bluuebunny/crossref_metadata_2025_split huggingface dataset:
Universal cervical cancer control through a right to health lens: refocusing national policy and programmes on underserved women
Authors: Perehudoff Katrina , Vermandere Heleen , Williams Alex , Bautista-Arredondo Sergio , De Paepe Elien , Dias Sonia , Gama Ana , Keygnaert Ines , Longatto-Filho Adhemar , Ortiz Jose , Padalko Elizaveta , Reis Rui Manuel , Vanderheijden Nathalie , Vega Bernardo , Verberckmoes Bo , Degomme Olivier 
Published: July 2020

Abstract
Background
Cervical cancer claims 311,000 lives annually, and 90% of these deaths occur in low- and middle-income countries. Cervical cancer is a highly preventable and treatable disease, if detected through screening at an early stage. Governments have a responsibility to screen women for precancerous cervical lesions. Yet, national screening programmes overlook many poor women and those marginalised in society. Under-screened women (called hard-to-reach) experience a higher incidence of cervical cancer and elevated mortality rates compared to regularly-screened women. Such inequalities deprive hard-to-reach women of the full enjoyment of their right to sexual and reproductive health, as laid out in Article 12 of the International Covenant on Economic, Social and Cultural Rights and General Comment No. 22.

Discussion
This article argues first for tailored and innovative national cervical cancer screening programmes (NCSP) grounded in human rights law, to close the disparity between women who are afforded screening and those who are not. Second, acknowledging socioeconomic disparities requires governments to adopt and refine universal cancer control through NCSPs aligned with human rights duties, including to reach all eligible women. Commonly reported- and chronically under-addressed- screening disparities relate to the availability of sufficient health facilities and human resources (example from Kenya), the physical accessibility of health services for rural and remote populations (example from Brazil), and the accessibility of information sensitive to cultural, ethnic, and linguistic barriers (example from Ecuador). Third, governments can adopt new technologies to overcome individual and structural barriers to cervical cancer screening. National cervical cancer screening programmes should tailor screening methods to under-screened women, bearing in mind that eliminating systemic discrimination may require committing greater resources to traditionally neglected groups.

Conclusion
Governments have human rights obligations to refocus screening policies and programmes on women who are disproportionately affected by discrimination that impairs their full enjoyment of the right to sexual and reproductive health. National cervical cancer screening programmes that keep the right to health principles (above) central will be able to expand screening among low-income, isolated and other marginalised populations, but also women in general, who, for a variety of reasons, do not visit healthcare providers for regular screenings.
Global prevalence and mortality of severe Plasmodium malariae infection: a systematic review and meta-analysis
Authors: Kotepui Manas , Kotepui Kwuntida Uthaisar , Milanez Giovanni D. , Masangkay Frederick R. 
Published: July 2020

Abstract
Background
Severe complications among patients with Plasmodium malariae infection are rare. This is the first systematic review and meta-analysis demonstrating the global prevalence and mortality of severe P. malariae infection in humans.

Methods
The systematic review and meta-analysis followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. All research articles published on the severity and mortality of P. malariae infection cases in humans were retrieved from three public databases: PubMed, Scopus, and ISI Web of Science. The pooled prevalence estimate and 95% confidence interval (CI) of complications in patients with P. malariae malaria was analysed using the random-effects model provided in Stata software. The pooled odds ratio (OR) and 95% CI of severe malaria for P. malariae infection and Plasmodium falciparum infection were analysed using Review Manager software.

Results
Six studies were used to estimate the pooled prevalence of severe P. malariae malaria. Out of 10,520 patients infected with P. malariae, the pooled prevalence estimate of severe P. malariae infection was 3% (95% CI 2–5%), with high heterogeneity (I2: 90.7%). Severe anaemia (3.32%), pulmonary complications (0.46%), and renal impairments (0.24%) were the most common severe complications found in patients with P. malariae infection. The pooled proportion of severe anaemia for P. malariae infection and P. falciparum infection was comparable among the four included studies (OR: 0.74, 95% CI 0.22–2.45, I2 = 98%). The pooled proportion of pulmonary complications was comparable between patients with P. malariae infection and those with P. falciparum infection among the four included studies (OR: 1.44; 95% CI 0.17–12.31, I2: 92%). For renal complications, the funnel plot showed that the pooled proportion of renal complications for P. malariae infection and P. falciparum infection was comparable among the four included studies (OR: 0.94, 95% CI 0.18–4.93, I2: 91%). The mortality rate of patients with P. malariae infection was 0.17% (18/10,502 cases).

