bluuebunny/crossref_metadata_2025_split huggingface dataset:
Perceptions of online informational social support among mothers in a lactation-focused virtual community: A survey study
Authors: Munyan Kristen , Kennedy Erin 
Published: September 2022

Background: Peer support, also described as woman-to-woman support, has been well established as an effective intervention for overcoming barriers to breastfeeding duration. To access support and receive information, mothers are likely to access social media platforms, especially given the challenges to healthcare access presented by the COVID-19 pandemic. Previous research has established that virtual communities can promote peer-to-peer support similar to that seen in communities of practice. Research Aim: The aims of this study were to describe levels of perceived informational social support among mothers in an online virtual community and to determine which features of the virtual community were perceived most favorably by breastfeeding mothers. Methods: The study design was a cross-sectional survey of members of an existing social media community of breastfeeding mothers with use of the Online Social Support Scale–Informational subscale, Breastfeeding Self-Efficacy Short Form, and additional open-ended questions during the early phases of the COVID-19 pandemic. Participants were recruited within a single, lactation-focused virtual community that was moderated by lactation support professionals. Results: In regard to online social support specific to information seeking, the reported social support was moderate to high (M = 35.53, range = 17–48). Most items had a score average of approximately 3, indicating that participants perceived informational support “Pretty often” from their group interactions. Participants in this study had an average Breastfeeding Self-Efficacy–Short Form score of 57.91, indicating a moderately high level of breastfeeding self-efficacy. Content analysis of open-ended items regarding favorable characteristics of the virtual community indicated participants appreciated the immediacy of feedback and the presence of lactation support professionals within the community. Conclusion: Mothers in the lactation professional-led virtual community perceived moderately high support in health information seeking and experienced moderately high breastfeeding self-efficacy. Additional work is needed to determine the impact of participation in virtual communities on breastfeeding outcomes.
Intraductal fully covered self-expanding metal stents in the management of post-liver transplant anastomotic strictures: a UK wide experience
Authors: Ahmed Wafaa , Kyle Dave , Khanna Amardeep , Devlin John , Reffitt David , Zeino Zeino , Webster George , Phillpotts Simon , Gordon Robert , Corbett Gareth , Gelson William , Nayar Manu , Khan Haider , Cramp Matthew , Potts Jonathan , Fateen Waleed , Miller Hamish , Paranandi Bharat , Huggett Matthew , Everett Simon M. , Hegade Vinod S. , O’Kane Rebecca , Scott Ryan , McDougall Neil , Harrison Phillip , Joshi Deepak 
Published: September 2022

Background: Fully covered intraductal self-expanding metal stents (IDSEMS) have been well described in the management of post-liver transplant (LT) anastomotic strictures (ASs). Their antimigration waists and intraductal nature make them suited for deployment across the biliary anastomosis. Objectives: We conducted a multicentre study to analyse their use and efficacy in the management of AS. Design: This was a retrospective, multicentre observational study across nine tertiary centres in the United Kingdom. Methods: Consecutive patients who underwent endoscopic retrograde cholangiopancreatography with IDSEMS insertion were analysed retrospectively. Recorded variables included patient demographics, procedural characteristics, response to therapy and follow-up data. Results: In all, 162 patients (100 males, 62%) underwent 176 episodes of IDSEMS insertion for AS. Aetiology of liver disease in this cohort included hepatocellular carcinoma ( n = 35, 22%), followed by alcohol-related liver disease ( n = 29, 18%), non-alcoholic steatohepatitis ( n = 20, 12%), primary biliary cholangitis ( n = 15, 9%), acute liver failure ( n = 13, 8%), viral hepatitis ( n = 13, 8%) and autoimmune hepatitis ( n = 12, 7%). Early AS occurred in 25 (15%) cases, delayed in 32 (20%) cases and late in 95 (59%) cases. Age at transplant was 54 years (range, 12–74), and stent duration was 15 weeks (range, 3 days–78 weeks). In total, 131 (81%) had complete resolution of stricture at endoscopic re-evaluation. Stricture recurrence was observed in 13 (10%) cases, with a median of 19 weeks (range, 4–88 weeks) after stent removal. At removal, there were 21 (12%) adverse events, 5 (3%) episodes of cholangitis and 2 (1%) of pancreatitis. In 11 (6%) cases, the removal wires unravelled, and 3 (2%) stents migrated. All were removed endoscopically. Conclusion: IDSEMS appears to be safe and highly efficacious in the management of post-LT AS, with low rates of AS recurrence.
The diagnostic accuracy of PIK3CA mutations by circulating tumor DNA in breast cancer: an individual patient data meta-analysis
Authors: Galvano Antonio , Castellana Luisa , Gristina Valerio , La Mantia Maria , Insalaco Lavinia , Barraco Nadia , Perez Alessandro , Cutaia Sofia , Calò Valentina , Bazan Russo Tancredi Didier , Francini Edoardo , Incorvaia Lorena , Mirisola Mario Giuseppe , Vieni Salvatore , Rolfo Christian , Bazan Viviana , Russo Antonio 
Published: September 2022

