bluuebunny/crossref_metadata_2025_split huggingface dataset:
Rising and Falling Trends in Incidence Rates of Vulvar and Vaginal Cancers in the United States, 2000-2016
Authors: Yue Yang-yang , Zhou Wei-li , Pei Dong-mei 
Published: August 2020

Abstract
Background: Few studies focus on incidence trends in vulvar and vaginal by histological type, race, age, and region. We aimed to evaluate the temporal incidence trends and survival for the two cancers.Methods: Cases with primary vulvar or vaginal carcinoma from 2000-2016 were identified from the Surveillance, Epidemiology, and End Results 18 registries. Annual percent change (APC) and average APC (AAPC) were calculated to evaluated trends. Relative survival was estimated to compare survival outcomes.Results: Vulvar cancer incidence rates were highest among non-Hispanic whites (20.9 per 1,000,000 person-years) and in the Midwest (27.7), while vaginal cancer rates were highest among non-Hispanic blacks (8.2) and in the South (6.7). Overall, vulvar cancer rate increased 0.4% annually (AAPC, 0.4%; 95% CI, 0.1% to 0.6%), but vaginal cancer rate decreased 1.4% annually (AAPC, -1.4%; 95% CI, -2.0% to -0.5%). The increased vulvar cancer rate was only observed for squamous cell carcinoma (APC, 1.0%), while the decreased vaginal cancer rate was only observed for other malignancies (APC, -1.7%). Vulvar cancer rates increased only among whites (APC, 1.2%), but vaginal cancer rates decreased only among whites (AAPC, -1.3%) and Asians (APC, -2.7%). Vulvar cancer rates increased among patients aged 50-59 (APC, 1.1%), 60-69 (APC, 1.3%), and 70-79 (APC, 1.2%) years, while vaginal cancer rates decreased among patients aged 50-59 (APC, -1.4%) and 80 (APC, -1.4%) years or older. Overall, whites had the highest five-year relative survival for both vulvar (72.22%) and vaginal (49.03%) cancers. Conclusion: There were profound disparities in vulvar and vaginal cancer incidence rates attributable to histological type, race, age, and region. The increased vulvar cancer rates and the declined vaginal cancer rate highlights the importance of further studies to investigate the reason for the disparities.
Geospatial Inequality of Anemia Among Children in Ethiopia
Authors: Endris bilal , Dinant Geert-Jan , Gebreyesus Seifu Hagos , Spigt Mark 
Published: August 2020

Abstract
Background: Anemia remains a severe public health problem among children in Ethiopia. The lack of progress in the trend of anemia infers the failure of national anemia prevention and control programs. If there are considerable geospatial differences in the prevalence of anemia in Ethiopia, targeted approaches, based on the distribution and specific risk factors for that setting are needed to efficiently target health interventions. This study aimed to identify and locate anemia hotspots among children in Ethiopia. Methods: Data analysis was performed using Ethiopia Demographic and Health Survey (EDHS) 2016 Data. Blood specimens for anemia testing were collected from children age 6-59 months. Hemoglobin analyses were placed in a HemoCue photometer and the results were recorded onsite for 9,268 children. The outcome variable anemia was categorized into a dichotomous variable (anemic and not anemic); a child was considered as anemic if the blood-hemoglobin count was less than 11.0 g/dl. We applied Kulldorf’s spatial scan statistics and used SaTScanTM to identify locations and estimate cluster sizes. In addition, we ran LISA (local indicator of spatial association) and the Getis-Ord Gi(d) local statistics to detect and locate hotspots of anemia. We ran multilevel multivariable analysis to identify risk factors for anemia clustering.Result: More than half (57%) of children aged 6-59 months were anemic in Ethiopia. Higher prevalence of anemia was found among children who live in Somali region (83%), in rural area (58%), in the lowest wealth quintile (68%), and among children of mothers’ with no education (59%). We found significant geospatial inequality of anemia among children in Ethiopia. We identified one anemia cluster (hotspot) in the eastern part of Ethiopia. Women anemia, stunting and high fertility were associated with anemia clustering.Conclusion: Anemia clustering was found in the eastern part of Ethiopia. We recommend that policy makers and programmers should especially target this area for accelerated reduction of anemia.
Polarity- and molecular orbital-engineered host materials for stable and efficient blue thermally activated delayed fluorescence
Authors: Ihn Soo-Ghang , Jeong Daun , Kwon Eunsuk , Kim Sangmo , Chung Yeon Sook , Sim Myungsun , Chwae Jun , Koishikawa Yasushi , Jeon Soon Ok , Kim Jong Soo , Kim Joonghyuk , Nam Sungho , Choi Hyeonho , Kim Sunghan 
Published: August 2020

