bluuebunny/crossref_metadata_2025_split huggingface dataset:
The practice of integrated healthcare and the experiences of people in Ghana’s Ashanti region
Authors: Ampomah Irene G. , Malau-Aduli Bunmi S. , Seidu Abdul-Aziz , Malau-Aduli Aduli E. O. , Emeto Theophilus I. 
Published: January 2022

Abstract

Background
The Ghanaian government has implemented interventions that integrate traditional medicine (TM) into its national health system in response to the high prevalence of TM use. However, empirical evidence of the experiences of service users and the practice of integrated health in Ghana is scanty. Therefore, this study explored the experiences of people with TM integration into the formal health system in Ashanti region using an adapted TM integration framework.

Methods
A sequential explanatory mixed methods study design comprising survey administration and in-depth interviews for data collection was utilised to address the research objective. Framework analysis was used in analysing the qualitative data and for triangulation of results.

Results
Participants were aware of licensing and training of TM practitioners in a science-based university in Ghana. However, knowledge of the existence of TM units in selected hospitals in the region was minimal. Integration knowledge was largely influenced by sex, marital status, household size and residential status, where males and urban dwellers were more familiar with the process than females and rural dwellers. Low patronage of integrated health services in the region was attributable to weak cross referrals. However, service users who had engaged with the integrated system recounted a satisfactory outcome.

Conclusion
Service users’ unfamiliarity with the presence of integrated facilities in Ghana could be an impediment to the practice of integrated healthcare. Sensitisation of the public about the practice of an integrated system could refine the Ghanaian integrated system. Regular evaluation of patient satisfaction and outcome measures might also serve as an effective strategy for improving health services delivery since evaluation is becoming an important component of health service design and implementation. There is the need for future studies to focus on exploring the perceptions and experiences of health practitioners and hospital administrators regarding the practice of integrated health in Ghana.
Integrated analysis of 1804 samples of six centers to construct and validate a robust immune-related prognostic signature associated with stromal cell abundance in tumor microenvironment for gastric cancer
Authors: Huo Junyu , Guan Ge , Cai Jinzhen , Wu Liqun 
Published: January 2022

Abstract
Background
Stromal cells in tumor microenvironment could promote immune escape through a variety of mechanisms, but there are lacking research in the field of gastric cancer (GC).

Methods
We identified differential expressed immune-related genes (DEIRGs) between the high- and low-stromal cell abundance GC samples in The Cancer Genome Atlas and GSE84437 datasets. A risk score was constructed basing on univariate cox regression analysis, LASSO regression analysis, and multivariate cox regression analysis in the training cohort (n=772). The median value of the risk score was used to classify patients into groups with high and low risk. We conducted external validation of the prognostic signature in four independent cohorts (GSE26253, n=432; GSE62254, n=300; GSE15459, n=191; GSE26901, n=109) from the Gene Expression Omnibus (GEO) database. The immune cell infiltration was quantified by the CIBERSORT method.

Results
The risk score contained 6 genes (AKT3, APOD, FAM19A5, LTBP3, NOV, and NOX4) showed good performance in predicting 5-year overall survival (OS) rate and 5-year recurrence-free survival (RFS) rate of GC patients. The risk death and recurrence of GC patients growing with the increasing risk score. The patients were clustered into three subtypes according to the infiltration of 22 kinds of immune cells quantified by the CIBERSORT method. The proportion of cluster A with the worst prognosis in the high-risk group was significantly higher than that in the low-risk group; the risk score of cluster C subtype with the best prognosis was significantly lower than that of the other two subtypes.

