bluuebunny/crossref_metadata_2025_split huggingface dataset:
The cost-effectiveness of a proportionate parenting programme for primary caregivers and their child: an economic evaluation using evidence from the E-SEE Trial
Authors: Cox Edward , Walker Simon , Blower Sarah , Sampaio Filipa , Bywater Tracey , Richardson Gerry 
Published: June 2022

AbstractBackgroundBehavioural and mental disorders have become a public health crisis; averting mental ill-health in early years can achieve significant longer-term health benefits and cost savings. This study assesses whether the Enhancing Social-Emotional Health and Wellbeing in the Early Years (E-SEE-Steps)—a proportionate universal delivery model comprising the Incredible Babies book (IY-B) and the Incredible Years Infant (IY-I) and Toddler (IY-T) parenting programmes is cost-effective compared to services as usual (SAU) for the primary caregiver, child and dyad.MethodsUsing UK data for 339 primary caregivers from the E-SEE trial, we conducted a within-trial economic evaluation assessing the cost-effectiveness of E-SEE Steps. Health outcomes were expressed in quality-adjusted life-years (QALY) and costs in UK pounds sterling (2018–19). Missing data were populated via multiple imputation and costs and QALYs discounted at 3.5% per annum. Cost-effectiveness results were conducted for primary caregivers, children and dyad using econometric modelling to control for patient co-variables. Uncertainty was explored through scenario and sensitivity analyses.ResultsThe average cost of E-SEE Steps intervention was £458.50 per dyad. E-SEE Steps was associated with modest gains in primary caregiver HRQoL but minor decrements in child HRQoL compared to SAU. For primary caregivers, E-SEE Steps was more effective (0.034 QALYs) and more costly (£446) compared to SAU, with a corresponding incremental cost-effectiveness ratio (ICER) of £13,011 per QALY. In children, E-SEE Steps was strictly dominated with poorer outcomes (-0.005 QALYs) and greater costs (£178) relative to SAU. QALY gains in primary caregivers exceeded those QALY losses found in children, meaning E-SEE Steps was more effective (0.031 QALYs) and costly (£621) for the dyad (ICER: £20,062 per QALY). All scenario analyses found E-SEE Steps cost-effective for the dyad at a £30,000 per QALY threshold. Sensitivity analyses found significant cost reductions from expansions in programme delivery and attendance.ConclusionsE-SEE Steps achieved modest health gains in primary caregivers but small negative effects on children and was more costly than SAU. E-SEE Steps appears cost-effective for the dyad, but the results should be interpreted with caution given the potential detrimental impact on children.Trial registrationISRCTN11079129; Pre participant trial enrolment, 11/05/2015
Influenza a virus triggers acute exacerbation of chronic obstructive pulmonary disease by increasing proinflammatory cytokines secretion via NLRP3 inflammasome activation
Authors: Ji Shuang , Dai Meng-Yuan , Huang Yun , Ren Xiang-Chun , Jiang Meng-Long , Qiao Jin-Ping , Zhang Wen-Ying , Xu Yuan-Hong , Shen Ji-Long , Zhang Ren-Quan , Fei Guang-He 
Published: June 2022

Abstract
Background
Influenza A virus (IAV) triggers acute exacerbation of chronic obstructive pulmonary disease (AECOPD), but the molecular mechanisms remain unclear. In this study, we investigated the role of IAV induced NLRP3 inflammasome activation to increase airway inflammation response in the progression of AECOPD.

Methods
Human bronchial epithelial cells were isolated and cultured from normal and COPD bronchial tissues and co-cultured with IAV. The NLRP3 inflammasome associated genes were identified using RNA sequencing, and the expressions of NLRP3 inflammasome components were measured using qRT-PCR and western blot after cells were transfected with siRNA and treated with MCC950. Moreover, IAV-induced COPD rat models were established to confirm the results; 37 AECOPD patients were included to measure the serum and bronchoalveolar lavage fluid (BALF) of interleukin (IL)-18 and IL-1β.

Results
Increased levels of NLRP3 inflammasome components were not seen until 6 h post-inoculation in normal cells. However, both cell groups reached peak NLRP3 level at 12 h post-inoculation and maintained it for up to 24 h. ASC, Caspase-1, IL-1β and IL-18 were also elevated in a similar time-dependent pattern in both cell groups. The mRNA and protein expression of the NLRP3 inflammasome components were decreased when COPD cells treated with siRNA and MCC950. In COPD rats, the NLRP3 inflammasome components were elevated by IAV. MCC950 alleviated lung damage, improved survival time, and reduced NLRP3 inflammasome components expression in COPD rats. Additionally, the serum and BALF levels of IL-1β and IL-18 were increased in AECOPD patients.