Abstract
To utilize thermally activated delayed fluorescence (TADF) technology for future displays, it is necessary to develop host materials that can harness the full potential of blue TADF emitters. We suggest an elaborative approach for designing host molecules for blue TADF devices with simultaneously improved efficiency and stability. We significantly enhanced the delayed fluorescence quantum yield by engineering the molecular geometry, polarity, and excited-state dipole moment of host molecules based on 3′,5-di(9H-carbazol-9-yl)-[1,1′-biphenyl]-3-carbonitrile. The engineerd hosts stabilized the charge-transfer excited states of TADF emitters, suppressed exciton quenching, and improved the charge balance in the emitting layer. Moreover, because the hosts are phosphine-oxide bond-free molecules, they are photochemically and electrochemically stable compared to bis[2-(diphenylphosphino)phenyl] ether oxide, the most popular high-polarity host. The devices employing the hosts exhibited a two-fold increase in external quantum efficiency and a 37-fold increase in operation lifetime compared to control devices with the same TADF emitter.
Factors Associated with Radiological Hip Joint Involvement in Patients with Ankylosing Spondylitis
Authors: Liu Wei , Song Hui , Man Siliang , Li Hongchao , Dong Peng 
Published: August 2020

Abstract
Background: The associated factors for hip involvement in patients with ankylosing spondylitis (AS) are poorly known. This study was to analyze the clinical data of patients with AS and to explore the potential associated factors of AS-related radiological hip joint.Methods: This was a cross-sectional study of patients diagnosed with AS and treated at the Beijing Jishuitan Hospital between 01/2013 and 12/2019. A BASRI-hip score ≥ 2 was defined as radiological hip joint involvement. Univariable and multivariable logistic regression analyses were performed to analyze the factors associated with radiological hip joint involvement.Results: A total of 350 AS patients were included. Patients with radiological hip joint involvement (BASRI-hip ≥2) accounted for 50.6% (177/350). The proportion of men was 83.7% (293/350). The mean age was 35.0±12.7 years old. The mean duration of the disease was 10.8±8.6 years. The HLA-B27 positive rate was 90.9% (318/350). The multivariable analysis showed that the juvenile onset (OR=4.955, 95%CI: 2.464-9.961, P<0.001), bone mass lower than peers (OR=2.862, 95%CI: 1.593-5.142, P<0.001), BMI <18.5 kg/m2 (OR=2.832, 95%CI: 1.321-6.069, P=0.007), BASFI (OR=1.278, 95%CI: 1.069-1.527, P=0.007), and continuous NSAIDs treatment (OR=0.400, 95%CI: 0.200-0.799, P=0.009) were independently associated with radiological hip joint involvement in patients with AS.Conclusion: AS with radiological hip joint involvement had worse body function and lower bone density. The associated factors with radiological hip joint involvement in AS patients included juvenile-onset, thin body size. The prognosis of patients with AS who received continuous NSAIDs drug treatment might be improved.
Prognosis of Probable Autoimmune Hepatitis Patients in a Retrospective Cohort Study
Authors: Fujita Koji , Oura Kyoko , Tadokoro Tomoko , Morishita Asahiro , Kobara Hideki , Tsutsui Kunihiko , Himoto Takashi , Masaki Tsutomu 
Published: August 2020

