bluuebunny/crossref_metadata_2025_split huggingface dataset:
Vanilla bisquits and lobola bridewealth: parallel discourses on early pregnancy and schooling in rural Zambia
Authors: Blystad Astrid , Moland Karen Marie , Munsaka Ecloss , Sandøy Ingvild , Zulu Joseph 
Published: October 2020

AbstractBackgroundAdolescent pregnancy is a complex socio-economic phenomenon ranking high on the global health policy agenda. Early childbearing is associated with early marriage and school drop-out, and is defined as a problem to the health and development of girls. This paper reports from formative research. The formative research aimed to explore socio-cultural and structural dynamics at work behind early pregnancy and school drop out in rural Zambia. The study findings have been used to inform a school based intervention to reduce early pregnancy (RISE: ‘Research Initiative to Support the Empowerment of Girls’). Theoretically the study is informed by social constructionism.MethodsA qualitative approach was employed. Semi-structured qualitative interviews (61) and focus group discussions (7) were carried out with girls (in and out of school), boys, parents, teachers, health workers and community- and district leaders in 2014–15. Systematic text condensation was drawn upon in the analysis of the material.ResultsThe study findings indicate that the official Zambian discourse that presents early pregnancy as a serious challenge and schooling as the prime way to confront the problem enjoy substantial support at community levels. However, a parallel discourse on fertility, early marriage and childbearing as social and economic security surfaced and was articulated by the same study participants. The latter contrasting discourse questioned schooling as the only solution to secure a girl’s future arguing that there are many reasons why early pregnancy may emerge as rational.ConclusionsGrasping the complexity of local discourse is vital in planning health interventions. The present study revealed that although delayed child bearing and schooling among girls enjoyed high status and legitimacy in the study area, the social and economic context worked to reward early marriage. Interventions to reduce early pregnancies in rural Zambian communities need to fundamentally address the material constraints that condition and reinforce a culture of early childbearing.
Propensity for COVID-19 severe epidemic among the populations of the neighborhoods of Fortaleza, Brazil, in 2020
Authors: Braga Jose Ueleres , Ramos Alberto Novaes , Ferreira Anderson Fuentes , Lacerda Victor Macêdo , Freire Renan Monteiro Carioca , Bertoncini Bruno Vieira 
Published: October 2020

Abstract
Background
The state of Ceará (Northeast Brazil) has shown a high incidence of coronavirus disease (COVID-19), and most of the cases that were diagnosed during the epidemic originated from the capital Fortaleza. Monitoring the dynamics of the COVID-19 epidemic is of strategic importance and requires the use of sensitive tools for epidemiological surveillance, including consistent analyses that allow the recognition of areas with a greater propensity for increased severity throughout the cycle of the epidemic. This study aims to classify neighborhoods in the city of Fortaleza according to their propensity for a severe epidemic of COVID-19 in 2020.

Methods
We conducted an ecological study within the geographical area of the 119 neighborhoods located in the city of Fortaleza. To define the main transmission networks (infection chains), we assumed that the spatial diffusion of the COVID-19 epidemic was influenced by population mobility. To measure the propensity for a severe epidemic, we calculated the infectivity burden (ItyB), infection burden (IonB), and population epidemic vulnerability index (PEVI). The propensity score for a severe epidemic in the neighborhoods of the city of Fortaleza was estimated by combining the IonB and PEVI.

Results
The neighborhoods with the highest propensity for a severe COVID-19 epidemic were Aldeota, Cais do Porto, Centro, Edson Queiroz, Vicente Pinzon, Jose de Alencar, Presidente Kennedy, Papicu, Vila Velha, Antonio Bezerra, and Cambeba. Importantly, we found that the propensity for a COVID-19 epidemic was high in areas with differing socioeconomic profiles. These areas include a very poor neighborhood situated on the western border of the city (Vila Velha), neighborhoods characterized by a large number of subnormal agglomerates in the Cais do Porto region (Vicente Pinzon), and those located in the oldest central area of the city, where despite the wealth, low-income groups have remained (Aldeota and the adjacent Edson Queiroz).

