bluuebunny/crossref_metadata_2025_split huggingface dataset:
Microfinance and Financial Inclusion
Authors: Mader Philip 
Published: April 2017

Abstract
This article examines the impact of microfinance—the provision of financial services to poor and low-income populations, usually in the global South—on poverty. Microfinance is regarded as a financial market solution to the social problem of poverty, promising poverty alleviation in a market-friendly and cost-efficient way. Proponents hope that the financial inclusion of poor and low-income population segments will help them cope better with multifaceted problems of poverty, in particular their uncertain and low incomes. This article first provides an overview of microfinance, focusing on its economic and gender impacts, before tracing the microfinance sector’s historical origins and rise. It also considers the practices of the microfinance sector as well as the critical debates over microfinance. Finally, it describes three sets of recent developments relating to microfinance: a spate of crises including overindebtedness and collapse, new methods and mission, and the sector’s expanding scope of activities.
Conclusion
Authors: Rank Mark R. 
Published: April 2017

Abstract
This concluding article proposes a new paradigm in which to understand poverty, focusing primarily on the United States even as several dimensions of the paradigm apply globally across other countries. It first considers the major tenets of the “old” paradigm, which is to a large extent a reflection and affirmation of both the free market economic structure and the culture of individualism that have profoundly shaped the American ideology. It then introduces the new paradigm, which aims to stimulate a fundamental shift in how we conceptualize and act toward the problem of poverty, and some of its major themes: poverty results from structural failings; poverty is a conditional state in which individuals move in and out; poverty constitutes deprivation; poverty as injustice; the condition of poverty affects and undermines each one of us.
Ideologies and Beliefs about Poverty
Authors: Hunt Matthew O. , Bullock Heather E. 
Published: April 2017

AbstractThis article examines ideologies and beliefs about poverty. In 1981, Kluegel and Smith provided the first comprehensive summary and critique of scholarly research on beliefs about social stratification. Focusing primarily on the United States and Great Britain, they reviewed research on public beliefs in three primary areas: opportunity, the distributive process, and social class. In so doing, they identified four key questions that continue to define research in this area: What is believed about social inequality? What principles organize thought around social inequality? What determines what is believed? What are the consequences of these beliefs? This article considers what Americans (and to a lesser extent, the British) perceive and believe about social inequality; the nature of ideologies and other social psychological processes governing the intrapersonal organization of beliefs; selected factors that shape patterns of belief; and selected consequences that stratification beliefs hold for the person and for politics.
How Politics and Institutions Shape Poverty and Inequality
Authors: Brady David , Blome Agnes , Kleider Hanna 
Published: April 2017

Abstract
This article explores the influence of politics and institutions on poverty and inequality. It first considers the general contention that poverty is shaped by the combination of power resources and institutions. On one hand, scholars in the power resources tradition have emphasized the role of class-based collective political actors for mobilizing “power resources” in the state and economy. On the other hand, institutionalists have highlighted the role of formal rules and regulations. The article goes on to discuss the theoretical arguments of power resources theory and the evidence for key power resources (that is, collective political actors like labor unions and parties). It also reviews institutional explanations, focusing on the key concepts and theories and as well as the evidence linking the most salient institutions to poverty. Finally, it examines how state policy influences poverty and presents several challenges for future research.
Linking Poverty and Children’s Development
Authors: McLoyd Vonnie C. , Jocson Rosanne M. , Williams Abigail B. 
Published: April 2017

Abstract
This article examines the effects and mediators of childhood poverty, with particular emphasis on the confluence of forces that gave rise to these foci and perspectives. It first considers macroeconomic trends as a context for the study of childhood poverty in the United States, followed by a review of developments that directed attention to the dynamics and context of childhood poverty as research topics, along with a summary of the findings generated by this research. It then discusses perspectives that have emerged about processes that mediate links between poverty and child development, including the social causation and social selection perspectives, as well as the applicability of these perspectives for understanding the effects of poverty on children living in developing countries. Finally, it assesses the role of poverty in maternal and child mental health and the influence of parenting practices and investments on child development.
Hydraulic Fracturing and Legal Frameworks
Authors: Wiseman Hannah 
Published: April 2017

Abstract
An oil and gas extraction technique called hydraulic fracturing has been common in the United States for many decades. However, a recent change in this technique—the development of a specific fracturing or “fracking” practice called slickwater or slickwater fracturing—has turned the world of petroleum extraction on its head, opening up massive new deposits of oil and gas in the United States and around the world. This article uses the United States as a case study of the benefits and risks of fracturing and the legal frameworks that apply to this practice, exploring how the legal approach has been largely piecemeal and reactive. US states have been the primary regulatory bodies responsible for controlling risks, and their regulations vary substantially. The federal government also has regulated in limited areas, however—again in a largely reactive and patchwork manner.
Dual-Force Vaginoplasty for Treatment of Segmental Vaginal Aplasia
Authors: El Saman Ali M. , Farag Mohamad A. , Shazly Sherif A. , Noor Mohamed , Ali Mohammed K. , Othman Essam R. , Khalifa Mansour , Farghly Tarek A. , El Saman Dina A. 
Published: April 2017

BACKGROUND:
Vaginal aplasia occurs in 1 in 5,000–10,000 female live births. In this report, we evaluated a novel dual-force vaginoplasty technique for treatment of 11 patients with segmental vaginal aplasia.

