bluuebunny/crossref_metadata_2025_split huggingface dataset:
Health worker perceptions of stigma towards Zambian adolescent girls and young women: a qualitative study
Authors: Meek Caroline , Mulenga Drosin M. , Edwards Patrick , Inambwae Sophie , Chelwa Nachela , Mbizvo Michael T. , Roberts Sarah T. , Subramanian Sujha , Nyblade Laura 
Published: October 2022

Abstract
Background
The high prevalence of HIV among adolescent girls and young women aged 15–24 in Eastern and Southern Africa indicates a substantial need for accessible HIV prevention and treatment services in this population. Amidst this need, Zambia has yet to meet global testing and treatment targets among adolescent girls and young women living with HIV. Increasing access to timely, high-quality HIV services in this population requires addressing the intensified anticipated and experienced stigma that adolescent girls and young women often face when seeking HIV care, particularly stigma in the health facility setting. To better understand the multi-level drivers and manifestations of health facility stigma, we explored health workers’ perceptions of clinic- and community-level stigma against adolescent girls and young women seeking sexual and reproductive health, including HIV, services in Lusaka, Zambia.

Methods
We conducted 18 in-depth interviews in August 2020 with clinical and non-clinical health workers across six health facilities in urban and peri-urban Lusaka. Data were coded in Dedoose and thematically analyzed.

Results
Health workers reported observing manifestations of stigma driven by attitudes, awareness, and institutional environment. Clinic-level stigma often mirrored community-level stigma. Health workers clearly described the negative impacts of stigma for adolescent girls and young women and seemed to generally express a desire to avoid stigmatization. Despite this lack of intent to stigmatize, results suggest that community influence perpetuates a lingering presence of stigma, although often unrecognized and unintended, in health workers and clinics.

Conclusions
These findings demonstrate the overlap in health workers’ clinic and community roles and suggest the need for multi-level stigma-reduction approaches that address the influence of community norms on health facility stigma. Stigma-reduction interventions should aim to move beyond fostering basic knowledge about stigma to encouraging critical thinking about internal beliefs and community influence and how these may manifest, often unconsciously, in service delivery to adolescent girls and young women.
Depression and fatigue in active IBD from a microbiome perspective—a Bayesian approach to faecal metagenomics
Authors: Thomann Anne Kerstin , Wüstenberg Torsten , Wirbel Jakob , Knoedler Laura-Louise , Thomann Philipp Arthur , Zeller Georg , Ebert Matthias Philip , Lis Stefanie , Reindl Wolfgang 
Published: October 2022

Abstract
Background
Extraintestinal symptoms are common in inflammatory bowel diseases (IBD) and include depression and fatigue. These are highly prevalent especially in active disease, potentially due to inflammation-mediated changes in the microbiota-gut-brain axis. The aim of this study was to investigate the associations between structural and functional microbiota characteristics and severity of fatigue and depressive symptoms in patients with active IBD.

Methods
We included clinical data of 62 prospectively enrolled patients with IBD in an active disease state. Patients supplied stool samples and completed the questionnaires regarding depression and fatigue symptoms. Based on taxonomic and functional metagenomic profiles of faecal gut microbiota, we used Bayesian statistics to investigate the associative networks and triangle motifs between bacterial genera, functional modules and symptom severity of self-reported fatigue and depression.

Results
Associations with moderate to strong evidence were found for 3 genera (Odoribacter, Anaerotruncus and Alistipes) and 3 functional modules (pectin, glycosaminoglycan and central carbohydrate metabolism) with regard to depression and for 4 genera (Intestinimonas, Anaerotruncus, Eubacterium and Clostridiales g.i.s) and 2 functional modules implicating amino acid and central carbohydrate metabolism with regard to fatigue.