Conclusion
Although measures against COVID-19 should be applied to the entire municipality of Fortaleza, the classification of neighborhoods generated through this study can help improve the specificity and efficiency of these measures.
Identifying community physical activity and health resources for treatment of back pain by utilizing members of a physical activity network
Authors: Sedney Cara L. , Haggerty Treah , Zizzi Samuel , Dekeseredy Patricia 
Published: October 2020

Abstract
Background
Back pain is one of the leading causes of health care expenditure in the US and is linked to an increased body mass index. Many evidence-based modalities for the prevention and treatment of back pain closely mirror recommendations for weight loss and include physical activity and health maintenance activities (PAHM). The primary aim of this study was to ascertain community assets, and perceptions of the use of PAHM in the treatment of back pain by West Virginia Physical Activity Network (WVPAN) members.

Methods
Participants for the study were recruited from the West Virginia Physical Activity Network. This grassroots organization is filled with volunteers from various sectors who were recruited from various workshops, conferences, or coalition meetings over a period of several years. This network was purposely selected as the study population because of the statewide reach and their familiarity with resources in their local communities. A brief survey instrument was designed to gather their scaled perceptions about various treatment modalities related to back pain, and to gather their local knowledge related to specific providers in their communities. In addition, participants were given a free text box to list any local assets or resources for the nine treatments listed, and county of residence, and the nature of their connection to the physical activity network. Descriptive analyses were used to describe overall patterns of survey data. The qualitative data were compiled manually by the research team to show themes of specific treatments mentioned across different parts of the state.

Results
Participants overwhelmingly supported physical therapy, flexibility training, yoga, and core strengthening as treatments for back pain. The majority of respondents were “undecided” about other treatments such as cognitive behavioral therapies and acupuncture.

Conclusions
The implementation of PAHM interventions in communities could help treat patients with back pain, and may reduce reliance on the pharmacological treatment for back pain. The current study’s data support the potential of such approaches in many West Virginia counties. Also, local resources, and context can be gleaned from community leader surveys utilizing previously developed infrastructure for PAHM promotion.
Home-based screen time behaviors amongst youth and their parents: familial typologies and their modifiable correlates
Authors: Arundell Lauren , Parker Kate , Timperio Anna , Salmon Jo , Veitch Jenny 
Published: October 2020

Abstract
Background
Excessive screen time behaviors performed by children and parents at home is a major public health concern. Identifying whether child and parent screen time behaviors cluster and understanding correlates of these familial clusters can help inform interventions for the whole family. This study characterized familial typologies of screen time behaviors and identified key modifiable correlates of these typologies.

Methods
Parents participating in the cross-sectional Sitting in the Home (SIT) study reported the duration (mins/day) they and their child (aged 11.2 ± 2.62 years) spent in six screen time behaviors at home (computer/laptop for home/work, computer/laptop for leisure, TV/videos/DVDs, tablet/smart phone for home/work, tablet/smart phone for leisure, and electronic games) and completed items related to 21 potential correlates framed by an adapted Social Cognitive Theory, Family Perspective. Latent Class Analysis was used to identify typologies based on parent and child data for the six behaviors. Multinomial logistic regression analysis assessed the relative risk of typology membership for each potential correlate, adjusting for child and parent age and sex.

Results
The sample comprised 542 parent-child dyads (parents: 40.7 ± 6.3 yrs., 94% female; children: 11.2 ± 2.6 yrs., 46% female). Three typologies were identified: 1) high computer/moderate TV (n = 197); 2) high TV/tablet/smartphone, low computer (n = 135); and 3) low-screen users (n = 210). ‘Low-screen users’ spent the least amount of time in all screen time behaviors (assigned as reference category). Greater child preference for screen time behaviors, parental support for screen time behaviors and frequency of homework requiring a tablet/laptop were associated with higher odds of being in the ‘high computer/moderate TV’ typology. The odds of being in the ‘high TV/tablet/smartphone, low computer’ typology were greater amongst children with a higher preference for screen time behaviors, and lower among more active parents.

