcomes. This study explored the prevalence of IPV and its relationship with the unmet need for family planning among a sample of married Afghan women aged 18–49 years.

Methods
This study used the data from Afghanistan Demographic and Health Survey (DHS) conducted in 2015. The data relating to IPV, unmet need for family planning, and sociodemographic characteristics of Afghan women aged 18–49 (n = 20,593) were extracted and analyzed accounting for the sampling weights and survey design in bivariate and multivariate analyses using the STATA software version 14.

Results
An estimated 55.89% experienced some type of IPV during the last 12 months. Unmet need for family planning was documented in less than a third of the population. Illiterate employed women from poorer families who were living in the rural areas were more likely to suffer from any type of IPV. Moreover, those from Pashtun, Tajik, and Pashai ethnic groups had a higher odds of any type of violence compared to the reference group (Turkmen). Illiterate women (OR = 1.37, 95% CI 1.02–1.83) with more than 5 pregnancy experiences (OR = 1.44, 95% CI 1.19–1.74) had more unmet needs for family planning compared to the reference group. The unmet needs were almost 40% and 30% less likely to be observed among women from Pashtun and Tajik ethnic backgrounds compared to the reference group (Turkmen), respectively. The likelihood of having unmet needs was 30% less in those women who suffered from any type of violence.

Conclusion
IPV is an important predictor of several adverse health outcomes. The findings portray the disastrous situation of Afghan women’s rights violation and violence against them and communicate an important message to the international communities and human rights advocate to take immediate actions in order to mitigate the current situation and prevent the violence against Afghan women to improve the integrity of their reproductive health.
The systematic development of attributes and levels for a discrete choice experiment of HIV patient preferences for long-acting antiretroviral therapies in the United States
Authors: Brah Aaron T. , Barthold Douglas , Hauber Brett , Collier Ann C. , Ho Rodney J. Y. , Marconi Vincent C. , Simoni Jane M. , Graham Susan M. 
Published: February 2022

Abstract
Introduction
Patient preferences for long-acting antiretroviral therapies (LA-ART) should inform development of regimens with optimal adherence and acceptability. We describe a systematic process used to identify attributes and levels for a discrete choice experiment (DCE) designed to elicit preferences for potential LA-ART options in the US.

Methods
Our approach was conducted in four stages: data collection, data reduction, removing inappropriate attributes, and optimizing wording. We started with 8 attributes defining potential LA-ART products based on existing literature and knowledge of products in development. We conducted 12 key informant interviews with experts in HIV treatment. The list of attributes, the set of plausible levels for each attribute, and restrictions on combinations of attribute levels were updated iteratively.

Results
Despite uncertainty about which products will become available, key informant discussions converged on 4 delivery modes (infusions and patches were not considered immediately feasible) and 6 additional attributes. Treatment effectiveness and frequency of clinical monitoring were dropped. Oral lead-in therapy was split into two attributes: pre-treatment time undetectable and pre-treatment negative reaction testing. We omitted product-specific systemic and local side effects. In addition to mode, the final set of attributes included: frequency of dosing; location of treatment; pain; pre-treatment time undetectable; pre-treatment negative reaction testing; and late-dose leeway.

Conclusions
A systematic process successfully captured elements that are both feasible and relevant to evaluating the acceptability of potential LA-ART alternatives to patients.
Controlled human exposure to diesel exhaust: a method for understanding health effects of traffic-related air pollution
Authors: Long Erin , Schwartz Carley , Carlsten Christopher 
Published: February 2022

AbstractDiesel exhaust (DE) is a major component of air pollution in urban centers. Controlled human exposure (CHE) experiments are commonly used to investigate the acute effects of DE inhalation specifically and also as a paradigm for investigating responses to traffic-related air pollution (TRAP) more generally. Given the critical role this model plays in our understanding of TRAP’s health effects mechanistically and in support of associated policy and regulation, we review the methodology of CHE to DE (CHE–DE) in detail to distill critical elements so that the results of these studies can be understood in context. From 104 eligible publications, we identified 79 CHE–DE studies and extracted information on DE generation, exposure session characteristics, pollutant and particulate composition of exposures, and participant demographics. Virtually all studies had a crossover design, and most studies involved a single DE exposure per participant. Exposure sessions were typically 1 or 2 h in duration, with participants alternating between exercise and rest. Most CHE–DE targeted a PM concentration of 300 μg/m3. There was a wide range in commonly measured co-pollutants including nitrogen oxides, carbon monoxide, and total organic compounds. Reporting of detailed parameters of aerosol composition, including particle diameter, was inconsistent between studies, and older studies from a given lab were often citedin lieuof repeating measurements for new experiments. There was a male predominance in participants, and over half of studies involved healthy participants only. Other populations studied include those with asthma, atopy, or metabolic syndrome. Standardization in reporting exposure conditions, potentially using current versions of engines with modern emissions control technology, will allow for more valid comparisons between studies of CHE–DE, while recognizing that diesel engines in much of the world remain old and heterogeneous. Inclusion of female participants as well as populations more susceptible to TRAP will broaden the applicability of results from CHE–DE studies.
Unconventional protein post-translational modifications: the helmsmen in breast cancer
Authors: Liu Jiena , Wang Qin , Kang Yujuan , Xu Shouping , Pang Da 
Published: February 2022