Conclusions
NLRP3 inflammasome is activated in COPD patients as a pre-existing condition that is further exacerbated by IAV infection.
Work-related factors affecting the retention of medical officers in the preventive health sector in Sri Lanka
Authors: Arnold Mahendra , Fernando Dinusha , Wickramanayake Kapila , Karunapema Palitha , Wickramatilake Sepali , Fernando Yamuna , Denawaka Chandani , Mahesh Pasyodun Koralage Buddhika , Pandithrathna Sujeewa 
Published: June 2022

Abstract
Background
Retention of human resources in the healthcare system, particularly doctors at district level is a great challenge faced by the decentralized health systems in poorly resourced countries. Medical Officers of Health (MOH), medical doctors who provide preventive health services, are a particularly important human resource in the preventive health sector in Sri Lanka. This study explores the relative importance of different factors affecting the retention of MOHs in the preventive health sector of Sri Lanka.

Methods
A descriptive cross-sectional study was carried out among Medical Officers of Health in the Colombo district with 18 MOH Offices with 74 medical officers. A pre-tested self-administered questionnaire was used as the study instrument. Data were analyzed using descriptive statistics, correlation and regression analyses.

Results
Of the 74 medical officers 64 responded with a response rate of response rate of 86.5%. Regression analysis showed that all four variables; recognition, work schedule, remuneration and responsibility are positively and significantly correlated with retention of Medical Officers of Health in the preventive health sector. The variable ‘work schedule’ showed the highest impact on the retention of Medical Officers of Health.

Conclusions
In order to retain trained Medical Officers of Health in the Sri Lankan preventive health sector, health authorities should address the factors identified in this study. If policymakers fail to address these factors, preventive health services will face negative implications due to the shortage of key service providers.
Pregnancy and childbirth outcomes among indigenous adolescents in Guatemala: a cohort study
Authors: Gómez Noe , Del Risco Sánchez Odette , Pinho-Pompeu Maira , Machado Helymar , Bahamondes Luis , Surita Fernanda 
Published: June 2022

Abstract
Objective
To assess some characteristics and outcomes associated with pregnancy among Indigenous adolescents and compare them with other women who gave birth in a public hospital in Guatemala.

Methods
We conducted a retrospective cohort study of 8048 cases. Sociocultural variables, gynecological and obstetric history, childbirth, and perinatal outcomes were compared among women who gave birth at San Juan De Dios Hospital between January 2018 and June 2019. They were classified into four groups according to age and ethnicity. Indigenous adolescents (819/10.2%) were compared with Nonindigenous adolescents (813/10.1%), Indigenous adult women (3324/41.3%), and Nonindigenous adult women (3092/38.4%). Bivariate analysis and multiple logistic regression were applied.

Results
We found that Indigenous adolescents who gave birth in the public hospital had fewer years of schooling than Nonindigenous adolescents (p < 0.001), Indigenous adults (p < 0.001), and Nonindigenous adults (p < 0.001). Indigenous adolescents were more likely to have an unplanned pregnancy than Nonindigenous adolescents (p = 0.038) and Nonindigenous adults (p < 0.001) and were more likely to be single (p < 0.001) and use less previous contraception than Indigenous and Nonindigenous adult women (p = 0.007 and p = 0.013, respectively). More than one-third of Indigenous adolescents and adults did not attend antenatal care; Indigenous adolescents had fewer antenatal care visits than Nonindigenous adults (p < 0.001), and the results were borderline in comparison to Nonindigenous adolescents (p = 0.051). Indigenous and Nonindigenous adult women underwent episiotomy less often than Indigenous adolescents (OR: 0.60 [95% CI 0.49–0.74] and OR: 0.56 [95% CI 0.45–0.70], respectively) and received less local anesthesia than Indigenous adolescents (OR: 0.59 [95% CI 0.46–0.76] and OR: 0.77 [95% CI 0.60–0.99], respectively). Nonindigenous adults received more analgesia than Indigenous adolescents (OR: 1.36 [95% CI 1.07–1.73]). Nonindigenous adolescents had more newborns with low birth weight than Indigenous adolescents (OR: 1.44 [95% CI 1.10–1.87]).