Conclusions
Three familial typologies of screen time behaviors were identified. The findings highlight that screen time in the home can be influenced by the home environment, parental behaviours and role modelling, child preferences as well as school policies. Findings can inform the development of family screen time interventions, however more research exploring the influence of factors outside of the home is warranted.
Years of life lost due to premature death and their trends in people with malignant neoplasm of female genital organs in Shanghai, China during 1995–2018: a population based study
Authors: Luo Zheng , He Yuan , Ma Guifen , Deng Yang , Chen Yichen , Zhou Yi , Xu Xiaoyun , Li Xiaopan , Du Yan 
Published: October 2020

Abstract
Background
The increasing aging population has been posing a significant challenge to disease burden in developing countries. In particular, the contribution of population aging to and long term changes of disease burden of malignant neoplasm of female genital organs (MNFGO) have not been quantitatively demonstrated.

Methods
Data were collected from the Shanghai Vital Statistics System of Pudong New Area (PNA). Crude mortality rate (CMR), age-standardized mortality rate by Segi’s world standard population (ASMRW), and years of life lost (YLL) of MNFGO as the underlying cause of death in age and pathology types from 1995 to 2018 were calculated. The joinpoint regression was used to estimate the trends of those rates by identifying the annual percent changes (APCs), and the decomposition method was used to calculate the increased rates and the contribution resulting from demographic and non-demographic factors.

Results
From 1995 to 2018, a total of 2869 MNFGO-specific deaths were reported in PNA, accounting for 0.64% of the total deaths. The CMR and ASMRW of MNFGO were 9.23/105 person-years and 4.80/105 person-years, respectively. Ovary cancer was the most common cause of MNFGO death, accounting for 43.9% (1260/2869) of all MNFGO death. Other common causes of MNFGO death included cervix uteri cancer, uterus unspecified cancer, and corpus uteri cancer. With the increase of age, the mortality rate of MNFGO in residents had shown an upward trend ([APC (95%CI) = 3.46 (2.74, 4.18), P < 0.001)] for each five-year age group from 0 to 4 to 85+ years. From 1995 to 2018, YLL of MNFGO in Shanghai PNA was 42,152.82 years, and the rate of YLL was 135.56 /105. The top three MNFGO types in YLLs were ovary cancer, cervix uteri cancer and uterus unspecified cancer. Demographic factors contributed significantly to the upward trends of CMR, ASMRW, and YLL rates of MNFGO.

Conclusion
With aggravated population aging in Shanghai, MNFGO is and will continue to be a serious threat to women’s health. More precise and effective prevention strategies are needed to target high risk population, to achieve efficient health resource allocation and to improve women’s health in particular.
Incidence and risk factors of symptomatic knee osteoarthritis among the Chinese population: analysis from a nationwide longitudinal study
Authors: Ren Yan , Hu Jiang , Tan Jing , Tang Xiaoming , Li Qianrui , Yang Huazhen , Liu Chunrong , He Qiao , Zou Kang , Sun Xin , Tan Bo 
Published: October 2020

AbstractBackgroundKnee osteoarthritis (OA) is a common disease condition associated with aging and a frequent cause of primary care consultations. Few longitudinal studies have been conducted to investigate the incidence of symptomatic knee osteoarthritis (OA) and to identify its risk factors among the Chinese population.MethodsThe China Health and Retirement Longitudinal Study (CHARLS) is a nationwide longitudinal survey of persons aged ≥45 years. Symptomatic knee OA was diagnosed when both self-reported knee pain and self-reported physician-diagnosis arthritis existed. Using the national survey data collected from the CHARLS, we estimated the incidence of symptomatic knee OA, taking into account the complex survey design and response rate. We applied weighted logistic regression analysis to identify its risk factors.ResultsIn the 4-year follow-up, the cumulative incidence of symptomatic knee OA among middle-aged and older Chinese adults was 8.5%; the incidence was higher among females (11.2%) than males (5.6%). Female (odds ratio (OR) 1.98 [95% confidence interval (CI) 1.65–2.37]), rural area (OR 1.32 [95% CI 1.08–1.60]), and West region (OR 2.33 [95% CI 1.89–2.87]) were associated with a higher risk of incident symptomatic knee OA. Physical activities (OR 0.47 [95% CI 0.29–0.76]) and high education level (OR 0.60 [95% CI 0.41–0.88]) was associated with a lower risk of incident symptomatic knee OA, while histories of heart disease (OR 1.40 [95% CI 1.07–1.82]), kidney disease (OR 1.80 [95% CI 1.35–2.39]), and digestive disease (OR 1.54 [95% CI 1.30–1.82]) were associated with a higher risk of incident symptomatic knee OA.ConclusionThe cumulative incidence of symptomatic knee OA over 4 years was relatively high, and varied by province and region. Lack of physical activities was confirmed to be risk factors of incident symptomatic knee OA. The presence of heart disease, kidney disease, and digestive disease may be associated with a higher risk of incident symptomatic knee OA, further research need to confirm these findings.
A narrative review of economic constructs in commonly used implementation and scale-up theories, frameworks and models
Authors: Vicki Brown , Huong Tran , Miranda Blake , Rachel Laws , Marj Moodie 
Published: October 2020

