bluuebunny/crossref_metadata_2025_split huggingface dataset:
Explanatory models of hypertension in Guatemala: recognizing the perspectives of patients, family members, health care providers and administrators, and national-level health system stakeholders
Authors: Figueroa Juan Carlos , Paniagua-Avila Alejandra , Sub Cuc Ingrid , Cardona Sayra , Ramirez-Zea Manuel , Irazola Vilma , Fort Meredith P. 
Published: December 2022

Abstract
Background
Uncontrolled hypertension is a major public health burden and the most common preventable risk factor for cardiovascular diseases in Guatemala and other low- and middle-income countries. Prior to an initial trial that evaluated a hypertension intervention in rural Guatemala, we collected qualitative information on the needs and knowledge gaps of hypertension care within Guatemala’s public healthcare system. This analysis applied Kleinman’s Explanatory Models of Illness to capture how patients, family members, community-, district-, and provincial-level health care providers and administrators, and national-level health system stakeholders understand hypertension.

Methods
We conducted in-depth interviews with three types of participants: 1) national-level health system stakeholders (n = 17), 2) local health providers and administrators from district, and health post levels (25), and 3) patients and family members (19) in the departments of Sololá and Zacapa in Guatemala. All interviews were conducted in Spanish except for 6 Maya-Kaqchikel interviews. We also conducted focus group discussions with auxiliary nurses (3) and patients (3), one in Maya-Tz’utujil and the rest in Spanish. Through framework and matrix analysis, we compared understandings of hypertension by participant type using the Explanatory Model of Illness domains -etiology, symptoms, pathophysiology, course of illness, and treatment.

Results
Health providers and administrators, and patients described hypertension as an illness that spurs from emotional states like sadness, anger, and worry; is inherited and related to advanced age; and produces symptoms that include a weakened body, nerves, pain, and headaches. Patients expressed concerns about hypertension treatment’s long-term consequences, despite trying to comply with treatment. Patients stated that they combine biomedical treatment (when available) with natural remedies (teas and plants). Health providers and administrators and family members stated that once patients feel better, they often disengage from treatment. National-level health system stakeholders referred to lifestyle factors as important causes, considered patients to typically be non-compliant, and identified budget limitations as a key barrier to hypertension care. The three groups of participants identified structural barriers to limited hypertension care (e.g., limited access to healthy food and unaffordability of medications).

Conclusion
As understandings of hypertension vary between types of participants, it is important to describe their similarities and differences considering the role each has in the health system. Considering different perceptions of hypertension will enable better informed program planning and implementation efforts.
Intracellular osteopontin protects from autoimmunity-driven lymphoma development inhibiting TLR9-MYD88-STAT3 signaling
Authors: Rizzello Celeste , Cancila Valeria , Sangaletti Sabina , Botti Laura , Ratti Chiara , Milani Matteo , Dugo Matteo , Bertoni Francesco , Tripodo Claudio , Chiodoni Claudia , Colombo Mario P. 
Published: December 2022

Abstract
Background
Autoimmune disorders, including Systemic Lupus Erythematosus (SLE), are associated with increased incidence of hematological malignancies. The matricellular protein osteopontin (OPN) has been linked to SLE pathogenesis, as SLE patients show increased serum levels of OPN and often polymorphisms in its gene. Although widely studied for its pro-tumorigenic role in different solid tumours, the role of OPN in autoimmunity-driven lymphomagenesis has not been investigated yet.

Methods
To test the role of OPN in the SLE-associated lymphomagenesis, the SLE-like prone Faslpr/lpr mutation was transferred onto an OPN-deficient background. Spleen from Faslpr/lpr and OPN-/-Faslpr/lpr mice, as well as purified B cells, were analysed by histopathology, flow cytometry, Western Blot, immunohistochemistry, immunofluorescence and gene expression profile to define lymphoma characteristics and investigate the molecular mechanisms behind the observed phenotype. OPN cellular localization in primary splenic B cells and mouse and human DLBCL cell lines was assessed by confocal microscopy. Finally, gain of function experiments, by stable over-expression of the secreted (sOPN) and intracellular OPN (iOPN) in OPN-/-Faslpr/lpr -derived DLBCL cell lines, were performed for further validation experiments.