Conclusions
This systematic review demonstrated that approximately two percent of patients with P. malariae infection developed severe complications, with a low mortality rate. Severe anaemia, pulmonary involvement, and renal impairment were the most common complications found in patients with P. malariae infection. Although a low prevalence and low mortality of P. malariae infection have been reported, patients with P. malariae infection need to be investigated for severe anaemia and, if present, treated aggressively to prevent anaemia-related death.
Smoking, general and oral health related quality of life – a comparative study from Nepal
Authors: Sagtani Reshu Agrawal , Thapa Sunaina , Sagtani Alok 
Published: July 2020

AbstractBackgroundPerceived dental health has shown to have a significant predictive effect on overall health perception and life satisfaction. Thus, it seems plausible that Health Related Quality of Life (HRQOL) measures are associated with Oral Health Related Quality of Life (OHRQOL) dimensions in Nepalese context as well. The adverse effects of tobacco on oral health are reported worldwide including Nepal. However, evidence which can quantify effects of tobacco smoking on dental health perception is limited. Thus, a study was designed to find association of smoking and socio demographic characteristics with OHRQOl and to determine association between OHRQOL and HRQOL among dental patients in Nepal.MethodsA cross sectional study was conducted among 125 current smokers and 125 non-smokers who attended oral surgery OPD of a teaching hospital in Kathmandu, Nepal. The study participants were enrolled through consecutive sampling and data was collected through a semi-structured questionnaire. The questionnaire consisted of questions related to sociodemographic characteristics, tobacco history, Oral Health Impacts Profile (OHIP)-14 and World Health Organization Quality of Life Brief version (WHOQOL-Bref) to assess OHRQOl and HRQOL respectively. Descriptive and inferential statistics were calculated by using SPSS version 18.0. The level of significance was set at 5%.ResultsAmong the socio demographic characteristics, patients with education of more than Class 12 had significantly higher average OHRQOL scores (p = 0.013) compared to illiterate patients. Current smokers reported significantly poorer scores in sub scales of psychological disability (p = 0.001), social disability (p = 0.003), physical pain (p < 0.001), functional limitation (p = 0.007) and also overall perceived oral health compared to nonsmokers. OHRQOL was significantly correlated with overall HRQOL in physical (p = 0.015) and psychological (p = 0.04) domains in this study sample.ConclusionsImprovements in OHRQOL may require a multidimensional approach with focus of social factors like education and behavioral factors like cigarette smoking. Also, improvement in OHRQOL might also lead to betterment of perceived overall health as they are interlinked.
A cross-sectional study on preferred employment settings of final-year nursing students in Israel
Authors: Sela Yael , Grinberg Keren , Shapiro Yair , Nissanholtz-Gannot Rachel 
Published: July 2020

Abstract
Background
Despite the growing demand for community nurses, their number remains relatively low. We examined perceptions of final-year nursing students regarding their preferred work setting after graduation and the factors affecting their choice.

Methods
A cross-sectional survey using a structured questionnaire was developed specifically for this study. The questionnaire was distributed among fourth-year students from all nursing training frameworks across Israel.

Results
Of 281 respondents (76.6% women, average age, 29.3 years), most (80.9%) preferred working in hospitals, while 5% preferred community settings; 14% were undecided. Students’ knowledge on hospital nurses’ tasks was greater compared to their knowledge on community nurses’ tasks. Moreover, hospital nurses’ tasks were perceived as more important than those of community nurses. The contribution of clinical placement in hospital nursing was perceived as significantly more meaningful than the contribution of clinical placement in community nursing. The vast majority of students (94.3%) stated that they would prefer to undergo a hospital nursing internship. A significant correlation was noted between students’ clinical placement, the exposure to community nursing roles, and the perception of the community nurse’s role: clinical placements that were perceived as a positive experience led to a more positive perception of community nurses’ roles.