Conclusion
This study established and validated a robust prognostic model for gastric cancer by integrated analysis 1804 samples of six centers, and its mechanism was explored in combination with immune cell infiltration characterization.
Integrated weighted gene coexpression network analysis identifies Frizzled 2 (FZD2) as a key gene in invasive malignant pleomorphic adenoma
Authors: Han Zhenyuan , Ren Huiping , Sun Jingjing , Jin Lihui , Wang Qin , Guo Chuanbin , Tian Zhen 
Published: January 2022

Abstract
Background
Invasive malignant pleomorphic adenoma (IMPA) is a highly malignant neoplasm of the oral salivary glands with a poor prognosis and a considerable risk of recurrence. Many disease-causing genes of IMPA have been identified in recent decades (e.g., P53, PCNA and HMGA2), but many of these genes remain to be explored. Weighted gene coexpression network analysis (WGCNA) is a newly emerged algorithm that can cluster genes and form modules based on similar gene expression patterns. This study constructed a gene coexpression network of IMPA via WGCNA and then carried out multifaceted analysis to identify novel disease-causing genes.

Methods
RNA sequencing (RNA-seq) was performed for 10 pairs of IMPA and normal tissues to acquire the gene expression profiles. Differentially expressed genes (DEGs) were screened out with the cutoff criteria of |log2 Fold change (FC)|> 1 and adjusted p value  < 0.05. Then, WGCNA was applied to systematically identify the hidden diagnostic hub genes of IMPA.

Results
In this research, a total of 1970 DEGs were screened out in IMPA tissues, including 1056 upregulated DEGs and 914 downregulated DEGs. Functional enrichment analysis was performed for identified DEGs and revealed an enrichment of tumor-associated GO terms and KEGG pathways. We used WGCNA to identify gene module most relevant with the histological grade of IMPA. The gene FZD2 was then recognized as the hub gene of the selected module with the highest module membership (MM) value and intramodule connectivity in protein–protein interaction (PPI) network. According to immunohistochemistry (IHC) staining, the expression level of FZD2 was higher in low-grade IMPA than in high-grade IMPA.

Conclusion
FZD2 shows an expression dynamic that is negatively correlated with the clinical malignancy of IMPA and it plays a central role in the transcription network of IMPA. Thus, FZD2 serves as a promising histological indicator for the precise prediction of IMPA histological stages.
Examining the association between opium use, cigarette smoking and alcohol consumption with the liver enzyme levels in a population-based study: Fasa Persian cohort data
Authors: Bijani Mostafa , Dehghan Azizallah , Razavi Saeed , Karimi Shahnaz 
Published: January 2022

Abstract
Objectives
Opium use, cigarette smoking, and alcohol consumption are serious health problems in many countries including Iran. The present study aimed to examine the association between the opium use, cigarette smoking and alcohol consumption with liver enzyme levels in Southern Iran. This analytical cross-sectional study was conducted in 2020. The entire population of the Fasa Persian cohort study in the southern region of Iran was selected as the sample. Accordingly, 10,145 people participated in the study.

Results
Results indicated that there was a significant relationship between cigarette smoking and alcohol consumption with liver enzymes (AST, ALT, and ALP). There was also a significant relationship between inhaled opium and liver enzymes, but oral opium revealed no significant relationship with the activity of liver enzymes. Accordingly, policymakers of the health care system are recommended to hold educational programs to improve the health literacy level of the society and take effective preventative strategies in reducing the use of these substances.
The role of the microbiota in the management of intensive care patients
Authors: Szychowiak Piotr , Villageois-Tran Khanh , Patrier Juliette , Timsit Jean-François , Ruppé Étienne 
Published: January 2022