Background: The circulating tumor DNA (ctDNA) diagnostic accuracy for detecting phosphatidylinositol 4,5-bisphosphate 3-kinase catalytic subunit alpha ( PIK3CA) mutations in breast cancer (BC) is under discussion. We aimed to compare plasma and tissue PIK3CA alterations, encompassing factors that could affect the results. Methods: Two reviewers selected studies from different databases until December 2020. We considered BC patients with matched tumor tissue and plasma ctDNA. We performed meta-regression and subgroup analyses to explore sources of heterogeneity concerning tumor burden, diagnostic technique, sample size, sampling time, biological subtype, and hotspot mutation. Pooled sensitivity, specificity, positive likelihood ratio (PLR), negative likelihood ratio (NLR), diagnostic odds ratio (DOR), and the related area under the curve (AUC) were elaborated for the overall population and each subgroup. Results: The pooled analysis was carried out on 25 cohorts for a total of 1966 patients. The overall ctDNA sensitivity and specificity were 0.73 (95% CI: 0.70–0.77) and 0.87 (95% CI: 0.85–0.89). The AUC was 0.93. Pooled concordance, negative predictive value and positive predictive value values were 0.87 (95% CI: 0.82–0.92), 0.86 (95% CI: 0.81–0.90), and 0.89 (95% CI: 0.81–0.95) with pooled PLR, NLR, and DOR of 7.94 (95% CI: 4.90–12.86), 0.33 (95% CI: 0.25–0.45), and 33.41 (95% CI: 17.23–64.79), respectively. The pooled results consistently favored next-generation sequencing (NGS)- over polymerase chain reaction-based methodologies. The best ctDNA performance in terms of sensitivity, specificity, and AUC (0.85, 0.99, and 0.94, respectively) was observed in the low-time sampling subgroup (⩽18 days between tissue and plasma collection). Meta-regression and subgroup analyses highlighted sampling time as a possible major cause of heterogeneity. Conclusions: These findings reliably estimate the high ctDNA accuracy for the detection of PIK3CA mutations. A ctDNA-first approach for the assessment of PIK3CA mutational status by NGS may accurately replace tissue tumor sampling, representing the preferable strategy at diagnosis of metastatic BC in patients who present with visceral involvement and at least two metastatic lesions, primarily given low clinical compliance or inaccessible metastatic sites.
Uncontrolled blood pressure and contributing factors among patients with hypertension at outpatient care of Bedele General Hospital, Southwest Ethiopia: A cross-sectional study
Authors: Sheleme Tadesse , Jilo Oda , Bekele Firomsa , Olika Wayessa , Safera Birbirsa , Babu Yadeta 
Published: September 2022