Conclusions
Nursing students’ perception of community nursing is based upon limited information which does not reflect community nurses’ actual role and work.
Genome-wide DNA methylation profiling identifies epigenetic signatures of gastric cardiac intestinal metaplasia
Authors: Lin Runhua , Li Chenxi , Liu Zhaohui , Wu Ruinuan , Lu Jianghong 
Published: July 2020

Abstract
Background
Measuring the DNA methylome may offer the opportunity to identify novel disease biomarkers and insights into disease mechanisms. Although aberrant DNA methylation has been investigated in many human cancers and precancerous lesions, the DNA methylation landscape of gastric cardiac intestinal metaplasia (IM) remains unknown. Therefore, we aimed to investigate the genome-wide DNA methylation landscape and to search for potential epigenetic biomarkers of gastric cardiac IM.

Methods
Histopathologic profiling was performed on a total of 118 gastric cardiac biopsies from cancer-free individuals. Genome-wide DNA methylation analysis was performed on 11 gastric cardiac mucosal biopsies (IM = 7; normal = 4) using Illumina 850K microarrays. Transcriptional relevance of any candidate epigenetic biomarker was validated by qRT-PCR.

Results
The detection rate of gastric cardiac IM was 23% (27/118) in cancer-free individuals. Genome-wide DNA methylation profiling showed a global decrease in methylation in IM compared with normal tissues (median methylation = 0.64 and 0.70 for gastric cardiac IM and normal tissues, respectively). Differential methylation analysis between gastric cardiac IM and normal tissues identified 38,237 differentially methylated probes (DMPs) with a majority of sites showing hypermethylation in IM compared with normal tissues (56.3% vs. 43.7%). Subsequent analysis revealed a significant enrichment of hypermethylated DMPs in promoter and CpG islands (p < 0.001 for both, Pearson χ2 test). For DMPs located in promoter CpG islands showing extreme hypermethylation, the candidate gene with the largest number of DMPs (n = 7) was mapped to HOXA5. Accordingly, mRNA expression of HOXA5 was significantly reduced in IM compared to normal tissue.

Conclusions
Our results suggest the implication of alterations in DNA methylation in gastric cardiac IM and highlight that HOXA5 hypermethylation may be a promising epigenetic biomarker, emphasizing the role of aberrant HOXA5 expression in the pathogenesis of gastric cardiac IM.
Developing an SMS text message intervention on sexual and reproductive health with adolescents and youth in Peru
Authors: Guerrero Fiorella , Lucar Nora , Garvich Claux Mijail , Chiappe Marina , Perez-Lu Jose , Hindin Michelle J. , Gonsalves Lianne , Bayer Angela M. 
Published: July 2020

Abstract
Background
Improved access to sexual and reproductive health (SRH) services and information is essential for supporting adolescents and youth in making informed decisions and optimizing each young person’s outcomes related to their SRH, health and well-being and countries’ current and future social and economic development. Mobile phones offer opportunities for young people to privately access SRH content and to be linked to SRH services. The objective of this study was to develop the content for an SMS (short message service or “text message”) platform jointly with adolescents and youth in three regions in Peru (Lima, Ayacucho and Loreto) as part of the ARMADILLO (Adolescent/Youth Reproductive Mobile Access and Delivery Initiative for Love and Life Outcomes) Study.

Methods
Content development was done in three stages. During Stage 1, we held community consultations with 13–17 year old adolescents, 18–24 year old youth and professionals who work with young people through the education and health sectors (“adult advisers”) to identify and rate SRH topics of interest through group free- and guided-brainstorming activities and an individual written sharing activity. During Stage 2, the team developed the preliminary domains, sub-domains and content for the SMS platform. During Stage 3, we held focus groups with adolescents to validate the SMS content, including both individual scoring of and group feedback for each SMS. Group feedback asked about their general impressions and understanding and their thoughts about the language and usefulness of the SMS.

