bluuebunny/crossref_metadata_2025_split huggingface dataset:
HIV prevalence and associated risk factors among men who have sex with men in three regions of Paraguay, 2020
Authors: Aguilar Gloria , Samudio Tania , Méndez Julieta , López Gladys , Giménez Liliana , Schaerer Christian , Gómez Santiago , Báez Teresita , Morel Zoilo , Munoz Sergio , McFarland William 
Published: October 2022

Background Our study aimed to measure HIV prevalence and associated risk factors among men who have sex with men (MSM) in three regions of Paraguay in 2020. Methods MSM were recruited for cross-sectional surveys in three regions of Paraguay using respondent-driven sampling. Interview were conducted face-to-face to collect demographic characteristics and risk and preventive behaviors. The analysis assessed HIV prevalence and associated risk factors in the three samples of MSM within each region. Results A total of 1,207 MSM were recruited, including 559 in Asunción-Central, 245 in Alto Paraná, and 403 in Caaguazú. HIV prevalence was 24.2% (95% CI 20.6–27.9) in Asunción-Central, 10.2% (95% CI 6.7–14.6) in Alto Paraná, and 3.2% (95% CI 1.7–5.4) in Caaguazú. In Asunción-Central, associations with HIV were age ≥25 years (1.86, 95% CI 1.15–3.00), being employed (1.82, 95% CI 1.07–3.11), self-reporting as homosexual (1.90, 95% CI 1.06–3.43), having sex with a known HIV-positive partner acquisition (4.19, 95% CI 2.37–7.43), self-perceived as being at higher risk for HIV acquisition (4.15, 95% CI 2.54–6.77), and able to access condoms and lubricants (1.82, 95% CI 1.08–3.05). In Alto Paraná, associations with HIV were self-reporting as homosexual (4.33, 95% CI 1.19–15.65) and having higher HIV knowledge (2.53, 95% CI 0.97–6.61). In Caaguazú, associations with HIV were self-reporting as homosexual (7.06, 95% CI 1.53–32.46) and being diagnosed with depression (4.68, 95% CI 0.89–24.43). Conclusions HIV prevalence among MSM in Paraguay varied by region, being highest in the capital and major metropolitan area of Asunción-Central, followed by the border area of Alto Paraná. While being self-identified as homosexual was associated with HIV in all three regions, other associations differed, indicating prevention programs need to be tailored to the locale.
A Conceptual Model of Adaptive Protective Factors for Migrant Workers
Authors: Singh Aruna , Vijila Y. , Gael Karubu Armel 
Published: October 2022

About 450 million of 1.2 billion Indians migrated within the country, according to recently released Census 2011 data. Of this, 78 million, or 15.6% of all domestic migrants, moved from rural to urban areas. This is how their numbers have changed over 2001 and where they moved. Migrant workers show an enhancement in the occurrence of stern maladaptation to the host cities due to slaughter of social eminence, inequity and parting from the family. Several migrant workers are not entitled to avail of basic facilities such as education, social security, housing and medical benefits. Using a resilience perspective, this study attempted to find out adaptive protective factors responsible for the resilience of migrant labour in the host city. Data was collected through an interview schedule by using a structured questionnaire on 240 migrant workers in the Tiruchirappalli district of Tamil Nadu. The questionnaire was constructed on demographic characteristics and different dimensions of adaptive protective factors such as structural adaptation, labour market competitiveness, opportunity for informal entrepreneurship, language acquisition and access to mobility on the seven-point Likert scale. By doing structural equation modelling (SEM) analysis and confirmatory factor analysis (CFA), it is found that favourableness in structural adaptation and opportunity for informal entrepreneurship stood out as the most predictive adaptive protection factors along with language acquisition, access to mobility and level of competitiveness in the labour market for migrant workers.
Comparative cost savings of biosimilar and dose rounding utilization in oncology care
Authors: Abdelmeseh Verona , Brown Britny R , Huynh Justin P , Zullo Andrew R 
Published: October 2022