Conclusions
This study provides the first evidence of association triplets between microbiota composition, function and extraintestinal symptoms in active IBD. Depression and fatigue were associated with lower abundances of short-chain fatty acid producers and distinct pathways implicating glycan, carbohydrate and amino acid metabolism. Our results suggest that microbiota-directed therapeutic approaches may reduce fatigue and depression in IBD and should be investigated in future research.
MiR-493-5p inhibits Th9 cell differentiation in allergic asthma by targeting FOXO1
Authors: Rao Xingyu , Dong Heting , Zhang Weili , Sun Huiming , Gu Wenjing , Zhang Xinxing , Huang Li , Yan Yongdong , Hao Chuangli , Ji Wei , Zhu Canhong , Chen Zhengrong 
Published: October 2022

AbstractThe role of micro RNAs (miRNAs) in asthma remains unclear. In this study, we examined the role of miRNA in targeting FOXO1 in asthma. Results showed that miR-493-5p was one of the differentially expressed miRNAs in the PBMCs of asthmatic children, and was also associated with Th cell differentiation. The miR-493-5p expression decreased significantly in the OVA-induced asthma mice than the control groups. The miR-493-5p mimic inhibited the expression of the IL-9, IRF4 and FOXO1, while the inhibitor restored these effects. Moreover, the Dual-Luciferase analysis results showed FOXO1 as a novel valid target of miR-493-5p. According to the rescue experiment, miR-493-5p inhibited Th9 cell differentiation by targeting FOXO1. Then the exosomes in association with the pathogenesis of asthma was identified. Various inflammatory cells implicated in asthmatic processes including B and T lymphocytes, DCs, mast cells, and epithelial cells can release exosomes. Our results demonstrated that the DC-derived exosomes can inhibit Th9 cell differentiation through miR-493-5p, thus DC-derived exosomal miR-493-5p/FOXO1/Th9 may serve as a potential therapeutic target in the development of asthma.
Quality of life instruments in atrial fibrillation: a systematic review of measurement properties
Authors: Sale Alicia , Yu Jessica 
Published: October 2022

Abstract
Objectives
To identify the most frequently used atrial fibrillation-specific quality of life (QoL) instruments across atrial fibrillation (AF) ablation studies and to perform a systematic review of the most frequently used instrument’s measurement properties. This study uses quality of life instruments as an overarching term for any patient reported outcome measure that assesses a person’s health related well-being, functional status, and disease related symptoms.

Methods
A literature mapping exercise was undergone to identify the most frequently used AF-specific QoL instruments across AF ablation studies published from 2016 to 2021. A systematic review of the most frequently used AF QoL instruments identified from the mapping exercise was performed using the COSMIN guidelines for systematic reviews of patient-reported outcome measurements. A systematic search was conducted in Ovid MEDLINE, Ovid Embase, Ovid PsycINFO, EBSCO CINAHL, and Cochrane CENTRAL. The search used variations of the keywords “atrial fibrillation”, “quality of life”, and “catheter ablation”.

Results
Forty-five instruments were identified via the literature mapping exercise. After excluding non-patient reported outcome instruments, non-AF specific instruments, and instruments appearing only once, six instruments were identified: AF Effect on QualiTy-of-Life (AFEQT), AF Severity Scale, Minnesota Living with Heart Failure Instrument, AF Quality of Life Instrument, Arrhythmia Specific instrument in Tachycardia and Arrhythmia (ASTA), and SCL (Arrhythmia Symptom Checklist, Frequency and Severity). A systematic review of these six AF-specific health related QoL instruments was performed. We screened 3221 articles and 17 studies were eligible for inclusion. Using the COSMIN guidelines, ASTA and AFEQT had the best ratings across measurement properties with both instruments having good ratings for instrument development and internal consistency. However, none of the 17 included articles assessed measurement error and cross-cultural validity.