AbstractBreast cancer is the most prevalent malignant tumor and a leading cause of mortality among females worldwide. The tumorigenesis and progression of breast cancer involve complex pathophysiological processes, which may be mediated by post-translational modifications (PTMs) of proteins, stimulated by various genes and signaling pathways. Studies into PTMs have long been dominated by the investigation of protein phosphorylation and histone epigenetic modifications. However, with great advances in proteomic techniques, several other PTMs, such as acetylation, glycosylation, sumoylation, methylation, ubiquitination, citrullination, and palmitoylation have been confirmed in breast cancer. Nevertheless, the mechanisms, effects, and inhibitors of these unconventional PTMs (particularly, the non-histone modifications other than phosphorylation) received comparatively little attention. Therefore, in this review, we illustrate the functions of these PTMs and highlight their impact on the oncogenesis and progression of breast cancer. Identification of novel potential therapeutic drugs targeting PTMs and development of biological markers for the detection of breast cancer would be significantly valuable for the efficient selection of therapeutic regimens and prediction of disease prognosis in patients with breast cancer.
Factors related to pregnancy status and unwanted pregnancy among lebanese women during the COVID-19 lockdown: a cross-sectional study
Authors: Haddad Chadia , Malhab Sandrella Bou , Sacre Hala , Malaeb Diana , Azzi Joelle , Khachman Dalia , Lahoud Nathalie , Salameh Pascale 
Published: February 2022

Abstract
Background
Home confinement and lockdowns have created challenges and vulnerabilities, causing relevant changes in sexual health and couple stability, particularly in women. The objective of this study was to evaluate the socio-economic and psychological factors related to current pregnancy status and unwanted pregnancy among Lebanese women during the COVID-19 lockdown.

Methods
A cross-sectional online study conducted between June 8 and August 1, 2020, enrolled 369 Lebanese women using the snowball technique for data collection. All married women between 18 and 51, with access to the internet and currently living with their partners, were eligible to participate. Current pregnancy status and unwanted pregnancy were assessed using binary questions. The SPSS software 25 was used for data analysis, and multivariable analysis was performed, taking the pregnancy status and unwanted pregnancy as the dependent variables. The statistical significance was set at a p-value < 0.05.

Results
Our results showed that 11.1% of women were pregnant, of whom 22.0% reported unwanted pregnancies. Having children (ORa = 0.183) and taking contraceptives (ORa = 0.231) were significantly associated with a reduced chance of becoming pregnant. Higher psychological violence would negatively affect pregnancy, but the association was not significant (p = 0.065). Regular visits to the physician for routine checks were also linked to a decreased risk of unwanted pregnancy (ORa = 0.053). Higher psychological violence would affect unwanted pregnancy; however, the association was insignificant (p = 0.056).

Conclusion
The study findings showed that having children and taking contraceptives are associated with a reduced pregnancy. Additionally, psychological violence was found to be related to current pregnancy status and unplanned pregnancy. During a pandemic, vulnerable women should be identified and given adequate care, knowledge, and awareness regarding their reproductive health.
Exploring factors that determine the innovation of micro and small enterprises: the role of entrepreneurial attitude towards innovation in Woldia, Ethiopia
Authors: Kassa Erstu Tarko , Getnet Mirete Tilahun 
Published: February 2022