Introduction The exponential rise in cancer costs has led many centers to utilize dose rounding to the nearest vial size when the difference in dose is ≤10% to decrease costs. The recent approval of several biosimilar products has presented another opportunity to mitigate the rising costs of oncology care. Scarce information exists about the expected cost savings of combining dose rounding strategies (DRS) with biosimilar use (BU). We therefore assessed the cost savings of combining DRS and BU. Methods Electronic health record data for two health systems in Rhode Island were used to identify patients who received ≥1 of trastuzumab, trastuzumab-anns, bevacizumab, or bevacizumab-awwb from October 1, 2015 to September 1, 2020. Costs were estimated using Medicare drug pricing. Multivariable generalized estimating equations adjusting for age, gender, presence of metastases, dosing weight, and dose administered were used to compare costs per dose between the four exposure groups: DRS + BU, DRS only, BU only, and neither DRS or BU. Results A total of 1156 patients were administered 15,145 doses of drug. After covariate adjustment, average savings per dose was greatest in the DRS + BU group (vs. the neither DRS nor BU group); $331 for trastuzumab and $497 for bevacizumab. Conclusions Combining dose rounding with biosimilar substitution for trastuzumab and bevacizumab resulted in significant cost savings per dose and should be implemented by healthcare systems.
Understanding Grotesque Transparency as a Strategy for Fundamentalist Radicalization: Implications for Social Marketing Theory and Practice
Authors: Nahon-Serfaty Isaac 
Published: October 2022

Background To counter the effects of radicalization, we should first understand the persuasion mechanisms used by fundamentalist organizations to reach and engage with potential candidates to religious radicalization, particularly in Western societies. Focus of the Article The paper analyzes ISIS and Al-Qeada (AQ) propaganda as grotesque transparency strategy, with particular attention to the so-called “Islamic State.” Research Questions The main research question guiding this case study is: how the “grotesque transparency” strategy is articulated in the context of radicalization propaganda by Islamist terrorist organizations? The secondary research question is: how the understanding of the “grotesque transparency” strategy could inform social marketing and policy initiatives to counter the effects of such propaganda? Importance to the Social Marketing Field The novelty of grotesque transparency in the context of digital networks lies in the ease with which potentially everyone can be a propagandist, transforming the strategic prescriptions of the organized terrorist into an individual “creative” tactic or action. In this context of media fragmentation, the notion of social marketing as mainly a strategic endeavor to favor general change of attitudes and behaviors may be reconsidered as a more dialogic and individualized interaction to understand the expectations, needs and ideas of the “tribal groups.” Methods By applying the “aquarium metaphor”, the author describes the narrative of such radical groups, including the visual elements that are key in the case of grotesque transparency in the digital media ecosystem. Results The visually grotesque gives meaning to events in a world of excess, fragmentation, and disenchantment. The language of the ocular reduces ambiguity, privileges the concrete, and facilitates moral judgments. It has become a way of “knowing” based on emotion. Recommendations for Practice Social marketing experts and officers might reconsider the very notion of strategy when trying to counter the effects of grotesque transparency radical propaganda among certain groups of the population, moving beyond the more traditional approach of control-command to a more open and interactive process to engage in a dialogue and connect with individuals, their families and peers through strategizing. Limitations The analysis presented here of the Islamist terrorist propaganda is based on a literature review and some empirical research. The question of reception and tactical appropriation by some groups remains an important area to be explored in future research.
Bioinformatics methods in biomarkers of preeclampsia and associated potential drug applications
Authors: Peng Ying , Hong Hui , Gao Na , Wan An , Ma Yuyan 
Published: October 2022

Abstract
Background
Preeclampsia is a pregnancy-related condition that causes high blood pressure and proteinuria after 20 weeks of pregnancy. It is linked to increased maternal mortality, organ malfunction, and foetal development limitation. In this view, there is a need critical to identify biomarkers for the early detection of preeclampsia. The objective of this study is to discover critical genes and explore medications for preeclampsia treatment that may influence these genes.

Methods
Four datasets, including GSE10588, GSE25906, GSE48424 and GSE60438 were retrieved from the Gene Expression Omnibus database. The GSE10588, GSE25906, and GSE48424 datasets were then removed the batch effect using the “sva” R package and merged into a complete dataset. The differentially expressed genes (DEGs) were identified using the “limma” R package. The potential small-molecule agents for the treatment of PE was further screened using the Connective Map (CMAP) drug database based on the DEGs. Further, Weight gene Co-expression network (WGNCA) analysis was performed to identified gene module associated with preeclampsia, hub genes were then identified using the logistic regression analysis. Finally, the immune cell infiltration level of genes was evaluated through the single sample gene set enrichment analysis (ssGSEA).