Results
Despite reduced autoimmunity signs, OPN-/-Faslpr/lpr mice developed splenic lymphomas with higher incidence than Faslpr/lpr counterparts. In situ and ex vivo analysis featured such tumours as activated type of diffuse large B cell lymphoma (ABC-DLBCL), expressing BCL2 and c-MYC, but not BCL6, with activated STAT3 signaling. OPN-/-Faslpr/lpr B lymphocytes showed an enhanced TLR9-MYD88 signaling pathway, either at baseline or after stimulation with CpG oligonucleotides, which mimic dsDNA circulating in autoimmune conditions. B cells from Faslpr/lpr mice were found to express the intracellular form of OPN. Accordingly, gene transfer-mediated re-expression of iOPN, but not of its secreted isoform, into ABC-DLBCL cell lines established from OPN-/-Faslpr/lpr mice, prevented CpG-mediated activation of STAT3, suggesting that the intracellular form of OPN may represent a brake to TLR9 signaling pathway activation.

Conclusion
These data indicate that, in the setting of SLE-like syndrome in which double strand-DNA chronically circulates and activates TLRs, B cell intracellular OPN exerts a protective role in autoimmunity-driven DLBCL development, mainly acting as a brake in the TLR9-MYD88-STAT3 signaling pathway.
Lessons from the COVID-19 pandemic for substance misuse services: findings from a peer-led study
Authors: Holloway Katy , Murray Shannon , Buhociu Marian , Arthur Alisha , Molinaro Rondine , Chicken Sian , Thomas Elwyn , Courtney Sam , Spencer Alan , Wood Rachel , Rees Ryan , Walder Stephen , Stait Jessica 
Published: December 2022

Abstract
Background
The measures implemented to contain the spread of the COVID-19 virus disrupted the provision of substance misuse treatment and support. However, little is known about the impact of this disruption on individuals seeking treatment for drug- and/or alcohol-related problems (henceforth service users). This study aimed to help substance misuse services learn lessons and identify ways of optimising delivery and minimising harm in the event of any future lockdowns or global crises.

Methods
The study was co-produced by a team of peer researchers, practitioners, policymakers and academics. Telephone interviews were conducted with 202 substance misuse service users over a 6-month period commencing June 2020. The interviews were conducted by a small group of seven peer researchers each with lived experience of substance use problems. The interview data were recorded by the peers in an anonymous online questionnaire survey and analysed using standard quantitative and qualitative methods.

Results
Service users responded to the COVID-19 pandemic in a variety of ways. Diverse responses were noted in relation to their substance use patterns, their personal lives and their substance misuse treatment experiences. For some, the pandemic acted as a new risk environment factor that increased their vulnerability to substance-related harm. For others, it facilitated aspects of the enabling environment, thereby reducing the risk of harm.

Conclusions
Service users are not a homogenous group, and an individualised approach to treatment that recognises the potential for varied responses to the same stimuli is needed. The findings suggest that service users would benefit from having a choice in how they access treatment and from greater access to outreach programmes that take treatments and harm reduction tools such as naloxone into the community. The research also supports the involvement of people with lived experience in substance use research, policy and practice.
Socio-economic difference in purchases of ultra-processed foods in Australia: an analysis of a nationally representative household grocery purchasing panel
Authors: Coyle Daisy H. , Huang Liping , Shahid Maria , Gaines Allison , Di Tanna Gian Luca , Louie Jimmy Chun Yu , Pan Xiongfei , Marklund Matti , Neal Bruce , Wu Jason H. Y. 
Published: December 2022

Abstract
Background
Consumption of ultra-processed foods is associated with increased risk of obesity and non-communicable diseases. Little is known about current patterns of ultra-processed foods intake in Australia. The aim of this study was to examine the amount and type of ultra-processed foods purchased by Australian households in 2019 and determine whether purchases differed by socio-economic status (SES). We also assessed whether purchases of ultra-processed foods changed between 2015 and 2019.