Abstract
Background: Autoimmune hepatitis (AIH) is an idiopathic inflammatory liver disease with genetic susceptibility and unknown environmental triggers, which results in failures of physiologic immunotolerance and destruction of the liver tissues. The gold standard for diagnosis is the International Autoimmune Hepatitis Group (IAIHG) scoring system: the disease is classified as definite or probable according to the scores. However, conventional research on probable AIH has focused on the Caucasian population and there is little data pertaining to the Asian population. Therefore, this study aimed to assess and compare the prognosis of Japanese patients with probable and definite AIH. Methods: Patients with probable and definite AIH diagnosed based on IAIHG scores between 1987 and 2018 were enrolled in this retrospective study. Results: Seventy-two patients with definite AIH and 49 patients with probable AIH were evaluated in the study. Univariate analysis revealed age, fibrosis stage 4, and the fibrosis-4 index were prognostic factors for overall survival. Multivariate analysis indicated that age and liver cirrhosis significantly affected the overall survival. When the cut off albumin-bilirubin score was set appropriately, cirrhosis was differentially diagnosed using albumin-bilirubin score with 100% sensitivity and 70.5% specificity. Classification of probable or definite disease did not alter overall survival with statistical significance. Conclusions: Our findings suggest that probable AIH should be managed as definite AIH is managed in Japanese population. The albumin-bilirubin score helps identify liver cirrhosis and is a prognostic biomarker for overall survival.
Medical Professionals Have Higher Risk for Colorectal Adenoma But Lower Risks for Reflux Esophagitis and Atrophic Gastritis: A Propensity Score-Based Analysis
Authors: Qiao Chen , Zhang Min , Li Zhen , Zuo Xiu-Li 
Published: August 2020

Abstract
Background: Previous studies had indicated that medical professionals’ lifestyles were not as healthy as recommended. Whether these lifestyles lead to higher incidences of gastrointestinal diseases is unknown. Objectives: To compare the incidences of gastrointestinal diseases between medical professionals and general populations. Methods: Subjects who underwent endoscopy examination for physical examination in Qilu Hospital from January 2017 to September 2019, were retrospectively reviewed. Propensity score based analysis was used to generate two age- and sex-matched groups, Medical Professional Group and General Population Group. The positive rates of gastrointestinal disorders in two groups, were analyzed by Pearson’s Chi-square test. Subgroup analysis within Medical Professional Group was performed to identify risk factors for medical staffs. Results: 1534 records were enrolled, 791 for gastroscope and 743 for colonoscope. Among upper gastrointestinal diseases, the detection rates of atrophic gastritis and reflux esophagitis showed significant differences, which were 19.8% in Medical Professional Group and 25.9% in General Population Group (p=.04) for atrophic gastritis, 4.0% in Medical Professional Group and 12.6% in General Population Group (p<0.001) for reflux esophagitis. Among the subjects who received colonoscopy, the adenoma detection rate of the Medical Professional Group (17.5%) was statistically distinguished from the General Population Group (11.5%) (p = .02). Conclusion: In a provincial comprehensive hospital in China, medical Professional Group has significantly higher risk for colorectal adenoma, but lower risks for atrophic gastritis and reflux esophagitis.
COVID-19 pandemic and self-reported symptoms of depression, anxiety, and stress among health care workers in Ethiopia
Authors: Jemal kemal , Senbeta Berhanu , Geleta Tinsae Abeya , Awol Mukemil 
Published: August 2020

Abstract
BackgroundThe Coronavirus Diseases 2019 (COVID-19) pandemic has become a major problem in many of the world nations including Ethiopia. Moreover, it is a public health emergency of the community concern and poses a mental health problem to health care workers (HCWs). Therefore, this study aimed to assess the level of self-reporting symptoms of depression, anxiety, and stress during the COVID-19 pandemic among healthcare workers in Ethiopia.MethodsAn institutional-based cross-sectional study was conducted using an online survey from June 25, 2020, to July 25, 2020, in Ethiopia. The data were collected using a self-reported Depression, Anxiety, and Stress Scale (DASS-21). Data were cleaned, coded, and entered using Epi info version 7.5.1 and exported for analyzed to the Social Science package software Version 23 Statistical Package. Moreover, multiple logistic regression analysis was used to identify the associated factors at p-value less than 0.05.ResultsA total of 816 HCWs responded to self-reporting questions. From HCWs who screened positive for depression, anxiety, and stress; 60.3%, 78%, and 33.8% of them had scored moderate to extremely severe symptoms of depression, anxiety, and stress respectively. Females, HCWs who working in Oromiya Specialized Zone, medical laboratory professionals, and HCWs who have working in the COVID-19 treatment isolation department were significantly associated with depression, anxiety, and stress.ConcussionIn this study, health care workers had reported a high prevalence of depression, anxiety, and stress symptoms. Female gender, Oromiya especial zone, medical laboratory professionals, and HCWs who have working in the COVID-19 treatment isolation centers were significantly associated with depression, anxiety, and stress. Psychological intervention for health care workers in central Ethiopia needs special attention.
Effect of Different Types of Modic Changes on Segmental Motion and Disc Degeneration in Cervical Spine
Authors: Zhang Fan , Wang Jin , Xu Haocheng , Lyu Feizhou 
Published: August 2020