Conclusion
Indigenous adolescents who gave birth in a public hospital in Guatemala were more likely to be single during pregnancy and attend fewer years of school than Nonindigenous adolescents. Unplanned pregnancies were more common among Indigenous adolescents, and some of them underwent not recommended obstetric practices during childbirth, such as episiotomy. Police should be enforced ensuring equal opportunities for different ethnic and age groups regarding pregnancy.
Assessing the prevalence and association between physical, emotional, and sexual of intimate partner violence against women in Nigeria
Authors: Tesfaw Lijalem Melie , Muluneh Essey Kebede 
Published: June 2022

AbstractBackgroundSeveral studies were carried out on prevalence and associated factors of physical, emotional, and sexual violence against women. However, little attention was given to a comprehensive study that assesses the association between physical, emotional, and sexual violence against women. Thus, this study aimed to assess the association between physical, emotional, and sexual violence against women and their prevalence.MethodsA retrospective cross-sectional design was implemented based on the 2018 Nigeria Demographic and Health Survey involving 8061 married women aged 15–49. A log-linear statistical model for the three-way table was used to assess the association between emotional, physical, and sexual violence. SAS statistical software was used for data management and parameter estimation.ResultsAmong a total of 8061 women considered in the study 3022 (37.49%), 4216 (52.3%) and 1186 (14.71%) women have experienced physical, emotional, and sexual violence, respectively. The estimated odds of the interaction between emotional and physical violence (e1.9281 = 6.876); physical and sexual violence (e−2.0529 = 0.128) were significantly differ from 1.0 with p-values < 0:0001 and 0.0201, respectively.ConclusionOver 33 percent of women experienced at least one incident of physical, emotional, or sexual violence in their lifetime. Physical violence against women has a significant association with emotional and sexual violence. However, it does not imply physical violence causes the other violence since cross-sectional data used for the analysis and other factors were not taken into consideration. The lack of a three-way association between emotional, physical, and sexual violence was also perceived. Therefore, as the prevalence of intimate partner violence against women s high, Nigeria as a country needs to strive to reduce it with the collaboration of other nations in the world to achieve Sustainable Development Goal (SDG). Design and apply guidelines to aware of the community about intimate partner violence against women and besides, take appropriate sentencing on those who commit the violence are the better approaches to prevent violence. Traditional habits that might be the cause of violence should be avoided to reduce or prevent the burden of women due to violence.
Menstrual hygiene practices and associated factors among Indian adolescent girls: a meta-analysis
Authors: Majeed Jaseela , Sharma Prerna , Ajmera Puneeta , Dalal Koustuv 
Published: June 2022

Abstract
Background
Menstrual hygiene management (MHM) and practices by adolescent females of low and middle-income countries (LMICs) are a severe public health issue. The current systematic review and meta-analysis aimed to estimate the pooled proportion of the hygiene practices, menstrual problems with their associated factors, and the effectiveness of educational interventions on menstrual hygiene among adolescent school girls in India.

Methods
PRISMA checklist and PICO guidelines were used to screen the scientific literature from 2011 to 2021. The Newcastle–Ottawa Scale was used to assess the quality of studies. Four themes were developed for data analysis, including hygiene practices, type of absorbent used, menstruation associated morbidities and interventions performed regarding menstruation. Eighty-four relevant studies were included and a meta-analysis, including subgroup analysis, was performed.

Results
Pooled data revealed a statistically significant increase in sanitary pad usage “(SMD = 48.83, 95% CI = 41.38–57.62, p < 0.00001)” and increased perineum practices during menstruation “(SMD = 55.77, 95% CI = 44.27–70.26, p < 0.00001)”. Results also reported that most prevalent disorders are dysmenorrhea “(SMD = 60.24, 95% CI = 50.41–70.06, p < 0.0001)”, Pre-menstrual symptoms “(SMD = 62.67, 95% CI = 46.83–78.50, p < 0.00001)”, Oligomenorrhea “(SMD = 23.57, CI = 18.05–29.10, p < 0.00001), Menorrhagia “(SMD = 25.67, CI = 3.86–47.47, p < 0.00001)”, PCOS “(SMD = 5.50, CI = 0.60–10.40, p < 0.00001)”, and Polymenorrhea “(SMD = 4.90, CI = 1.87–12.81, p < 0.0001)”. A statistically significant improvement in knowledge “(SMD = 2.06, 95% CI = 0.75–3.36, p < 0.00001)” and practice “(SMD = 1.26, 95% CI = 0.13–2.65, p < 0.00001)” on menstruation was observed. Infections of the reproductive system and their repercussions can be avoided with better awareness and safe menstruation practices.