Methods
We used grocery purchase data from a nationally representative consumer panel in Australia to assess packaged and unpackaged grocery purchases that were brought home between 2015 to 2019. Ultra-processed foods were identified according to the NOVA system, which classifies foods according to the nature, extent and purpose of industrial food processing. Purchases of ultra-processed foods were calculated per capita, using two outcomes: grams/day and percent of total energy. The top food categories contributing to purchases of ultra-processed foods in 2019 were identified, and differences in ultra-processed food purchases by SES (Index of Relative Social Advantage and Disadvantage) were assessed using survey-weighted linear regression. Changes in purchases of ultra-processed foods between 2015 to 2019 were examined overall and by SES using mixed linear models.

Results
In 2019, the mean ± SD total grocery purchases made by Australian households was 881.1 ± 511.9 g/d per capita. Of this, 424.2 ± 319.0 g/d per capita was attributable to purchases of ultra-processed foods, which represented 56.4% of total energy purchased. The largest food categories contributing to total energy purchased included mass-produced, packaged breads (8.2% of total energy purchased), chocolate and sweets (5.7%), biscuits and crackers (5.7%) and ice-cream and edible ices (4.3%). In 2019, purchases of ultra-processed foods were significantly higher for the lowest SES households compared to all other SES quintiles (P < 0.001). There were no major changes in purchases of ultra-processed foods overall or by SES over the five-year period.

Conclusions
Between 2015 and 2019, ultra-processed foods have consistently made up the majority of groceries purchased by Australians, particularly for the lowest SES households. Policies that reduce ultra-processed food consumption may reduce diet-related health inequalities.
Green microwave synthesis of ZnO and CeO2 nanorods for infectious diseases control and biomedical applications
Authors: Gharbia Nevein , Elsabbagh Sabha , Saleh Ali , Hafez Hoda 
Published: December 2022

AbstractControl of Infectious diseases such as; bacteria and viruses, has become a globally critical issue, since the appearance of COVID-19 virus in 2020. In addition to the microbial resistance of the currently available therapeutic drugs as well as, its prolonged side effects make its use is of health care concern. Green nanotechnology approach is a promising solution for controlling such infectious diseases and many biomedical purposes. In the present study, green synthesis approach based on microwave-assisted hydrothermal method is an innovative and environmentally friendly method for preparation of bioactive CeO2 and ZnO nanorod structured materials using Olea europaea (O. e.) leaf plant extract as a natural medicinal capping agent for controlling the shape and size of nano-products. The optical and structural analyses of the obtained nanorod-structures are characterized using; TEM, FTIR, XRD, SBET analyses and particle size analyzer. The green-synthesized ZnO and CeO2 nanorods display an average crystallite size of approximately 15 and 5 nm, respectively. The antimicrobial activity of ZnO and CeO2 nanorods compared with the traditional hydrothermal methods, was examined on six clinical pathogens including; (E. coli Serratia sp., S. aureus, Bacillus subtilis, Streptococcus mutant, and MRSA). The results indicated superior antimicrobial and anti-tumor activities towards hepatocellular carcinoma cell lines (IC50 = 117.24 and 103.50 μg mL−1 for ZnO and CeO2 and LD50 > 3000 mg kg−1). This demonstrates that the green microwave process is a promising approach for the synthesis of effective ZnO and CeO2 nanomaterials applied for many biomedical applications.
Influence of eating concept on eating behavior and stunting in Indonesian Madurese ethnic group
Authors: Diana Rian , Rachmayanti Riris Diana , Khomsan Ali , Riyadi Hadi 
Published: December 2022

Abstract
Background and objectives
Stunting is a serious public health problem in Indonesia. Madura Island, which is inhabited by the Madurese ethnicity, had a very high stunting prevalence. The cultural factors of stunting mainly focus on food, food taboos, and early complementary feeding or prelacteal feeding practices. Therefore, this study aims to analyze the eating concept and its association with child feeding practices and stunting among the Madurese ethnic group in Indonesia.