AbstractTo transform micro and small enterprises to large companies, owners need to strive to launch new methods, systems, ways and innovations. Accordingly, innovation helps micro-enterprises to bounce to achieve fundamental change in their businesses. Micro and small enterprises are exposed by different factors to innovating new products and services. This study, therefore, focused on exploring factors that determine the innovation of service and manufacturing MSEs: the role of entrepreneurial attitude towards innovation in Woldia city administration. The researchers used a cross-sectional research design and followed a quantitative approach. The data were collected by using a structured questionnaire. The collected data were analysed by using SPSS v-25 and Amos graphics to conduct descriptive, factor, correlation, regression and path analysis. The study finding revealed that government support, access to infrastructure, entrepreneurial training, entrepreneurial attitude and the leadership of the owners significantly affected the innovation of service and manufacturing MSEs. Entrepreneurial training and leadership of the owners directly and indirectly affected the innovation of services and manufacturing MSEs through the mediating variable of entrepreneurial attitude.
The impact of post-traumatic stress on quality of life and fatigue in women with Gulf War Illness
Authors: Shastry Nandan , Sultana Esha , Jeffrey Mary , Collado Fanny , Kibler Jeffrey , DeLucia Christian , Fletcher Mary Ann , Klimas Nancy , Craddock Travis J. A. 
Published: February 2022

AbstractBackgroundGulf War Illness (GWI) is a chronic, multi-symptomatic disorder characterized by fatigue, muscle pain, cognitive problems, insomnia, rashes, and gastrointestinal issues affecting an estimated 30% of the ~ 750,000 returning military Veterans of the 1990–1991 Persian Gulf War. Female Veterans deployed to combat in this war report medical symptoms, like cognition and respiratory troubles, at twice the rate compared to non-deployed female Veterans of the same era. The heterogeneity of GWI symptom presentation complicates diagnosis as well as the identification of effective treatments. This is exacerbated by the presence of co-morbidities. Defining subgroups of the illness may help alleviate these complications. One clear grouping is along the lines of gender. Our aim is to determine if women with GWI can be further subdivided into distinct subgroups based on post-traumatic stress disorder (PTSD) symptom presentation.MethodsVeterans diagnosed with GWI (n = 35) and healthy sedentary controls (n = 35) were recruited through the Miami Veterans Affairs Medical Health Center. Symptoms were assessed via the RAND short form health survey, the multidimensional fatigue inventory, and the Davidson trauma scale. Hierarchal regression modeling was performed on measures of health and fatigue with PTSD symptoms as a covariate. This was followed by univariate analyses conducted with two separate GWI groups based on a cut-point of 70 for their total Davidson trauma scale value and performing heteroscedastic t-tests across all measures.ResultsBased on the distinct differences found in PTSD symptomology regarding all health and trauma symptoms, two subgroups were derived within female GWI Veterans. Hierarchical regression models displayed the comorbid effects of GWI and PTSD, as both conditions had measurable impacts on quality of life and fatigue (ΔR2= 0.08–0.672), with notable differences in mental and emotional measures. Overall, a cut point analysis indicated poorer quality of life and greater fatigue within all measures for women with GWI and PTSD symptoms in comparison to those women with GWI without PTSD symptoms and healthy controls.ConclusionsOur current findings support the understanding that comorbid symptoms of GWI and PTSD subsequently result in poorer quality of life and fatigue, along with establishing the possibility of varying clinical presentations.
LncRNA CASC15 upregulates cyclin D1 by downregulating miR-365 in laryngeal squamous cell carcinoma to promote cell proliferation
Authors: Zhu Minhui , Zhang Caiyun , Zhou Peng , Chen Shicai , Zheng Hongliang 
Published: February 2022

Background This study investigated the role of lncRNA CASC15 in laryngeal squamous cell carcinoma (LSCC). Methods This study included 58 LSCC patients. Both tumor (LSCC) and adjacent (within 3 cm around tumors) non-tumor tissues from 3 different sites of each patient were collected. CCK-8 assay was used to determine cell proliferation. The expression levels of proteins and mRNAs were determined by Western blotting analysis and qRT-PCRs, respectively. Results CASC15 was upregulated in LSCC and high expression levels of CASC15 predicted poor survival. In LSCC tissues, CASC15 was negatively correlated with miR-365 but positively correlated with cyclin D1. In LSCC cells, overexpression of CASC15 resulted in downregulation of miR-365 and upregulation of cyclin D1. Overexpression of miR-365 did not affect the expression of CASC15 but downregulated cyclin D1. Overexpression of Cyclin D1 did not affect the expression of miR-365 and CASC15. Overexpression of CASC15 and cyclin D1 led to promoted, while overexpression of miR-365 led to inhibited LSCC cell proliferation. In addition, overexpression of miR-365 reduced the effects of overexpression of CASC15. Conclusion Therefore, CASC15 upregulates cyclin D1 by downregulating miR-365 in LSCC to promote cell proliferation.
Fashion designer’s identity self-verification through social media engagement on Instagram
Authors: Cheung Tin Chun , Choi Sun Young 
Published: February 2022