Conclusions
AFEQT and ASTA had the strongest measurement properties but not all measurement properties were assessed. Considering the large number of indeterminate and insufficient ratings, future research should focus on cross-cultural validation, measurement error, responsiveness, and interpretability. This review summarizes the current evidence for AF QoL instruments across AF ablation studies and outlines areas for future research.
Short-term postoperative outcomes of gastric adenocarcinoma patients treated with curative intent in low-volume centers
Authors: Lacueva Francisco-Javier , Escrig-Sos Javier , Marti-Obiol Roberto , Zaragoza Carmen , Mingol Fernando , Oviedo Miguel , Peris Nuria , Civera Joaquin , Roig Amparo ,   on behalf of the RECEG-CV group, Sabater Consol , Espert Vicente , Todoli Gonzalo , Cases María-José , Mella Mario , Lopez-Mozos Fernando , Carbonell Silvia , Bruna Marcos , Mulas Claudia , Trullenque Ramon , Barreras José-Antonio , Gomez Luis , Sancho Cristina , Aguilo Javier , Navarro Jose-Manuel , Compañ Antonio , Calero Alicia , Canelles Enrique , Montilla Erick , Rodriguez Rodolfo , Gonzalez Yannko , Moya Alejandro , Barber Xavier , Puche Jose , Asencio Francisco 
Published: October 2022

Abstract
Background
Quality standards in postoperative outcomes have not yet been defined for gastric cancer surgery. Also, the effect of centralization of gastric cancer surgery on the improvement of postoperative outcomes continues to be debated. Short-term postoperative outcomes in gastric carcinoma patients in centers with low-volume of annual gastrectomies were assessed. The effect of age on major postoperative morbidity and mortality was also analyzed.

Methods
Patients with gastric or gastroesophageal junction Siewert III type carcinomas who underwent surgical treatment with curative intent between January 2013 and December 2016 were included. Data were obtained from the population-based surgical registry Esophagogastric Carcinoma Registry of the Comunitat Valenciana (RECEG-CV). The RECEG-CV gathers information on demographic characteristics and comorbidity, preoperative study and neoadjuvant treatment, surgical procedure, pathological study, postoperative outcomes, and follow-up. Seventeen hospitals belonging to the public network participated in this registry.

Results
Data from 591 patients were analyzed. Postoperative major morbidity occurred in 154 (26.1%) patients. Overall 30-day or in-hospital mortality, and 90-day postoperative mortality rates were 8.6% and 10.1% respectively. Failure-to-rescue was 39% and it was significantly higher in patients aged 75 years or older in comparison with younger patients (55.3% vs 23.1% p < 0.001).
In the multivariable analysis, age ≥ 75 years (p = 0.029), laparoscopic approach (p = 0.005), and total gastrectomy (p = 0.005) were associated with major postoperative morbidity. Age ≥ 75 years (p = 0.027), pulmonary complications (p = 0.001), cardiac complications (p = 0.001), leakage (p = 0.003), and hemorrhage (p = 0.013) were associated with postoperative mortality.

Conclusions
Centralization of gastric adenocarcinoma treatment in centers with higher annual caseload should be considered to improve the short-term postoperative outcomes in low-volume centers. Patients aged 75 or older had a significantly increased risk of major postoperative morbidity and mortality, and higher failure-to-rescue.
Criterion validity of ActiGraph monitoring devices for step counting and distance measurement in adults and older adults: a systematic review
Authors: Ngueleu Armelle-Myriane , Barthod Corentin , Best Krista Lynn , Routhier François , Otis Martin , Batcho Charles Sèbiyo 
Published: October 2022

Abstract
Background
Wearable activity monitors such as ActiGraph monitoring devices are widely used, especially in research settings. Various research studies have assessed the criterion validity of ActiGraph devices for step counting and distance estimation in adults and older adults. Although several studies have used the ActiGraph devices as a reference system for activity monitoring, there is no summarized evidence of the psychometric properties. The main objective of this systematic review was to summarize evidence related to the criterion validity of ActiGraph monitoring devices for step counting and distance estimation in adults and/or older adults.

Methods
Literature searches were conducted in six databases (Medline (OVID), Embase, IEEExplore, CINAHL, Engineering Village and Web of Science). Two reviewers independently conducted selection, a quality analysis of articles (using COSMIN and MacDermid’s grids) and data extraction.