AbstractThe composition of the gut microbiota is highly dynamic and changes according to various conditions. The gut microbiota mainly includes difficult-to-cultivate anaerobic bacteria, hence knowledge about its composition has significantly arisen from culture-independent methods based on next-generation sequencing (NGS) such as 16S profiling and shotgun metagenomics. The gut microbiota of patients hospitalized in intensive care units (ICU) undergoes many alterations because of critical illness, antibiotics, and other ICU-specific medications. It is then characterized by lower richness and diversity, and dominated by opportunistic pathogens such as Clostridioides difficile and multidrug-resistant bacteria. These alterations are associated with an increased risk of infectious complications or death. Specifically, at the time of writing, it appears possible to identify distinct microbiota patterns associated with severity or infectivity in COVID-19 patients, paving the way for the potential use of dysbiosis markers to predict patient outcomes. Correcting the microbiota disturbances to avoid their consequences is now possible. Fecal microbiota transplantation is recommended in recurrent C. difficile infections and microbiota-protecting treatments such as antibiotic inactivators are currently being developed. The growing interest in the microbiota and microbiota-associated therapies suggests that the control of the dysbiosis could be a key factor in the management of critically ill patients. The present narrative review aims to provide a synthetic overview of microbiota, from healthy individuals to critically ill patients. After an introduction to the different techniques used for studying the microbiota, we review the determinants involved in the alteration of the microbiota in ICU patients and the latter’s consequences. Last, we assess the means to prevent or correct microbiota alteration.
Health data collection methods and procedures across EU member states: findings from the InfAct Joint Action on health information
Authors: Unim Brigid , Mattei Eugenio , Carle Flavia , Tolonen Hanna , Bernal-Delgado Enrique , Achterberg Peter , Zaletel Metka , Seeling Stefanie , Haneef Romana , Lorcy Anne-Charlotte , Van Oyen Herman , Palmieri Luigi 
Published: January 2022

Abstract
Background
Health-related data are collected from a variety of sources for different purposes, including secondary use for population health monitoring (HM) and health system performance assessment (HSPA). Most of these data sources are not included in databases of international organizations (e.g., WHO, OECD, Eurostat), limiting their use for research activities and policy making. This study aims at identifying and describing collection methods, quality assessment procedures, availability and accessibility of health data across EU Member States (MS) for HM and HSPA.

Methods
A structured questionnaire was developed and administered through an online platform to partners of the InfAct consortium form EU MS to investigate data collections applied in HM and HSPA projects, as well as their methods and procedures. A descriptive analysis of the questionnaire results was performed.

Results
Information on 91 projects from 18 EU MS was collected. In these projects, data were mainly collected through administrative sources, population health interview or health examination surveys and from electronic medical records. Tools and methods used for data collection were mostly mandatory reports, self-administered questionnaires, or record linkage of various data sources. One-third of the projects shared data with EU research networks and less than one-third performed quality assessment of their data collection procedures using international standardized criteria. Macrodata were accessible via open access and reusable in 22 projects. Microdata were accessible upon specific request and reusable in 15 projects based on data usage licenses. Metadata was available for the majority of the projects, but followed reporting standards only in 29 projects. Overall, compliance to FAIR Data principles (Findable, Accessible, Interoperable, and Reusable) was not optimal across the EU projects.

Conclusions
Data collection and exchange procedures differ across EU MS and research data are not always available, accessible, comparable or reusable for further research and evidence-based policy making. There is a need for an EU-level health information infrastructure and governance to promote and facilitate sharing and dissemination of standardized and comparable health data, following FAIR Data principles, across the EU.
Mapping emergent public engagement in societal transitions: a scoping review
Authors: Revez Alexandra , Dunphy Niall , Harris Clodagh , Rogan Fionn , Byrne Edmond , McGookin Connor , Bolger Paul , Ó Gallachóir Brian , Barry John , Ellis Geraint , O’Dwyer Barry , Boyle Evan , Flood Stephen , Glynn James , Mullally Gerard 
Published: January 2022

Abstract
Background
Transition discourses are gaining prominence in efforts to imagine a future that adequately addresses the urgent need to establish low carbon and climate resilient pathways. Within these discourses the ‘public’ is seen as central to the creation and implementation of appropriate interventions. The role of public engagement in societal transformation while essential, is also complex and often poorly understood. The purpose of this paper is to enhance our understanding regarding public engagement and to address the often superficial and shallow policy discourse on this topic.