AbstractIn recent years, online identity and social media engagement have been areas of study that have garnered a lot of interest. However, studies have yet to pinpoint empirical and theoretical connections between engagement and identity. Moreover, current research lacks holistic methods for measuring engagement rate and identity. Our multifaceted study examines how fashion designers use Instagram as a resource to self-verify their complex identities through social media analysis, body and face detection programmes such as Face++ and manual content identification. One-way and two-way ANOVA and t-tests were employed to determine the correlation in engagement rate between designers, image type and influence tier variables. By engaging with followers, designers verify their self-identities, which ultimately reinforces the fashion social identity online. We found variation in followers’ engagement behaviour when different identity types, image types, and designers of varying influence levels are presented. According to the result, images that reflected designers’ personal identity, such as selfies, body image, and miscellaneous images, drew higher engagement than role identity-related images. Among all image types, the full-body and upper torso more gained follower’s attention than a selfie, advertisement and product images in every influence tier. Therefore, fashion designers should consider posting body images as a meaningful form of identity and medium conveying their dressing aesthetic. Our findings suggest managerial implications for designers to strategise their content according to their tiers of influence.
Natural bone-mimicking nanopore-incorporated hydroxyapatite scaffolds for enhanced bone tissue regeneration
Authors: Kim Chansong , Lee Jin Woong , Heo Jun Hyuk , Park Cheolhyun , Kim Dai-Hwan , Yi Gyu Sung , Kang Ho Chang , Jung Hyun Suk , Shin Hyunjung , Lee Jung Heon 
Published: February 2022

Abstract

Background
A considerable number of studies has been carried out to develop alloplastic bone graft materials such as hydroxyapatite (HAP) that mimic the hierarchical structure of natural bones with multiple levels of pores: macro-, micro-, and nanopores. Although nanopores are known to play many essential roles in natural bones, only a few studies have focused on HAPs containing them; none of those studies investigated the functions of nanopores in biological systems.

Method
We developed a simple yet powerful method to introduce nanopores into alloplastic HAP bone graft materials in large quantities by simply pressing HAP nanoparticles and sintering them at a low temperature.

Results
The size of nanopores in HAP scaffolds can be controlled between 16.5 and 30.2 nm by changing the sintering temperature. When nanopores with a size of ~ 30.2 nm, similar to that of nanopores in natural bones, are introduced into HAP scaffolds, the mechanical strength and cell proliferation and differentiation rates are significantly increased. The developed HAP scaffolds containing nanopores (SNPs) are biocompatible, with negligible erythema and inflammatory reactions. In addition, they enhance the bone regeneration when are implanted into a rabbit model. Furthermore, the bone regeneration efficiency of the HAP-based SNP is better than that of a commercially available bone graft material.

Conclusion
Nanopores of HAP scaffolds are very important for improving the bone regeneration efficiency and may be one of the key factors to consider in designing highly efficient next-generation alloplastic bone graft materials.
A clinico-statistical study of factors associated with intraoperative bleeding in orthognathic surgery
Authors: Sugahara Keisuke , Koyama Yu , Koyachi Masahide , Watanabe Akira , Kasahara Kiyohiro , Takano Masayuki , Katakura Akira 
Published: February 2022

Abstract
Background
Excessive bleeding is a major intraoperative risk associated with orthognathic surgery. This study aimed to investigate the factors involved in massive bleeding during orthognathic surgeries so that safe surgeries can be performed. Patients (n=213) diagnosed with jaw deformities and treated with bimaxillary orthognathic surgery (Le Fort I osteotomy and bilateral sagittal split ramus osteotomy) in the Department of Oral and Maxillofacial Surgery at the Suidobashi Hospital, Tokyo Dental College between January 2014 and December 2016 were included. Using the patients’ medical and operative records, the number of cases according to sex, age at the time of surgery, body mass index (BMI), circulating blood volume, diagnosis of maxillary deformity, direction of maxillary movement, operative duration, incidence of bad split, injury of nasal mucosa, and blood type were analyzed.

Results
The results revealed that BMI, circulating blood volume, nasal mucosal injury, and operative time were associated with the risk of intraoperative massive bleeding in orthognathic surgeries. Chi-square tests and binomial logistic regression analyses showed significant differences in BMI, circulating blood volume, direction of maxillary movement, operative duration, and injury to the nasal mucosa. Operative duration emerged as the most important risk factor. Furthermore, a >4-mm upward migration of the posterior nasal spine predicted the risk of massive bleeding in orthognathic surgery.

Conclusions
The upward movement of the maxilla should be recognized during the preoperative planning stage as a risk factor for intraoperative bleeding, and avoiding damage to the nasal mucosa should be considered a requirement for surgeons to prevent massive bleeding during surgery.