Methods
This qualitative study was conducted in Sampang District, Madura Island, East Java, Indonesia. A total of 61 informants participated in this study (25 informants of in-depth interviews, 26 informants of FGDs, and 10 families in observations). Data collection consists of culture, values, and beliefs in child feeding practices that influence children’s nutritional status. The analysis used was content analysis by emphasizing the meanings, themes, and concepts of eating and stunting.

Results and conclusions
Stunting was considered a normal condition rather than a nutritional problem. The concept of eating is “eating rice.” Eating without other dishes is acceptable as long as there is rice on the plate. This concept affects inappropriate complementary food feeding practices and malnutrition among children under five. Overall, the study contributed to the improvement of the stunting reduction program by addressing how Madurese thought about eating and stunting.
Diagnostic performance of pre-management computed tomography findings as a predictor of conservative treatment success in patients with emphysematous pyelonephritis
Authors: Badawy Mohamed Ali , Abdelbaset Mohamed , Zahran Mohamed , Ghobrial Fady Kamal , El-Ghar Mohamed Abou , Elsorougy Ali , Abdelhamid Abdalla 
Published: December 2022

Abstract
Background
Emphysematous pyelonephritis (EPN) is one of the most serious urologic emergency which should be diagnosed and treated adequately to prevent impending septic shock and death. Computed tomography (CT) is the gold standard radiologic modality for diagnosis, grading and predicting the outcome. We aimed in this study to define the initial CT radiological findings correlated with EPN conservative management success.

Results
This study involved 54 patients (42 women and 12 males) with a mean age of 48 ± 10 years. EPN grades I, II, III, and IV were noticed in 12, 17, 20, and 5 patients, respectively. Ten patients (18.5%) received successful conservative management. On the other hand, renal drainage was needed in 42 patients (77.8%). Delayed nephrectomy was required in two cases (3.7%). In univariate and multivariate analyses, the absence of hydronephrosis and decreased air locules volume were predictors of conservative treatment success (P = 0.003 and 0.01, respectively).

Conclusions
Conservative therapy should be selected in certain patients of emphysematous pyelonephritis. Decreased air locules volume and the absence of hydronephrosis in pre-admission computed tomography were predictors for conservative therapy success.
Isolation and identification of four pathogenic bacterial strains from edible snake (Elaphe carinata and Ptyas mucosus) farms with pneumonia in China
Authors: Xia Ying , Long Siyu , Peng Yuxuan , Qin Songkang , Shen Yaoqin 
Published: December 2022

AbstractThis report describes an outbreak and treatment of pneumonia and enteritis in a snake farm with more than 3000 snakes containing Elaphe carinata (one-year-old) and Ptyas mucosus (three-month-old) seedlings in Huanggang, Hubei, China. Gentamicin was used once in the early stage as treatment, administered orally with water or feed by owners, but mortality increased. Lobar pneumonia was confirmed by dissection and histopathology in infected snakes. Four main pathogenic bacteria were isolated and identified with culture and 16S rRNA sequencing: Staphylococcus sciuri, Salmonella enteritis, Vagococcus fluvialis and Providencia vermicola. Drug susceptibility tests were performed, and amikacin, gentamicin and cefitriaxone were chosen accordingly. After two rounds of treatment, the clinical signs for Elaphe carinata were under control, and the mortality was close to 0% after treatment. However, treatments for Ptyas mucosus seedlings did not work well, potentially because of poor administration technique and weak body condition.
Development of a Core Set of Patient- and Caregiver-Reported Signs and Symptoms to Facilitate Early Recognition of Acute Chimeric Antigen Receptor T-Cell Therapy Toxicities
Authors: Spanjaart Anne M. , Pennings Elise R.A. , Kos Milan , Mutsaers Pim G.N.J. , Lugtenburg Pieternella J. , van Meerten Tom , van Doesum Jaap A. , Minnema Monique C. , Jak Margot , van Dorp Suzanne , Vermaat Joost S.P. , van der Poel Marjolein W.M. , van Oijen Martijn G.H. , Kuipers Maria T. , Nijhof Inger S. , Kersten Marie José 
Published: December 2022