Main text
The paper offers a review of evolving literature to map emergent public engagement in processes of transition and change. We adopt a pragmatic approach towards literature retrieval and analysis which enables a cross-disciplinary and cross-sectoral review. We use a scoping review process and the three spheres of transformation framework (designated as the practical, political and personal spheres) to explore trends within this complex research field. The review draws from literature from the last two decades in the Irish context and looks at emergence and evolving spaces of public engagement within various systems of change including energy, food, coastal management and flood adaptation, among others.

Conclusions
The results highlight the siloed and fragmented way in which public engagement in transitions is carried and we propose a more cross-sectoral and cross-disciplinary approach which depends on bringing into dialogue often contrasting theories and perspectives. The paper also illustrates some shifting engagement approaches. For instance, nexus articles between the practical and political spheres suggest deeper forms of public engagement beyond aggregated consumer behaviour to align technological delivery with institutional and societal contexts. While most articles in the practical sphere draw largely on techno-economic insights this influence and cross-disciplinarity is likely to draw in further innovations. Nexus articles between the political and personal sphere are also drawing on shifting ideas of public engagement and largely stress the need to disrupt reductive notions of engagement and agency within our institutions. Many of these articles call attention to problems with top-down public engagement structures and in various ways show how they often undermine and marginalise different groups.
Toxic metal concentrations and Cu–Zn–Pb isotopic compositions in tires
Authors: Jeong Hyeryeong 
Published: January 2022

Abstract
Background
Particles from non-exhaust emissions derived from traffic activities are a dominant cause of toxic metal pollution in urban environments. Recently, studies applying multiple isotope values using the Iso-source and positive matrix factorization (PMF) models have begun to be used as useful tools to evaluate the contribution of each pollution source in urban environments. However, data on the metal concentrations and isotopic compositions of each potential source are lacking. Therefore, this study presents data on toxic metals and Cu, Zn, and Pb isotopic compositions in tires, which are one of the important non-exhaust emission sources.

Findings
Among the toxic metals, Zn had the highest concentration in all tire samples, and the mean concentrations were in the order of Zn > Cu > Pb > Sn > Sb > Ni > Cr > As > Cd. Ni, Zn, Sn, and Sb had higher concentrations in domestic tires (South Korea), and the Cu, Cd, and Pb concentrations were relatively higher in imported tires. The mean values of δ65CuAE647, δ66ZnIRMM3702, and 206Pb/207Pb ranged from − 1.04 to − 0.22‰, − 0.09 to − 0.03‰, and 1.1242 to 1.1747, respectively. The concentrations and isotopic compositions of Cu and Pb in the tires showed large differences depending on the product and manufacturer. However, the differences in Zn concentration and δ66ZnIRMM3702 values were very small compared with those of Cu and Pb. The relationships of the Zn concentration and isotopic composition showed that domestic tires are clearly distinguishable from imported tires. Bi-plots of Cu, Zn, and Pb isotopic compositions indicated that tires can be clearly discriminated from natural-origin and other non-exhaust traffic emission sources.

Conclusions
The multi-isotope signatures of Cu, Zn, and Pb exhibited different isotopic values for other non-exhaust traffic emission sources than for tires, and application of the multi-isotope technique may be a powerful method for distinguishing and managing non-exhaust sources of metal contamination in urban environments.
An exploratory assessment of the legislative framework for combating counterfeit medicines in South Africa
Authors: Moshoeshoe R. J. , Enslin G. M. , Katerere D. R. 
Published: January 2022

Abstract
Background
Substandard and Falsified (SF) medical products are a growing global concern. They harm the individual patient, the healthcare system and the economy. The World Health Organisation (WHO) has highlighted contributing factors globally: insufficient national medicine regulation, poor enforcement of existing legislation, weak stakeholder collaboration and the rise of novel viruses, such as the COVID-19. The study aimed to assess the legislative and policy framework and institutional relationships governing pharmaceuticals and anti-counterfeiting strategies.