Objective: This study aimed to assess uncontrolled blood pressure and contributing factors among patients with hypertension. Methods: Hospital-based cross-sectional study was conducted from January to April 2021 at Bedele General Hospital. Data were collected using the semi-structured questionnaire. All patients with hypertension were included using consecutive sampling technique unless ineligible. EpiData 4.4.2 was used for data entry, and SPSS 24.0 was employed for analysis. Binary logistic regression analysis was performed to identify factors associated with uncontrolled blood pressure. Results: A total of 219 patients with hypertension were included in the study. About 60.3% of participants were male. The mean age of the study participants was 48.54 ± 12.93 years. The prevalence of uncontrolled blood pressure among the study participants was 56.2%. The factors significantly associated with uncontrolled blood pressure were age >60 years (adjusted prevalence ratio = 4.42; 95% confidence interval = (1.71, 11.46); p = 0.002) and the presence of comorbidity (adjusted prevalence ratio = 2.16; 95% confidence interval = (1.22, 3.82); p = 0.008). Conclusion: More than half of the study participants had uncontrolled blood pressure. Older age and comorbidity were the predictors of uncontrolled blood pressure. Attaining controlled blood pressure is important to avoid consequences of high blood pressure. So, healthcare provider should focus on achieving target blood pressure goal.
Environmental and maternal factors shaping tonsillar microbiota development in piglets
Authors: Fredriksen Simen , Guan Xiaonan , Boekhorst Jos , Molist Francesc , van Baarlen Peter , Wells Jerry M. 
Published: September 2022

Abstract
Background
The palatine tonsils are part of the mucosal immune system and stimulate immune responses through M cell uptake sampling of antigens and bacteria in the tonsillar crypts. Little is known about the development of the tonsillar microbiota and the factors determining the establishment and proliferation of disease-associated bacteria such as Streptococcus suis. In this study, we assessed tonsillar microbiota development in piglets during the first 5 weeks of life and identified the relative importance of maternal and environmental farm parameters influencing the tonsillar microbiota at different ages. Additionally, we studied the effect sow vaccination with a bacterin against S. suis on microbiota development and S. suis colonisation in their offspring.

Results
Amplicon sequencing of the 16S rRNA gene V3-V4 region revealed that a diverse tonsillar microbiota is established shortly after birth, which then gradually changes during the first 5 weeks of life without a large impact of weaning on composition or diversity. We found a strong litter effect, with siblings sharing a more similar microbiota compared to non-sibling piglets. Co-housing in rooms, within which litters were housed in separate pens, also had a large impact on microbiota composition. Sow parity and prepartum S. suis bacterin vaccination of sows had weaker but significant associations with microbiota composition, impacting on the abundance of Streptococcus species before and after weaning. Sex and birthweight had limited impact on the tonsillar microbiota, and none of the measured factors had consistent associations with microbiota diversity.

Conclusions
The piglet tonsillar microbiota is established shortly after birth. While microbiota development is associated with both environmental and maternal parameters, weaning has limited impact on microbiota composition. Intramuscular vaccination of sows pre-partum had a significant effect on the tonsillar microbiota composition of their piglets. These findings provide new insights into the mechanisms shaping the tonsillar microbiota.
Correspondence to: performance of the new SmartCardia wireless, wearable oximeter: a comparison with arterial SaO2 in healthy volunteers
Authors: Barker Steven J. , Wilson William C. 
Published: September 2022

AbstractIn a recent publication in BMC Anesthesiology, Rincon, et al.present accuracy data for three pulse oximeters with sensors located at three different anatomic sites. Their results for the Masimo Radical with fingertip sensor are erroneous, and we present valid data here. Rincon, et al.show a Bias ± Precision of 2.02 ± 4.6, while the correct laboratory values are -0.01 ± 1.16. The most probable reason for these invalid data is that insufficient time was used at each saturation plateau to allow stabilization of SpO2 readings on a fingertip sensor. It has been shown in the literature that fingertip sensors require at least a full minute of stable oxygenation conditions before their readings will be the same as earlobe sensors.
Nonlinear relationship with saturation effect observed between neutrophil to high-density lipoprotein cholesterol ratio and atherosclerosis in a health examination population: a cross‐sectional study
Authors: Zhou Yaqing , Dan Haijun , Bai Long , Jia Limei , Lu Baojin , Cui Wei 
Published: September 2022

Abstract
Background
The relationships between inflammatory indexes and atherosclerosis as well as those between blood lipid indexes and atherosclerosis have been widely studied, but the relationship between the neutrophil to high-density lipoprotein cholesterol ratio (NHR) and atherosclerosis had not been investigated until the present study.