Results
A total of 681 DEGs (376 down-regulated and 305 up-regulated genes) were identified between normal and preeclampsia samples. Then, Dexamethasone, Prednisone, Rimexolone, Piretanide, Trazodone, Buflomedil, Scoulerin, Irinotecan, and Camptothecin drugs were screened based on these DEGs through the CMAP database. Two modules including yellow and brown modules were the most associated with disease through the WGCNA analysis. KEGG analysis revealed that the chemokine signaling pathway, Th1 and Th2 cell differentiation, B cell receptor signalling pathway and oxytocin signalling pathway were significantly enriched in these modules. Moreover, two key genes, PLEK and LEP were evaluated using the univariate and multivariate logistic regression analysis from the hub modules. These two genes were further validated in the external validation cohort GSE60438 and qRT-PCR experiment. Finally, we evaluated the relationship between immune cell and two genes.

Conclusion
In conclusion, the present study investigated key genes associated with PE pathogenesis that may contribute to identifying potential biomarkers, therapeutic agents and developing personalized treatment for PE.
Evaluating continuum of maternal and newborn healthcare in Rwanda: evidence from the 2019–2020 Rwanda demographic health survey
Authors: Sserwanja Quraish , Gatasi Ghislaine , Musaba Milton W. 
Published: October 2022

Abstract
Background
Access to a complete continuum of maternal and child health care has been recommended globally for better pregnancy outcomes. Hence this study determined the level (pooled prevalence) and predictors of successfully completing continuum of care (CoC) in Rwanda.

Methods
We analyzed weighted secondary data from the 2019–2020 Rwanda Demographic and Health Survey (RDHS) that included 6,302 women aged 15 to 49 years who were selected using multistage stratified sampling. We analyzed complete continuum of care as a composite variable of three maternal care services: at least four ANC contacts, SBA, maternal and neonatal post-natal care. We used the SPSS version 25 complex samples package to conduct multivariable logistic regression.

Results
Of the 6,302 women, 2,131 (33.8%) (95% CI: 32.8–35.1) had complete continuum of care. The odds of having complete continuum of care were higher among women who had exposure to newspapers (adjusted odds ratio (AOR): 1.30, 95% CI: 1.11–1.52), those belonging to the eastern region (AOR): 1.24, 95% CI: 1.01–1.52), southern region (AOR): 1.26, 95% CI: 1.04–1.53), those with health insurance (AOR): 1.55, 95% CI: 1.30–1.85), those who had been visited by a field health worker (AOR: 1.31, 95% CI: 1.15–1.49), those with no big problems with distance to health facility (AOR): 1.25, 95% CI: 1.07–1.46), those who were married (AOR): 1.35, 95% CI: 1.11–1.64), those with tertiary level of education (AOR): 1.61, 95% CI: 1.05–2.49), those belonging to richer households (AOR): 1.33, 95% CI: 1.07–1.65) and those whose parity was less than 2 (AOR): 1.52, 95% CI: 1.18–1.95).

Conclusion
We have identified modifiable factors (exposure to mass media, having been visited by a field health worker, having health insurance, having no big problems with distance to the nearest health facility, belonging to richer households, being married and educated), that can be targeted to improve utilization of the entire continuum of care. Promoting maternity services through mass media, strengthening the community health programmes, increasing access to health insurance and promoting girl child education to tertiary level may improve the level of utilization of maternity services.
Association between water, sanitation and hygiene (WASH) and child undernutrition in Ethiopia: a hierarchical approach
Authors: Sahiledengle Biniyam , Petrucka Pammla , Kumie Abera , Mwanri Lillian , Beressa Girma , Atlaw Daniel , Tekalegn Yohannes , Zenbaba Demisu , Desta Fikreab , Agho Kingsley Emwinyore 
Published: October 2022

Abstract
Background
Undernutrition is a significant public health challenge and one of the leading causes of child mortality in a wide range of developing countries, including Ethiopia. Poor access to water, sanitation, and hygiene (WASH) facilities commonly contributes to child growth failure. There is a paucity of information on the interrelationship between WASH and child undernutrition (stunting and wasting). This study aimed to assess the association between WASH and undernutrition among under-five-year-old children in Ethiopia.