AbstractBackgroundTranslating research evidence into practice is challenging and, to date, there are relatively few public health interventions that have been effectively and cost-effectively implemented and delivered at scale. Theories, models and frameworks (herein termed ‘frameworks’) have been used in implementation science to describe, guide and explain implementation and scale-up. While economic constructs have been reported as both barriers and facilitators to effective implementation and scale-up of public health interventions, there is currently no published review of how economic constructs are considered within commonly used implementation and scale-up frameworks. This paper aimed to narratively review the economic constructs incorporated in commonly used implementation and scale-up frameworks.MethodsFrameworks for inclusion in the narrative review were identified from the literature and thematic content analysis was undertaken using a recursive deductive approach. Emergent key themes and sub-themes were identified and results were summarised narratively within each theme.ResultsTwenty-six framework publications were included in our analysis, with wide variation between frameworks in the scope and level of detail of the economic constructs included. Four key themes emerged from the data – ‘resources’, ‘benefit’, ‘cost’ and ‘funding’. Only five frameworks incorporated all four identified key themes. Overarching lenses from which to consider key themes included ‘stakeholder perspectives’, ‘stage in the research translation process’ and ‘context’. ‘Resources’ were most frequently considered in relation to the sub-themes of ‘types of resources’ (e.g. labour, time or infrastructure) and ‘availability’ of resources, and the opportunity for ‘economies of scale’. The ‘relative advantage of interventions’ emerged as an interconnecting sub-theme between ‘cost’ and ‘benefit’. ‘Funding’ was most often considered in relation to ‘funding sources’, ‘availability’, ‘sustainability’ or ‘contextual impact’. The concept of ‘opportunity cost’ was considered in relatively few frameworks, despite being fundamental to economic theory.ConclusionsImplementation and scale-up frameworks provide a conceptual map to inform the effective and cost-effective implementation of public health interventions delivered at scale. Despite evidence of an emerging focus on the economic considerations of implementation and scale-up within some commonly used frameworks, our findings suggest that there is significant scope for further exploration of the economic constructs related to implementation and scale-up.
The use of augmented antibiotic-loaded cement spacer in periprosthetic joint infection patients with acetabular bone defect
Authors: Fu Jun , Xiang Yi , Ni Ming , Chen Jiying , Li Xiang , Yu Baozhan , Liu Kan , Zhou Yonggang , Hao Libo 
Published: October 2020

Abstract
Background
Spacer complications may affect final clinical outcome of the two-stage approach in periprosthetic joint infection (PJI) patients. This study aimed to investigate clinical outcomes and complications of augmented antibiotic-loaded cement spacer in PJI patients with acetabular bone defect.

Methods
Data on PJI patients with acetabular bone defect receiving two-stage revision from January 2009 to December 2016, in our hospital were retrospectively reviewed. Screw-cement-shell was used to improve the stability of the hip with acetabular wall defect. Handmade acetabular spacer could prevent femoral spacer entering into pelvis in patients with acetabular internal wall defect. A total of 26 patients (11 males and 15 females) were included in the current study. Their mean age was 46.7 ± 15.4 years old. Clinical outcomes and complications were measured.

Results
Twenty-one of total 26 hips (21/26, 80.8%) showed positive cultures and 15/26 (57.7%) samples were cultured with staphylococcus. Of enrolled patients, 5/26 (19.2%) developed mixed infection. There was one patient (3.8%) with spacer dislocation and two (7.7%) with spacer fracture. One patient developed acute PJI 5 years after the second-stage revision, so overall success rate among these patients was 96.2%. Differences in Paprosky classifications before the first and second stage did not reach significant level (p > 0.05). Hip Harris score was raised from 40.9 ± 14.0 to 81.2 ± 11.2 (p < 0.05).