Results
This review included 21 studies involving 637 participants (age 30.3 ± 7.5 years (for adults) and 82.7 ± 3.3 years (for older adults)). Five ActiGraph devices (7164, GT1M, wGTX +, GT3X +/wGT3X + and wGT3X − BT) were used to collect data at the hip, wrist and ankle to assess various walking and running speeds (ranging from 0.2 m/s to 4.44 m/s) over durations of 2 min to 3 days (13 h 30 mins per day) for step counting and distance estimation. The ActiGraph GT3X +/wGT3X + and wGT3X − BT had better criterion validity than the ActiGraph 7164, wGTX + and GT1M according to walking and running speeds for step counting. Validity of ActiGraph wGT3X + was good for distance estimation.

Conclusion
The ActiGraph wGT3X − BT and GT3X +/wGT3X + have good criterion validity for step counting, under certain conditions related to walking speeds, positioning and data processing.
Breastfeeding by a mother taking cyclosporine for nephrotic syndrome
Authors: Li Ruizhe , Zhang Chuan , Wang Hongjing , An Yunfei 
Published: October 2022

Abstract
Background
Cyclosporine is widely used for immunosuppressive treatment of various systematic and local autoimmune diseases. Breastfeeding is conventionally contraindicated when treating with cyclosporine due to its excretion into breast milk, which may cause immune suppression of exposed infants and affect infants` growth. A few cases have tested cyclosporine levels in random breast milk samples and concluded the infants exposed to safe cyclosporine levels during breastfeeding. Since infants do not maintain a fixed feeding schedule, we monitored cyclosporine levels in breast milk at different times of the day to assess the safety of breast milk for infants throughout the day.

Case presentation
A 32-year-old dichorionic twin-pregnancy woman had nephrotic syndrome with renal biopsy confirmed type V lupus nephritis for over five years. She was treated only with prednisone 10 mg a day before pregnancy and during early pregnancy. Cyclosporine was added in her regimen from 22 weeks gestation and was adjusted to 225 mg a day from 28 weeks gestation. After parturition, she partially breastfed her twin infants while being treated with cyclosporine 3 mg/kg a day as well as prednisone and hydroxychloroquine sulfate. The cyclosporine level in maternal blood was determined, and several breast milk samples were collected for consecutive 48 h beginning on the ninth day after parturition. The concentration of cyclosporine in breast milk was measured and ranged from 0.443 to 5.307 mcg/L. Both infants grew and developed normally at the three-month follow-up, with no adverse effects observed. The study was conducted at West China Second University Hospital of Sichuan University, started in September 2021, with the consent of the participant and the approval of the ethics committee.

Conclusion
In this case, cyclosporine levels in breast milk were low at all times of the day. The growth and development of both infants were normal at three months postpartum. Thus, breastfeeding may still be an option for mothers with nephrotic syndrome who are treated with cyclosporine.
Children with a rare congenital genetic disorder: a systematic review of parent experiences
Authors: von der Lippe Charlotte , Neteland Ingrid , Feragen Kristin Billaud 
Published: October 2022

Abstract
Background
Caring for a child with a chronic disease may be demanding and stressful. When a child has a rare condition, the impact of care on parents is amplified due to the rarity of the diagnosis. In order to address the lack of generalized and synthesized knowledge regarding parents’ experiences of having a child with a rare genetic disorder, and give a holistic picture of these experiences, a systematic review of the available qualitative research was conducted.

Methods
We performed a systematic review, including qualitative studies on parents of children with rare genetic disorders, published between 2000 and 2020.

Results
The review included 33 qualitative studies. Findings were synthesized and categorized according to three main themes: Parents’ experiences with health care, Responsibilities and challenges, and Factors promoting positive experiences in parents. The findings demonstrate that parents of children with rare genetic disorders share many common challenges, despite evident differences across conditions.