Methods
A secondary data analysis was undertaken based on the Ethiopian Demographic and Health Surveys (EDHS) conducted from 2000 to 2016. A total of 33,763 recent live births extracted from the EDHS reports were included in the current analysis. Multilevel logistic regression models were used to investigate the association between WASH and child undernutrition. Relevant factors from EDHS data were identified after extensive literature review.

Results
The overall prevalences of stunting and wasting were 47.29% [95% CI: (46.75, 47.82%)] and 10.98% [95% CI: (10.65, 11.32%)], respectively. Children from households having unimproved toilet facilities [AOR: 1.20, 95% CI: (1.05,1.39)], practicing open defecation [AOR: 1.29, 95% CI: (1.11,1.51)], and living in households with dirt floors [AOR: 1.32, 95% CI: (1.12,1.57)] were associated with higher odds of being stunted. Children from households having unimproved drinking water sources were significantly less likely to be wasted [AOR: 0.85, 95% CI: (0.76,0.95)] and stunted [AOR: 0.91, 95% CI: (0.83, 0.99)]. We found no statistical differences between improved sanitation, safe disposal of a child’s stool, or improved household flooring and child wasting.

Conclusion
The present study confirms that the quality of access to sanitation and housing conditions affects child linear growth indicators. Besides, household sources of drinking water did not predict the occurrence of either wasting or stunting. Further longitudinal and interventional studies are needed to determine whether individual and joint access to WASH facilities was strongly associated with child stunting and wasting.
RETRACTED ARTICLE: Population-level counterfactual trend modelling to examine the relationship between smoking prevalence and e-cigarette use among US adults
Authors: Foxon Floe , Selya Arielle , Gitchell Joe , Shiffman Saul 
Published: October 2022

Abstract
Background
Studies have suggested that some US adult smokers are switching away from smoking to e-cigarette use. Nationally representative data may reflect such changes in smoking by assessing trends in cigarette and e-cigarette prevalence. The objective of this study is to assess whether and how much smoking prevalence differs from expectations since the introduction of e-cigarettes.

Methods
Annual estimates of smoking and e-cigarette use in US adults varying in age, race/ethnicity, and sex were derived from the National Health Interview Survey. Regression models were fitted to smoking prevalence trends before e-cigarettes became widely available (1999–2009) and trends were extrapolated to 2019 (counterfactual model). Smoking prevalence discrepancies, defined as the difference between projected and actual smoking prevalence from 2010 to 2019, were calculated, to evaluate whether actual smoking prevalence differed from those expected from counterfactual projections. The correlation between smoking discrepancies and e-cigarette use prevalence was investigated.

Results
Actual overall smoking prevalence from 2010 to 2019 was significantly lower than counterfactual predictions. The discrepancy was significantly larger as e-cigarette use prevalence increased. In subgroup analyses, discrepancies in smoking prevalence were more pronounced for cohorts with greater e-cigarette use prevalence, namely adults ages 18–34, adult males, and non-Hispanic White adults.

Conclusion
Population-level data suggest that smoking prevalence has dropped faster than expected, in ways correlated with increased e-cigarette use. This population movement has potential public health implications.
“Back Rx, a personalized mobile phone application for discogenic chronic low back pain: a prospective pilot study”
Authors: Vad Vijay B. , Madrazo-Ibarra Antonio , Estrin Deborah , Pollak John P. , Carroll Kaitlin M. , Vojta Deneen , Vad Amoli , Trapness Camilla 
Published: October 2022

Abstract
Background
Intervertebral disc pathology is the most common identifiable cause of chronic lower back pain (CLBP). There are limited conservative alternatives to treat discogenic axial CLBP. Back Rx is a mobile application (app) developed to treat patients with this condition, following the Back Rx exercise program, assisted by a virtual coach.

Methods
Patients 18 to 65 years of age, with axial CLBP (more than 3 months), and evidence of lumbar disc pathology by magnetic resonance imaging (MRI) were enrolled to the study. Patients’ symptomatology was prospectively evaluated at baseline and after 3 months of using the Back Rx app. The main outcome of the study was back pain evaluated using the visual analog scale (VAS) for pain. Secondary outcomes were the patient's functionality, the weekly pain medication intake, the patients’ adherence to the app, and the patients´ satisfaction rate.