PURPOSE: Prompt recognition of acute chimeric antigen receptor T (CAR T)-cell–mediated toxicities is crucial because adequate and timely management can prevent or reverse potential life-threatening complications. In the outpatient setting, patients and informal caregivers have to recognize and report signs and symptoms marking these acute toxicities. This study provides a core set of patient- and caregiver-reported signs and symptoms (outcomes, P/CROs) and definitions of red flags warranting immediate action to include in a daily checklist for support at home, with the goal to make outpatient post–CAR T-cell care safer, optimize patient and caregiver support, and thereby facilitating an early discharge/hospital visit reduction strategy. METHODS: We performed a systematic review of phase II/III trials of US Food and Drug Administration–approved CAR T-cell products and selected all common and severe adverse events that could be translated into a P/CRO for inclusion in a two-round modified Delphi procedure. Eleven CAR T-cell–dedicated hematologists from the Dutch CAR T-cell tumorboard representing all treating centers selected P/CROs for inclusion in the core set and defined red flags. The final core set was evaluated with patients and caregivers. RESULTS: From nine clinical trials, 457 adverse events were identified of which 42 could be used as P/CRO. The final core set contains 28 items, including five signs for measurement via wearables and two signs for caregiver-performed assessments. CONCLUSION: This study provides a core set of P/CROs that can serve as a framework for (eHealth) tools that aim to enable patients and caregivers to more effectively recognize and report signs and symptoms of acute toxicities after CAR T-cell therapy, which will enhance safe outpatient treatment monitoring.
Knowledge and practices of modern contraceptives among religious minority (Muslim) women: A cross-sectional study from Southern Nepal
Authors: Thakuri Dipendra Singh , K. C. Singh Yamuna , Karkee Rajendra , Khatri Resham B. 
Published: December 2022

Background
Uptake of family planning (FP) services could prevent many unwanted pregnancies, and unsafe abortions and avert maternal deaths. However, women, especially from ethnic and religious minorities, have a low practice of contraceptives in Nepal. This study examined the knowledge and practices of modern contraceptive methods among Muslim women in Nepal.

Methods
A cross-sectional study was conducted among 400 Muslim women in the Khajura Rural Municipality of Banke district. Data were collected using face to face structured interviews. Two outcome variables included i) knowledge of and ii) practices of contraceptives. Knowledge and practice scores were estimated using the list of questions. Using median as a cut-off point, scores were categorised into two categories for each outcome variable (e.g., good knowledge and poor knowledge). Independent variables were several sociodemographic factors. The study employed logistic regression analysis, and odds ratios (OR) were reported with 95% confidence intervals (CIs) at a significance level of p<0.05 (two-tailed).

Results
Almost two-thirds (69.2%) of respondents had good knowledge of modern contraceptive methods, but only 47.3% practised these methods. Women of nuclear family (adjusted odds ratio (aOR) = 0.60; 95% CI: 0.38,0.95), and who work in agricultural sector (aOR = 0.38; 95% CI: 0.22, 0.64) were less likely to have good knowledge on modern contraceptives. Women with primary (aOR = 2.59; 95% CI: 1.43, 4.72), secondary and above education (aOR = 4.41; 95% CI:2.02,9.63), women with good knowledge of modern contraceptives (aOR = 2.73; 95% CI: 1.66, 4.51), who ever visited a health facility for FP counselling (aOR = 4.40; 95% CI: 2.58, 7.50) had higher odds of modern contraceptives practices.

Conclusion
Muslim women had low use of modern contraceptive methods despite having satisfactory knowledge about them. There is a need for more equitable and focused high-quality FP practices. Targeted interventions are needed to increase the knowledge and practices of contraceptives in the Muslim community. The study highlights the need to target FP interventions among socially disadvantaged women, those living in a nuclear family, and those with poor knowledge of modern contraceptives.