Methods
The study was explorative and consisted of two phases. The first phase was between 2016 and 2017. It looked at document analysis (annual reports and press releases from 2011 to 2016) from government institutions involved in medicines regulation and law enforcement for SF seizure reports between 2004 and 2017. The second phase was between 2016 and 2018 through in-depth semi-structured interviews (seven in total) with selected stakeholders.

Results
First Phase—the data collected and reported by various departments was sporadic and did not always correlate for the same periods indicating, a lack of a central reporting system and stakeholder collaboration. In South Africa, counterfeiting of medicines mainly involves the smuggling of non-registered goods. The most common counterfeit items were painkillers, herbal teas, herbal ointments, while some were medical devices. Furthermore, Customs identified South Africa as a transhipment point for SF infiltration to neighbouring countries with less robust regulatory systems. Second phase—interview transcripts were analysed by thematic coding. These were identified as the adequacy of legislation, institutional capacity, enforcement and post-market surveillance, stakeholder collaboration and information sharing, and public education and awareness.

Conclusion
Document analysis and interviews indicate that South Africa already has a national drug policy and legislative framework consistent with international law. However, there is no specific pharmaceutical legislation addressing the counterfeiting of medicines. Law enforcement has also been complicated by poor stakeholder engagement and information sharing.
Hesitancy in COVID-19 vaccine uptake and its associated factors among the general adult population: a cross-sectional study in six Southeast Asian countries
Authors: Marzo Roy Rillera , Sami Waqas , Alam Md. Zakiul , Acharya Swosti , Jermsittiparsert Kittisak , Songwathana Karnjana , Pham Nhat Tan , Respati Titik , Faller Erwin Martinez , Baldonado Aries Moralidad , Aung Yadanar , Borkar Sharmila Mukund , Essar Mohammad Yasir , Shrestha Sunil , Yi Siyan 
Published: January 2022

Abstract
Background
Vaccines are effective and reliable public health interventions against viral outbreaks and pandemics. However, hesitancy regarding the Coronavirus disease (COVID-19) vaccine is evident worldwide. Therefore, understanding vaccination-related behavior is critical in expanding the vaccine coverage to flatten the infection curve. This study explores the public perception regarding COVID-19 vaccination and identifies factors associated with vaccine hesitancy among the general adult populations in six Southeast Asian countries.

Methods
Using a snowball sampling approach, we conducted a descriptive cross-sectional study among 5260 participants in Indonesia, Malaysia, Myanmar, Philippines, Thailand, and Vietnam between February and May 2021. Binary logistic regression analysis with a backward conditional approach was applied to identify factors associated with COVID-19 vaccine hesitancy.

Results
Of the total, 50.6% were female, and the median age was 30 years (range: 15–83 years). The majority of the participants believed that vaccination effectively prevents and controls COVID-19 (81.2%), and 84.0% would accept COVID-19 vaccines when they become available. They agreed that health providers’ advice (83.0%), vaccination convenience (75.6%), and vaccine costs (62.8%) are essential for people to decide whether to accept COVID-19 vaccines. About half (49.3%) expressed their hesitancy to receive the COVID-19 vaccines. After adjustment for other covariates, COVID-19 vaccine hesitancy was significantly associated with age, residential area, education levels, employment status, and family economic status. Participants from Indonesia, Myanmar, Thailand, and Vietnam were significantly more likely to express hesitancy in receiving COVID-19 vaccines than those from Philippines.

Conclusions
In general, participants in this multi-country study showed their optimistic perception of COVID-19 vaccines’ effectiveness and willingness to receive them. However, about half of them still expressed their hesitancy in getting vaccinated. The hesitation was associated with several socioeconomic factors and varied by country. Therefore, COVID-19 vaccination programs should consider these factors essential for increasing vaccine uptake in the populations.