Conclusion
Coordinated care, and a more holistic approach in the follow up of children with rare genetic disorders is needed. International collaboration on research, diagnostics, producing scientific correct and understandable information available for health care professionals and lay people should be prioritized.
Pearson syndrome: a multisystem mitochondrial disease with bone marrow failure
Authors: Yoshimi Ayami , Ishikawa Kaori , Niemeyer Charlotte , Grünert Sarah C. 
Published: October 2022

AbstractPearson syndrome (PS) is a rare fatal mitochondrial disorder caused by single large-scale mitochondrial DNA deletions (SLSMDs). Most patients present with anemia in infancy. Bone marrow cytology with vacuolization in erythroid and myeloid precursors and ring-sideroblasts guides to the correct diagnosis, which is established by detection of SLSMDs. Non hematological symptoms suggesting a mitochondrial disease are often lacking at initial presentation, thus PS is an important differential diagnosis in isolated hypogenerative anemia in infancy. Spontaneous resolution of anemia occurs in two-third of patients at the age of 1–3 years, while multisystem non-hematological complications such as failure to thrive, muscle hypotonia, exocrine pancreas insufficiency, renal tubulopathy and cardiac dysfunction develop during the clinical course. Some patients with PS experience a phenotypical change to Kearns-Sayre syndrome. In the absence of curative therapy, the prognosis of patients with PS is dismal. Most patients die of acute lactic acidosis and multi-organ failure in early childhood. There is a great need for the development of novel therapies to alter the natural history of patients with PS.
Bridging therapeutic opportunities: a survey by the Italian molecular tumor board workgroup of Alliance Against Cancer
Authors: Ciliberto Gennaro , Canfora Marco , Terrenato Irene , Agnoletto Chiara , Agustoni Francesco , Amoroso Loredana , Baldassarre Gustavo , Curigliano Giuseppe , Delmonte Angelo , De Luca Antonella , Fiorentino Michelangelo , Gregorc Vanesa , Ibrahim Toni , Lazzari Chiara , Mastronuzzi Angela , Pronzato Paolo , Santoro Armando , Scambia Giovanni , Tommasi Stefania , Vingiani Andrea , Giacomini Patrizio , De Maria Ruggero 
Published: October 2022

Abstract
Background
Molecular tumor boards (MTBs) match molecular alterations with targeted anticancer drugs upon failure of the available therapeutic options. Special and local needs are most likely to emerge through the comparative analysis of MTB networks, but these are rarely reported. This manuscript summarizes the state-of-art of 16 active Italian MTBs, as it emerges from an online survey curated by Alliance Against Cancer (ACC).

Main text
Most MTBs (13/16) are exclusively supported through local Institutional grants and meet regularly. All but one adopts a fully virtual or a mixed face-to-face/virtual calling/attendance meeting model. It appears that the ACC MTB initiative is shaping a hub-and-spoke virtual MTB network reminiscent of non-redundant, cost-effective healthcare organization models. Unfortunately, public awareness of MTB opportunities presently remains insufficient. Only one center has a website. Dedicated e-mail addresses are for the exclusive use of the MTB staff. More than half of ACC members consider a miscellanea of most or all solid and hematological malignancies, and more than one-third consider neoplasms arising at any anatomical location. The average number of Staff Members in MTBs is 9. More than 10 staff members simultaneously attend MTB meetings in 13 MTBs. A medical oncologist is invariably present and is in charge of introducing the clinical case either with (45%) or without previous discussion in organ-specific multidisciplinary Boards. All but two MTBs take charge of not only patients with no standard-of-care (SoC) therapy option, but also cases receiving NGS profiling in SoC settings, implying a larger number of yearly cases. All MTBs run targeted NGS panels. Three run whole-exome and/or RNAseq approaches. ESCAT-ESMO and/or Onco-KB levels of evidence are similarly used for diagnostic reporting. Most MTBs (11) provide a written diagnostic report within 15 days. Conclusions are invariably communicated to the patient by the medical oncologist.

Conclusions
MTB networking is crucial not only for molecular diagnosis and therapy assignment, but also for healthcare governance. Survey results show that MTBs review therapeutic opportunities at the crossover between standard-of-care with off-label, the former task being much beyond their scope. Societal and scientific implications of this beyond-the-scope MTB function may be relevant for healthcare in Italy and abroad.