Methods
For this cross‐sectional study, we continuously collected data from a health examination population in the Second Hospital of Hebei Medical University from January 2012 to December 2017 (N = 1978). The collected data included clinical data, hematological indexes, and brachial-ankle pulse wave velocity (Ba-PWV). Atherosclerosis was defined as Ba-PWV ≥ 1400 cm/s. The relationship between the NHR and atherosclerosis was explored via univariate regression analysis, multivariate regression analysis, smoothing function analysis, and analysis of a threshold saturation effect.

Results
Among 1978 participants, the mean age was 54 years, 1189 participants (60.11%) were male, and 1103 (55.76%) had a history of atherosclerosis. Univariate analysis showed a positive association between the NHR and atherosclerosis [odds ratio (OR) = 1.19, 95% confidence interval (CI): 1.11–1.27, P < 0.01], and this positive association remained significant on multivariate analyses with adjustments for confounding factors (OR = 1.14, 95% CI: 1.06–1.24, P < 0.01). Generalized additive model results revealed a non-linear relationship with a saturation effect between the NHR and atherosclerosis, with a threshold at 3.32. At values ≤ 3.32, the NHR was positively associated with atherosclerosis, but the association was not statistically significant for values > 3.32.

Conclusion
A nonlinear relationship with a certain saturation effect was observed between the NHR and atherosclerosis in a health examination population.
Primary care physician responses to requests by older adults for unnecessary drugs: a qualitative study
Authors: Xu Zhijie , Lu Yiting , Liang Xujian , Ye Yuanqu , Wang Yang , Deng Zhiling , Xu Yuanyuan , Fang Lizheng , Qian Yi 
Published: September 2022

Abstract
Background
Unnecessary drug use can cause avoidable harm to older adults and is particularly common in primary care, but how primary care physicians (PCPs) respond to older adult requests for unnecessary drugs has not been well studied. This study is to explore PCPs’ responses to requests for unnecessary drugs from older adults, and their influencing factors and potential solutions.

Methods
This qualitative study was conducted through semi-structured, in-depth interviews from January 4 to September 30, 2020 using a grounded theory methodology. A purposive sample of PCPs affiliated with community healthcare centers in Zhejiang Province and Guangdong Province, China were recruited. The face-to-face interviews were audio-recorded, transcribed verbatim, and independently coded by two investigators. Themes surrounding PCPs’ responses to requests for unnecessary drugs, their influencing factors and potential solutions were analysed using a constant comparative approach.

Results
Of the 23 participants involved in this study, 12 (52%) were women and the mean age was 35 years. PCPs frequently declined older adults’ requests for unnecessary drugs through dissuasion, and occasionally rebuffed patients or referred them to another practitioner. PCPs may fulfill requests due to physician acquiescence, patient pressure, or inadequate supervision and support. Participants recommended four potential solutions to improve the quality of prescribing, including developing professional communication skills, enhancing pharmacist-physician collaboration, improving electronic prescription systems, and strengthening prescription management.

Conclusions
PCPs typically deny requests by older adults for unnecessary drugs according to three main patterns, and guidance is necessary to reduce the potential for adverse consequences. Factors contributing to request fulfillment by PCPs require attention, and the potential solutions recommended by participants deserve consideration to improve the service quality of prescribing for older adults in primary care practices.
Values of OAS gene family in the expression signature, immune cell infiltration and prognosis of human bladder cancer
Authors: Gao Lijuan , Ren Ruimin , Shen Jing , Hou Jiayi , Ning Junya , Feng Yanlin , Wang Meiyue , Wu Lifei , Sun Yaojun , Wang Huang , Wang Deping , Cao Jimin 
Published: September 2022

Abstract
Background
Bladder cancer (BLCA) is one of the most common genitourinary malignancies in the world, but its pathogenic genes have not been fully identified and the treatment outcomes are still unsatisfactory. Although the members of 2', 5'-oligoadenylate synthetase (OAS) gene family are known involved in some tumorous biological processes, the roles of the OAS gene family in BLCA are still undetermined.

Methods
By combining vast bioinformatic datasets analyses of BLCA and the experimental verification on clinical BLCA specimen, we identified the expressions and biological functions of OAS gene family members in BLCA with comparison to normal bladder tissues.