Results
A total of 172 adolescents and youth ages 13–24 and 20 adult advisers participated. Adolescents and youth brainstormed and rated SRH topics and sub-topics that led to the initial structure for the SMS platform, with 9 domains, 25 sub-domains and 146 draft SMS. Adolescents provided high scores for the SMS, with all sub-domains receiving average scores of 3.0 or higher (out of 4.0) for the SMS included. Adolescents also provided suggestions to optimize content, including improvements to unclear messages, resulting in SMS with adolescent-friendly content in simple, straightforward language. This process also revealed that adolescents lacked knowledge and had misconceptions related to contraceptive methods.

Conclusion
This study details the systematic process used to develop relevant and accessible SRH information through a participatory approach. We document critical information about what young people know and how they think, enabling us to understand their perspective and literally speak their language. Results also provide future directions for programmatic, research and policy efforts with young people, in particular around gender norms, interpersonal violence, and access to SRH information and services, in similar settings.
“Personal recovery depends on NA unity”: an exploratory study on recovery-supportive elements in Narcotics Anonymous Flanders
Authors: Dekkers Anne , Vos Sam , Vanderplasschen Wouter 
Published: July 2020

Abstract
Background
Mutual aid organizations, such as Narcotics Anonymous (NA), can provide support in substance use disorder (SUD) recovery processes. However, research on NA and its recovery-supportive elements is scarce and perspectives of NA-members remain understudied, in particular outside the US. Therefore, this study aims to gain insight into recovery-supportive elements of NA, as experienced by its members.

Methods
To explore the perspectives on and experiences with recovery-supportive elements in NA, 11 in-depth interviews with NA-members were conducted in Flanders (Belgium). Interviews were audio-taped, transcribed verbatim and analyzed by using CHIME-D, a personal recovery framework (Connectedness, Hope, Identity, Meaning in life, Empowerment, Difficulties) developed by Leamy and colleagues in 2011.

Results
Various recovery-supportive elements of NA were highlighted, with Connectedness as a key component including opportunities for building up a social network and for providing a safety net or sounding board. Elements that enabled Connectedness were 1) a non-judgemental approach, and 2) mutual understanding through sharing in NA. Other elements of the CHIME-D framework were less frequently mentioned, although these were inextricably linked to Connectedness.

Conclusions
Connectedness appeared to be the crucial recovery-supportive element in NA, emphasizing the relational character of SUD recovery. Although other elements of the CHIME-D framework were identified, these were closely related to and intertwined with the concept of connectedness.
A propensity score-matched analysis comparing outpatient and short-stay hospitalization to standard inpatient hospitalization following total ankle arthroplasty
Authors: Plantz Mark A. , Sherman Alain E. , Kadakia Anish R. 
Published: July 2020

Abstract
Background
Given the trend toward value-based care, there has been increased interest in minimizing hospital length of stay (LOS) after orthopedic procedures. Outpatient total ankle arthroplasty (TAA) has become more popular in recent years; however, research on surgical outcomes of this procedure has been limited. This study sought to employ large sample, propensity score-matched analyses to assess the safety of outpatient and short-stay discharge pathways following TAA.

Methods
The ACS NSQIP database was used to identify 1141 patients who underwent primary and revision TAA between 2007 and 2017. Propensity score matching was used to match patients based on several factors, including age, sex, body mass index (BMI), American Society of Anesthesiologists (ASA) classification, and several comorbidities. The incidence of various 30-day complications was compared between the short and standard LOS groups to assess for any differences in short-term outcomes.

Results
A total of 892 patients were included in the final propensity score-matched analysis, with 446 patients in each group. The short LOS group had a significantly lower rate of medical complications (0.2% vs. 2.5%, p = 0.006) and non-home discharge (1.3% vs. 12.1%, p < 0.001). There was no significant difference in operative complications (0.4% vs. 1.8%, p = 0.107), unplanned readmission (0.4% vs. 1.1%, p = 0.451), reoperation (0.2% vs. 0.4%, p > 0.999), return to the OR (0.2% vs. 0.9%, p = 0.374), or mortality (0.7% vs. 0.0%, p > 0.249) between the short and standard LOS groups.