Conclusions
Learning about menstrual hygiene and health is essential for adolescent girls' health education to continue working and maintaining hygienic habits. Infections of the reproductive system and their repercussions can be avoided with better awareness and safe menstruation practices.
A pilot pragmatic trial of a “what matters most”-based intervention targeting intersectional stigma related to being pregnant and living with HIV in Botswana
Authors: Yang Lawrence H. , Eschliman Evan L. , Mehta Haitisha , Misra Supriya , Poku Ohemaa B. , Entaile Patlo , Becker Timothy D. , Melese Tadele , Brooks Merrian J. , Eisenberg Marlene , Stockton Melissa A. , Choe Karen , Tal Danielle , Li Tingyu , Go Vivian F. , Link Bruce G. , Rampa Shathani , Jackson Valerie W. , Manyeagae Gorata D. , Arscott-Mills Tonya , Goodman Melody , Opondo Philip R. , Ho-Foster Ari R. , Blank Michael B. 
Published: June 2022

AbstractWe conducted a pilot trial of an intervention targeting intersectional stigma related to being pregnant and living with HIV while promoting capabilities for achieving ‘respected motherhood’ (‘what matters most’) in Botswana. A pragmatic design allocated participants to the intervention (N = 44) group and the treatment-as-usual (N = 15) group. An intent-to-treat, difference-in-difference analysis found the intervention group had significant decreases in HIV stigma (d = − 1.20; 95% CI − 1.99, − 0.39) and depressive symptoms (d = − 1.96; 95% CI − 2.89, − 1.02) from baseline to 4-months postpartum. Some, albeit less pronounced, changes in intersectional stigma were observed, suggesting the importance of structural-level intervention components to reduce intersectional stigma.
Analysis of risk factors affecting union and refracture after combined surgery for congenital pseudarthrosis of the tibia: a retrospective study of 255 cases
Authors: Li Zhuoyang , Yu Hui , Huang Yiyong , Liu Yaoxi , Zhu Guanghui , Tan Qian , Mei Haibo , Yang Ge 
Published: June 2022

Abstract
Background
Congenital pseudarthrosis of the tibia (CPT) is a rare disease occurring in children. The aim of this study is to identify the factors affecting bone union and re-fracture after surgery for CPT and to provide reliable evidence for clinics.

Methods
We collected the detailed information of 255 cases with Crawford IV CPT treated by combined surgery in our hospital from 2013 to 2020. Basic characteristics were recorded. Univariate variance and logistic regression analysis were used to compare the correlations between factors and outcomes.

Results
92.5% of patients achieved primary union, 7.5% of patients had non-union and 13.3% of patients had re-fracture. Logistic regression analysis showed that age at index surgery (Coef. = 0.171, 95%CI 0.015–0.327, P = 0.032), and CPT location (Coef. = − 1.337, 95%CI − 2.218–0.456, P = 0.003) had statistical differences, while no factors had significant correlation with re-fracture. Furthermore, ROC curve showed that the optimal age threshold for first surgery was 2.37 years old.

Conclusions
For patients with Crawford IV CPT treated by combined surgery, the younger the age at index surgery and the closer the CPT location to the distal end, the easier to achieve bone union.
Identification of key genes and pathways related to cancer-associated fibroblasts in chemoresistance of ovarian cancer cells based on GEO and TCGA databases
Authors: Han Li , Guo Xiaojuan , Du Ruijuan , Guo Kelei , Qi Pei , Bian Hua 
Published: June 2022

Abstract
Background
Studies have revealed the implications of cancer-associated fibroblasts (CAFs) in tumor progression, metastasis, and treatment resistance. Here, in silico analyses were performed to reveal the key genes and pathways by which CAFs affected chemoresistance in ovarian cancer.

Methods
Candidate genes were obtained from the intersected differentially expressed genes in ovarian cancer, ovarian cancer chemoresistance, and ovarian CAF-related microarrays and chemoresistance-related genes from GeneCards databases. Kyoto Encyclopedia of Genes and Genomes enrichment analysis and Gene Set Enrichment Analysis were employed to identify the pathways engaged in ovarian cancer chemoresistance and ovarian CAF-related pathways. The top genes with high Degree in the protein-protein interaction network were intersected with the top genes enriched in the key pathways, followed by correlation analyses between key genes and chemotherapeutic response. The expression profiles of key genes were obtained from Human Protein Atlas database and TCGA-ovarian cancer data.

Results
p53, cell cycle, PI3K-Akt, and MAPK pathways were the key pathways related to the implication of CAFs in ovarian cancer chemoresistance. 276 candidate genes differentially expressed in CAFs were associated with ovarian cancer chemoresistance. MYC, IGF1, HRAS, CCND1, AKT1, RAC1, KDR, FGF2, FAS, and EGFR were enriched in the key chemoresistance-related ways. Furthermore, MYC, EGFR, CCND1 exhibited close association with chemotherapeutic response to platinum and showed a high expression in ovarian cancer tissues and platinum-resistant ovarian cancer cells.