Results
The expression levels of OAS gene family members were higher in BLCA than in normal bladder tissues. The expression levels of most OAS genes had correlations with genomic mutation and methylation, and with the infiltration levels of CD4 + T cells, CD8 + T cells, neutrophils, and dendritic cells in the microenvironment of BLCA. In addition, high expressions of OAS1, OAS2, OAS3, and OASL predicted better overall survival in BLCA patients.

Conclusions
The highly expressed OAS genes in BLCA can reflect immune cells infiltration in the tumor microenvironment and predict the better overall survival of BLCA, and thus may be considered as a signature of BLCA. The study provides new insights into the diagnosis, treatment, and prognosis of BLCA.
Prognostic and clinicopathological significance of transcription factor c-Jun in hypopharyngeal squamous cell carcinoma: a 3-year follow-up retrospective study
Authors: Huang Qiang , Ye Min , Li Feiran , Lin Lan , Hu Chunyan 
Published: September 2022

Abstract
Purpose
To investigate the expression and prognostic value of c-Jun in hypopharyngeal squamous cell carcinoma (HPSCC).

Methods
A retrospective study was performed on a cohort of 99 HPSCC patients. The expression of c-Jun and phosphorylated-c-Jun (p-c-Jun) was evaluated via immunohistochemistry (IHC) staining. Overall survival (OS) and progression-free survival (PFS) were assessed using Kaplan–Meier method and multivariate Cox regression analysis.

Results
The high expression of c-Jun and p-c-Jun in HPSCC accounted for 60.61% and 16.16%, respectively. High expression of c-Jun was closely associated with cT stage (p = 0.0401), tumor size (p = 0.0276), number of lymph node metastases (p = 0.0205) and pathological differentiation (p = 0.0108). The expression of c-Junhigh (p = 0.0043), p-c-Junhigh (p = 0.0376) and c-Junhigh/p-c-Junhigh were closely associated with poor OS. The Cox proportional multivariate hazard model revealed that lymphovascular invasion and c-Jun expression were independent influencing factors of OS in HPSCC patients.

Conclusion
Our findings suggest that c-Jun is a reliable prognostic factors in HPSCC patients.
Profile of judicialization in access to antineoplastic drugs and their costs: a cross-sectional, descriptive study based on a set of all lawsuits filed between 2016 and 2018 in a state in the Northeast Region of Brazil
Authors: de Oliveira Fábio Henrique Cavalcanti , de Lorena Sobrinho José Eudes , da Cruz Gouveia Mendes Antônio , Gutman Haynne Magalhães Santos , Filho Geraldo Jorge , Montarroyos Ulisses Ramos 
Published: September 2022

Abstract
Background
The judicialization of the acquisition of medication for healthcare is not restricted to Brazil but can also be found in other Latin American countries, despite the existence of a universal health system in the case of Brazil, the Unified Health System (known as the SUS). Right-to-medicines litigation has existed ever since the emergence of a high demand for treatment of Acquired Immuno-deficiency Syndrome (AIDS) but the current focus is on cancer. Pharmaceutical Assistance (PA) is the area within the SUS that is responsible for ensuring access to medication and the aim of this article is thus to draw up a profile of litigation related to PA in one economically significant state in the Northeast Region of Brazil, in terms of the following characteristics of lawsuits: the plaintiff filing the lawsuit; medical and health information; the cost of acquiring the requested medications; and the proportion accounted for by spending on antineoplastic drugs.

Methods
A cross-sectional, descriptive study was conducted of lawsuits filed between 2016 and 2018 at the Litigation Center of the State of Pernambuco Department of Health.

Results
A total of 2,947 lawsuits containing at least one requested medication were analyzed. The majority of the plaintiffs were male (51.7%); 49.8% of the requests originated in the Unified Health System (SUS), and plaintiffs were primarily patients in the Metropolitan region of the State capital, Recife. The most frequent cancers involved were those classified by the ICD as C61, C71 and C50. The median general expense on medications for the actions was U$1,734.94. Considering antineoplastic drugs alone, the cost exceeded U$7,500 per lawsuit over the three years, given that the median unit price for antineoplastic drugs is approximately US$65 compared to US$4 for non-antineoplastic drugs.

Conclusion
The present study is of relevance to the field of public health and examines how a profile of such healthcare litigation can be used as a tool for managing and improving decision-making in times of economic austerity.