Results
Seventy-five patients with CLBP were enrolled in the study. All patients had a statistically significant improvement from baseline to final follow-up in the average VAS scores, and the functionality evaluations. Average VAS scores decreased from 5.17 ± 2.1 at baseline to 3.8 ± 2.6 at final follow-up (P = 0.016). Patients showed a significant decrease in the number of pain medications taken during a week (P = 0.001). Overall compliance with the app was 52%, and 65% of the patients rated the overall experience as good or excellent.

Conclusion
The Back Rx app decreased pain and increased function in patients with discogenic axial CLBP compared to their baseline status. Further measures are needed to increase patients' compliance with the app and the Back Rx program.

Trial registration
Retrospectively registered in 2/2/2017 NCT03040310 (ClinicalTrials.gov).
Components of stigma and its impact on maternal and child health service and outcomes: perspective of Akha hill tribe women in Thailand
Authors: Mulikaburt Thanatchaporn , Apidechkul Tawatchai , Wongnuch Pilasinee , Kitchanapaibul Siwarak , Udplong Anusorn , Srichan Peeradone , Upala Panupong , Chomchoei Chalitar , Yeemard Fartima , Tamornpark Ratipark , Singkhorn Onnalin 
Published: October 2022

Abstract
Background
Maternal and child health (MCH) is crucial to the well-being of mothers and children. Stigma regarding access to MCH services is a major challenge, especially for hill tribe people in Thailand. The study aimed to understand the components of stigma and its impact on MCH service and outcomes including experiences and expectations to address the stigma in perspective of Akha hill tribe women in Thailand.

Methods
A phenomenological qualitative approach was used to gather information from Akha women who had attended MCH service one year prior and had an experience with stigma. A validated question guide was used in the study. The interview was conducted in private and confidential rooms in the Akha hill tribe villages between June and September 2021. A thematic analysis was used to extract the major and minor themes and develop the findings.

Results
A total of 61 Akha postdelivery participants were recruited to provide information; the average age was 28.9 years, 32.8% had no Thai ID card, and 93.4% were married. Language, traditional clothing, poverty, and name were identified as drivers of stigma, while health care providers’ background, gender differences between clients and health care providers, and knowledge gaps facilitated the stigma. Being a member of a hill tribe acted as the stigma marker. Stigma manifestation was presented in the forms of verbal or physical abuse, refusal to provide treatment, and intentional disclosure of personal information to the public. Accepting the situation with no better option, defending oneself to receive better care and services, and using a private care service were experiences in addressing the stigma. Gender matching, active MCH service, mobile emergency clinics, and appropriate, permanent medical equipment in health care facilities located in their villages were the expectations.

Conclusion
Akha women face a variety of stigmas in access to MCH services, with substantial impacts on health outcomes, especially the rate of services in women and child health. Creating laws to prevent the occurrence of any forms of stigma and implementing gender matching in MCH services should be considered.
Cerebellar hemorrhage in a healthy young adult: a case report
Authors: Ibrahim A. H. , Mohamad N. , Mohd Yusof Rasid T. A. , Abdullah M. S. 
Published: October 2022

Abstract
Background
Cavernous venous malformation is an uncommon entity that occurs in around 0.5% of the general population. Cerebellar cavernous venous malformation accounts for 1.2–11.8% of intracranial cavernous venous malformation cases. Patients are commonly asymptomatic until a hemorrhage occurs. In approximately 20% of the cases, cavernous venous malformation and developmental venous anomalies occur together, called mixed vascular malformation. Our case report reveals the imaging features of the mixed vascular malformation and highlights the appropriate imaging modality and sequence to detect the abnormalities.

Case presentation
We report the case of a 15-year-old Malay male, a healthy young male who presented with dizziness, vomiting, and mild headache for 1 month. Computed tomography brain imaging at presentation revealed cerebellar hemorrhage with multiple cavernous venous malformation and coexisting developmental venous anomalies, which was then confirmed by magnetic resonance imaging. The patient was started on dexamethasone 4 mg four times a day, observed in the ward, and discharged well without neurological sequelae.

Conclusion
A cavernous malformation with concurrent developmental venous anomalies requires accurate diagnosis. Our case report contributes to the literature on the imaging diagnosis of this disease, which is beneficial for current and future reference.