Conclusion
The study suggests the key genes (MYC, EGFR, and CCND1) and pathways (p53, cell cycle, PI3K-Akt, and MAPK) responsible for the effect of CAFs on ovarian cancer chemoresistance.
Acetyl-CoA metabolism drives epigenome change and contributes to carcinogenesis risk in fatty liver disease
Authors: Assante Gabriella , Chandrasekaran Sriram , Ng Stanley , Tourna Aikaterini , Chung Carolina H. , Isse Kowsar A. , Banks Jasmine L. , Soffientini Ugo , Filippi Celine , Dhawan Anil , Liu Mo , Rozen Steven G. , Hoare Matthew , Campbell Peter , Ballard J. William O. , Turner Nigel , Morris Margaret J. , Chokshi Shilpa , Youngson Neil A. 
Published: June 2022

Abstract
Background
The incidence of non-alcoholic fatty liver disease (NAFLD)-associated hepatocellular carcinoma (HCC) is increasing worldwide, but the steps in precancerous hepatocytes which lead to HCC driver mutations are not well understood. Here we provide evidence that metabolically driven histone hyperacetylation in steatotic hepatocytes can increase DNA damage to initiate carcinogenesis.

Methods
Global epigenetic state was assessed in liver samples from high-fat diet or high-fructose diet rodent models, as well as in cultured immortalized human hepatocytes (IHH cells). The mechanisms linking steatosis, histone acetylation and DNA damage were investigated by computational metabolic modelling as well as through manipulation of IHH cells with metabolic and epigenetic inhibitors. Chromatin immunoprecipitation and next-generation sequencing (ChIP-seq) and transcriptome (RNA-seq) analyses were performed on IHH cells. Mutation locations and patterns were compared between the IHH cell model and genome sequence data from preneoplastic fatty liver samples from patients with alcohol-related liver disease and NAFLD.

Results
Genome-wide histone acetylation was increased in steatotic livers of rodents fed high-fructose or high-fat diet. In vitro, steatosis relaxed chromatin and increased DNA damage marker γH2AX, which was reversed by inhibiting acetyl-CoA production. Steatosis-associated acetylation and γH2AX were enriched at gene clusters in telomere-proximal regions which contained HCC tumour suppressors in hepatocytes and human fatty livers. Regions of metabolically driven epigenetic change also had increased levels of DNA mutation in non-cancerous tissue from NAFLD and alcohol-related liver disease patients. Finally, genome-scale network modelling indicated that redox balance could be a key contributor to this mechanism.

Conclusions
Abnormal histone hyperacetylation facilitates DNA damage in steatotic hepatocytes and is a potential initiating event in hepatocellular carcinogenesis.
Long-term exposure to fine particulate matter and ozone and the onset of systemic autoimmune rheumatic diseases: an open cohort study in Quebec, Canada
Authors: Zhao Naizhuo , Smargiassi Audrey , Jean Sonia , Gamache Philippe , Laouan-Sidi Elhadji-Anassour , Chen Hong , Goldberg Mark S. , Bernatsky Sasha 
Published: June 2022

Abstract
Objectives
To estimate associations between fine particulate matter (PM2.5) and ozone and the onset of systemic autoimmune rheumatic diseases (SARDs).

Methods
An open cohort of over 6 million adults was constructed from provincial physician billing and hospitalization records between 2000 and 2013. We defined incident SARD cases (SLE, Sjogren’s syndrome, scleroderma, polymyositis, dermatomyositis, polyarteritis nodosa and related conditions, polymyalgia rheumatic, other necrotizing vasculopathies, and undifferentiated connective tissue disease) based on at least two relevant billing diagnostic codes (within 2 years, with at least 1 billing from a rheumatologist), or at least one relevant hospitalization diagnostic code. Estimated PM2.5 and ozone concentrations (derived from remote sensing and/or chemical transport models) were assigned to subjects based on residential postal codes, updated throughout follow-up. Cox proportional hazards models with annual exposure levels were used to calculate hazard ratios (HRs) for SARDs incidence, adjusting for sex, age, urban-versus-rural residence, and socioeconomic status.

Results
The adjusted HR for SARDS related to one interquartile range increase in PM2.5 (3.97 µg/m3) was 1.12 (95% confidence interval 1.08–1.15), but there was no clear association with ozone. Indirectly controlling for smoking did not alter the findings.

Conclusions
We found associations between SARDs incidence and PM2.5, but no relationships with ozone. Additional studies are needed to better understand interplays between the many constituents of air pollution and rheumatic diseases.