Abstract
Background: Few studies have reported the segmental motion characteristics of different types of Modic changes (MCs) in the cervical spine in contrast to the lumbar spine. Considering the close relationship between MCs and disc degeneration (DD), this study is designed to elucidate the relationship of MCs with DD and DD-based angular motion in the cervical spine.Methods: MRI of C2/3~C6/7 from 594 patients were reviewed and those with MCs were selected and evaluated. MCs were defined as type 0, I, II, and III, and the grade of DD was classified from A to E (recorded from 1 to 5 points) as previously reported. DD score of each segment (sDD), total sDD of the entire cervical spine (tDD), and VAS score (neck pain) of each patient with MC were also recorded. Cervical lordosis (CL), C7 slope (C7S), segmental angular motion (sROM) and total angular motion of the entire cervical spine (tROM) were calculated from X-ray images.Results: Totally 135 MC segments were evaluated. In the two groups of DD D and DD E, the sROM of MC I and III segments are smaller than that of MC 0 segments, and the sROM of MC II segments are similar to that of MC 0. In addition, MC I segments present smaller sROM than that of MC II in the group of DD E, and their sROM are larger than that of MC III in the group of DD D. No difference is found in tROM between the patients with MC I, II and III. Our results also show that MC I and III segments are associated with high sDD and tDD scores. Finally, the patients with MC I have larger CL and C7S than those with MC III, and there is no statistical difference in VAS scores of neck pain between the patients with MC I, II and III. Conclusions: In the cervical spine, both MC I and III indicate decreased segmental angular motion and high disc degeneration grade. Cervical MCs may not be a sign of unstable neck pain or an indication for interbody fusion.
A Complex Intervention to Improve Intercultural Communication and Aboriginal Patient Outcomes: Which Components Worked?
Authors: Ralph Anna P , Kerrigan Vicki , Castillon Craig , Mithen Vincent , O'Connor Elise , Hansen Martin , Keilor Natasha , Aitken Robyn , Madrill Gail , Roman Curtis , Cass Alan 
Published: August 2020

Abstract
BackgroundAboriginal language interpreters are under-utilised in healthcare in northern Australia. Self-discharge from hospital is an adverse outcome occurring at high rates among Aboriginal people, with poor communication thought to be a contributor. We previously reported increased Aboriginal interpreter uptake and decreased rates of self-discharge during implementation of a 12-month hospital-based intervention. Interrupted time-series analysis showed sudden increase and up-trending improvement in interpreter use, and a corresponding decrease in self-discharge rates, during a 12-month intervention period (April 2018 - March 2019) compared with a 24-month baseline period (April 2016 – March 2018). This paper aims to explore reasons for these outcomes, and further explore the likelihood of a causal association between study activities and outcomes. MethodsWe used the ‘Template for Intervention Description and Replication’ (TIDieR) as a framework to describe intervention components and evaluate their relative importance. Information on intercurrent activities that may have contaminated study findings was reviewed. The relationship between proportion of hospital separations among Aboriginal people ending in self-discharge and numbers of Aboriginal interpreter bookings made during April 2016-March 2019 was tested using linear regression. ResultsOne full-time Aboriginal Interpreter Coordinator was employed for the intervention period who identified language needs, promoted interpreter use and mentored interpreters. The intervention period start date corresponded with commencement of this role. Three ‘Working with Interpreter’ training sessions were held during the intervention period reaching 83 clinicians, and three medical officers volunteered as champions of interpreter use in hospital practice. Employment of the Aboriginal Interpreter Coordinator was deemed the most important component of the intervention, based on reach compared to the other components and timing of the changes in outcomes. There was an inverse association between interpreter bookings and self-discharge rate among Aboriginal inpatients (p=0.02). This association, the timing of changes and assessment of intercurrent activities at the hospital indicated that the study intervention was likely to be casually related to the measured outcomes. ConclusionsCommunication in healthcare can be improved through targeted strategies, with associated improvements in patient outcomes. Health services with high interpreter needs would benefit from employing an interpreter coordinator.
A Cambodian-Norwegian Competence Building Program in Child Mental Health: A Qualitative Focus-Group Study
Authors: Hafting Marit , Pat Puthy , Aadland Gunn , Fjermestad Krister , Jegannathan Bhoomikumar 
Published: August 2020