Conclusions
Outpatient and short-stay hospitalization had comparable safety to standard inpatient hospitalization after TAA. Outpatient or short-stay TAA should be considered for patients with low risk of short-term complications.
The use of innominate artery cannulation for antegrade cerebral perfusion in aortic dissection
Authors: Payabyab Eden C. , Hemli Jonathan M. , Mattia Allan , Kremers Alex , Vatsia Sohrab K. , Scheinerman S. Jacob , Mihelis Efstathia A. , Hartman Alan R. , Brinster Derek R. 
Published: July 2020

Abstract
Background
Direct cannulation of the innominate artery for selective antegrade cerebral perfusion has been shown to be safe in elective proximal aortic reconstructions. We sought to evaluate the safety of this technique in acute aortic dissection.

Methods
A multi-institutional retrospective review was undertaken of patients who underwent proximal aortic reconstruction for Stanford type A dissection between 2006 and 2016. Those patients who had direct innominate artery cannulation for selective antegrade cerebral perfusion were selected for analysis.

Results
Seventy-five patients underwent innominate artery cannulation for ACP for Stanford Type A Dissections. Isolated replacement of the ascending aorta was performed in 36 patients (48.0%), concomitant aortic root replacement was required in 35 patients (46.7%), of whom 7 had a valve-sparing aortic root replacement, ascending aorta and arch replacement was required in 4 patients (5%). Other procedures included frozen elephant trunk (n = 11 (14.7%)), coronary artery bypass grafting (n = 20 (26.7%)), and peripheral arterial bypass (n = 4 (5.3%)). Mean hypothermic circulatory arrest time was 19 ± 13 min. Thirty-day mortality was 14.7% (n = 11). Perioperative stroke occurred in 7 patients (9.3%).

Conclusions
This study is the first comprehensive review of direct innominate artery cannulation through median sternotomy for selective antegrade cerebral perfusion in aortic dissection. Our experience suggests that this strategy is a safe and effective technique compared to other reported methods of cannulation and cerebral protection for delivering selective antegrade cerebral perfusion in these cases.
Assessing the impacts of the Agenda Gap intervention for youth mental health promotion through policy engagement: a study protocol
Authors: Jenkins Emily , Haines-Saah Rebecca , McGuinness Liza , Hirani Saima , Boakye-Yiadom Noah , Halsall Tanya , Rivers Robert , Morris Jonathan 
Published: July 2020

Abstract
Background
Mental health challenges are a leading health concern for youth globally, requiring a comprehensive approach incorporating promotion, prevention and treatment within a healthy public policy framework. However, the broad enactment of this vision has yet to be realized. Further, mental health promotion evidence specific to youth is still emerging and has not yet focused at a policy level. This is a critical gap, as policy is a key mental health promotion lever that can alter the social and structural conditions that contribute to shaping youth mental health outcomes for all youth, across the full spectrum of need. Responsive to this research and intervention priority, our prototype study intervention—the Agenda Gap—is comprised of an innovative, multi-media engagement intervention, developed in collaboration with youth. This intervention aims to equip youth and build capacity for them to lead meaningful policy change reflective of the mental health needs of diverse communities of youth, including those who experience structural vulnerability and who would not typically have had their voice represented in policymaking processes.

Methods
This study will use a multiple case study design and mixed methods grounded in a realist approach and will be conducted in three sites across two Canadian provinces (British Columbia and Alberta). In an earlier phase of this research, we collaboratively designed the prototype intervention with youth, community and policy partners. In this phase of the study, the intervention will be implemented and further tested with new groups of youth collaborators (n = 10–15/site). Outcome data will be collected through realist qualitative interviews, validated questionnaires [i.e., Child and Youth Resilience Measure (CYRM-12), General Self-Efficacy (GSE) Scale, and the Critical Consiousness Scale (CCS)] and additional survey items developed by our study team. Analysis will focus on identification of key context-mechanism-outcome configurations to provide comprehensive insights into how this intervention works, for whom, and in what context.

Discussion
This study is unique in its “upstream” focus on youth-engaged policymaking as a tool for improving the social and structural conditions that influence youth mental health across socioecological levels. Through the implementation and testing of the Agenda Gap intervention with diverse youth, this study will contribute to the evidence base on youth-engaged policymaking as a novel and innovative, mental health promotion strategy.