Conclusions
Augmented antibiotic-loaded cement spacer could achieve satisfactory clinical outcomes in PJI patients with acetabular bone defect. It provided joint mobility, increased additional joint stability, and decreased iatrogenic bone defect caused by acetabular wear.
Mitral valve repair for degenerative mitral regurgitation in patients with left ventricular systolic dysfunction: early and mid-term outcomes
Authors: Li Jun , Zhao Yun , Zhou Tianyu , Wang Yongshi , Zhu Kai , Zhai Junyu , Sun Yongxin , Lai Hao , Wang Chunsheng 
Published: October 2020

Abstract
Background
This study aims to evaluate the early and mid-term outcomes of mitral valve repair for degenerative mitral regurgitation (MR) in patients with left ventricular systolic dysfunction.

Methods
From January 2005 to December 2016, the profiles of patients with degenerative MR who underwent mitral valve repair at our institution were analyzed. Left ventricular systolic dysfunction was defined as an ejection fraction < 60% or left ventricular end-systolic dimension > 40 mm. Finally, 322 patients with left ventricular systolic dysfunction were included in this study. The prognosis of left ventricular function during follow-up was evaluated and preoperative factors associated with deteriorated left ventricular systolic function during follow-up were analyzed.

Results
The in-hospital mortality rate was 1.6%. The rate of eight-year overall survival, freedom from reoperation for mitral valve and freedom from recurrent MR were 96.9, 91.2 and 73.4%, respectively. Intraoperative residual mild MR (hazard ratio 4.82) and an isolated anterior leaflet lesion (hazard ratio 2.48) were independent predictive factors for recurrent MR. During follow-up, 212 patients underwent echocardiography examinations at our institution. Among them, 132 patients had improved left ventricular systolic function, and 80 patients had deteriorated left ventricular systolic. Freedom from recurrent MR was found in 75.9% of the improved left ventricular systolic function group and 56.2% of the deteriorated left ventricular systolic function group (P = 0.047). An age > 50 years (odds ratio 2.40), ejection fraction≤52% (odds ratio 2.79) and left ventricular end-systolic dimension≥45 mm (odds ratio 2.31) were independent risk factors for deteriorated left ventricular systolic function during follow-up.

Conclusions
Mitral valve repair could be safely performed for degenerative MR in patients with left ventricular systolic dysfunction. Intraoperative residual mild MR and an isolated anterior leaflet lesion were independent predictive factors for recurrent MR. An age > 50 years, ejection fraction≤52% and left ventricular end-systolic dimension≥45 mm were independent risk factors for deteriorated left ventricular systolic function during follow-up.
Cost-effective treatment of ocular surface squamous neoplasia for an undocumented and uninsured New York City patient: a case report
Authors: Saffra Norman A. , Emborgo Trisha S. , Iacob Codrin E. , Kirsch David S. 
Published: October 2020

AbstractBackgroundNew York City has a heterogeneous population with many undocumented and uninsured immigrants from equatorial areas who have a higher incidence of ocular surface squamous neoplasia. To the best of our knowledge, this is the first documented selection of this cost-effective treatment of ocular surface squamous neoplasia (the use of absolute ethanol along the corneal margin, primary excision, double freeze-thaw cryopexy, and primary conjunctival closure) for an undocumented and uninsured New York City patient.Case presentationA 35-year-old man from Ecuador presented to a New York City emergency department due to worsening discomfort of a long-standing left eye pterygium. A slit-lamp examination of the left eye demonstrated a nasally located conjunctival mass measuring 6 × 8 mm extending onto the cornea (3 mm superiorly and 6 mm inferiorly on the cornea). Histological diagnosis confirmed squamous cell carcinomain situarising from the pterygium. Surgical excision with adjunctive absolute alcohol with additive double freeze-thaw cryopexy was performed. Our patient has remained free of tumor recurrence at year 2 postoperative visit.ConclusionsOur case highlights the need to choose a cost-effective treatment for ocular surface squamous neoplasia in an at-risk population among undocumented and uninsured patients. Areas in the world with similar types of populations or treatment challenges may need to consider this approach as a primary treatment option.