Abstract
BackgroundThe prevalence of mental health and neurodevelopmental disorders in young people is high in low- and middle-income counties, such as Cambodia, as risk factors in the perinatal period, malnutrition, infections and adverse childhood experiences can be abundant due to poverty and/or conflict. Collaboration between institutions from high-income countries and institutions in resource-poor settings for professional development can improve service providers’ knowledge and skills, which is key to bridging the gap between service needs and the ability to meet those needs.MethodsA Norwegian team comprised of a pediatrician, a child and adolescent psychiatrist and a child psychologist implemented a participatory program for competence building at Centre for Child and Adolescent Mental Health in Cambodia (Caritas-CCAMH) two weeks per year over a 14-year period. Herein, we explore some aspects of this Cambodian-Norwegian collaboration from the perspective of the Caritas-CCAMH staff with a qualitative approach using thematic analysis of the transcripts from a focus-group interview with 11 staff members at the end of the 14-year period. Results The multidisciplinary team at Caritas-CCAMH described the learning process with the Norwegian team as a “meeting between experts” characterized by collaboration in planning and implementation, which enhanced the contextual relevance of the project. Mixing theory and practice in clinical case discussions with a bio-psycho-social perspective was perceived as the cornerstone of the pedagogical process. Learning by observation and supervision from the Norwegian team led to mastering skills and enhancing self-confidence and job satisfaction. A pedagogical strategy that involved constant reflection back and forth enabled the customization of the content and method of knowledge exchange despite the difference in socio-economic conditions and learning styles that were unfamiliar to the mental health professionals from high-income countries.ConclusionsBuilding knowledge and skills within a dialogic partnership over a significant period of time contributed to learning across cultures. This model of continuity, low-investment and low-intensity collaborative capacity building may enrich the child and adolescent mental health settings in high-, low- and middle-income countries. Furthermore, the model appears feasible for Western professionals who collaborate with institutions for child and adolescent mental health in low- and middle-income countries.
A Cost Analysis of Options for Schistosomiasis Control Mda Programs Targeting Children Aged Five Years and Below in Umkhanyakude District of Kwazulu-natal Province, South Africa
Authors: Ncube Mhlengi Vella , Chimbari Moses John 
Published: August 2020

Abstract
BackgroundSchistosomiasis negatively impacts early childhood development. Inclusion of children aged five years and below in mass drug administration (MDA) programs for controlling schistosomiasis could improve early childhood development in communities where the disease is endemic. We estimated the projected cost of implementing a schistosomiasis control MDA program for children aged five years and below in the uMkhanyakude district of South Africa.MethodWe calculated the cost of implementing a schistosomiasis MDA program targeting children aged five years and below using an economies of scaled based cost function. We further compared different labor composition simulations to determine the most affordable and available human resources to implement the program. We also explored programs to which the MDA program could be integrated; and estimated what the costs for would be. Moreover, we simulated cost-effectiveness and determined the cost drivers for each simulation considered.ResultsA ward-based outreach team (WBOT) for implementing a schistosomiasis MDA program targeting children 5 years old and below was the best labor composition option. The simulations conducted indicated that treating children in batches of 2500 using the WBOT team approach could reduce the cost of treatment by 53% compared to treating the children on batches of 500. Integrating a schistosomiasis MDA targeting children aged 5 years and below with the immunization program was estimated to cost 3% less than integration with the deworming and Vitamin A supplementation program indicating that the former option is more cost-effective. Praziquantel, the drug that is used to treat schistosomiasis contributed 59% of the total cost for such a program.Conclusion.We estimated that US$4.3 million would be needed to implement a cost effective MDA program targeting children 5 years old and blow over 3 years in uMkhanyakude district.