TECHNIQUE:
The principle of the approach is to thin the atretic part between two counteracting forces. The instrument was inserted laparoscopically into the proximal hematocolpos. Two balloon catheters, one for drainage and one for traction, were threaded over the inserter. The traction catheter was then threaded over a silicon tube, leaving the balloon in the proximal portion of the vagina and connecting across the vaginal septum to a fenestrated Teflon olive, which was positioned against the distal surface of the vaginal septum. This created a dual “pushing and pulling” force across the septum, which, over 3–4 days, pulls the upper vaginal pouch down while the vaginal dimple is pushed up. The aplastic segment becomes thin and easy to dilate and permits achievement of vaginal patency. The drainage of the hematocolpos is predominantly through the balloon catheter so postoperative wound management is facilitated.

EXPERIENCE:
Eleven menarchal girls were diagnosed with segmental vaginal aplasia. The dual-force vaginoplasty was performed on each and was tolerated well with no operative complications. They all reported establishment of the menstrual cycle and significant improvement of pain during follow-up.

CONCLUSION:
Creation of a dual pushing–pulling force on the atretic vaginal segment is a feasible short procedure for management of segmental vaginal aplasia.
State Medicaid Coverage of Medically Necessary Abortions and Severe Maternal Morbidity and Maternal Mortality
Authors: Jarlenski Marian , Hutcheon Jennifer A. , Bodnar Lisa M. , Simhan Hyagriv N. 
Published: April 2017

OBJECTIVE:
To estimate the association between state Medicaid coverage of medically necessary abortion and severe maternal morbidity and in-hospital maternal mortality in the United States.

METHODS:
We used data on pregnancy-related hospitalizations from the Nationwide Inpatient Sample from 2000 to 2011 (weighted n=38,016,845). State-level Medicaid coverage of medically necessary abortion for each year was determined from Guttmacher Institute reports. We used multivariable logistic regression to examine the association between state Medicaid coverage of abortion and severe maternal morbidity and in-hospital maternal mortality, overall and stratified by payer.

RESULTS:
The unadjusted rate of severe maternal morbidity was lower among Medicaid-paid hospitalizations in states with Medicaid coverage of medically necessary abortion relative to those in states without such coverage (62.4 compared with 69.3 per 10,000). Among Medicaid-paid hospitalizations in states with Medicaid coverage of medically necessary abortion, there were 8.5 per 10,000 fewer cases (95% confidence interval [CI] 4.0–16.5) of severe maternal morbidity in adjusted analyses relative to those in states without such Medicaid coverage. Similarly, there were 10.3 per 10,000 fewer cases (95% CI 3.5–17.2) of severe maternal morbidity in adjusted analyses among private insurance–paid hospitalizations in states with Medicaid coverage of medically necessary abortion relative to those in states without such Medicaid coverage. The adjusted rate of in-hospital maternal mortality was not different for Medicaid-paid hospitalizations in states with and without Medicaid coverage of medically necessary abortion (9.2 and 9.0 per 100,000, respectively) nor for private insurance–paid hospitalizations (5.6 and 6.1 per 100,000, respectively).

CONCLUSION:
State Medicaid coverage of medically necessary abortion was associated with an average 16% decreased risk of severe maternal morbidity. An association between state Medicaid coverage of medically necessary abortion and a reduced risk of severe maternal morbidity was observed in women covered by both Medicaid and private insurance. Results suggest that Medicaid coverage of medically necessary abortion is not harmful to maternal health.
Outcomes of Twin Pregnancies in Women 45 Years of Age or Older
Authors: Gerber Rachel S. , Fields Jessica C. , Barberio Andrea L. , Bodenlos Kimberly , Fox Nathan S. 
Published: April 2017

OBJECTIVE:
To investigate outcomes of twin gestations in women 45 years or older at the time of delivery.

METHODS:
This was a retrospective cohort study of 139 women with twin gestations who were at least 45 years old when they delivered. They were cared for at two referral centers between 2005 and 2016. Analysis included baseline characteristics and pregnancy outcomes including mode of delivery, gestational age at delivery, hypertensive disease in pregnancy, gestational diabetes, and fetal growth restriction. Univariate analysis of the association between patient characteristics and outcomes was performed.

RESULTS:
The mean maternal age at delivery was 47.3±1.9 years with 99.3% undergoing in vitro fertilization and 95% using donor eggs. Patients had low baseline rates of hypertension (7.2%), obesity (9.5%), and pregestational diabetes (1.4%). The average gestational age of delivery was 35.4 weeks; 22.3% delivered before 34 weeks of gestation. There were high rates of cesarean delivery (93.5%, 95% confidence interval [CI] 87.7–96.8%), preeclampsia (44.6%, 95% CI 36.3–53.3%), and gestational diabetes (19%, 95% CI 13.0–26.8%). Preeclampsia developed in 50.5% of nulliparous women compared with 30.5% of women with a prior birth (P=.028). Preterm birth at less than 34 weeks of gestation occurred in 18.1% of women of white race compared with 30.3% of women of nonwhite race (P=.036).

CONCLUSION:
Twin pregnancy in a predominantly healthy cohort of women who were at least 45 years old when they delivered was associated with high rates of cesarean delivery, preeclampsia, and gestational diabetes, but overall favorable outcomes.
Timing of Systemic Chemotherapy in Patients With Colorectal Peritoneal Carcinomatosis Treated With Cytoreductive Surgery and Hyperthermic Intraperitoneal Chemotherapy
Authors: van Eden Wijntje J. , Kok Niels F. , Jóźwiak Katarzyna , Lahaye Max L. , Beets Geerard L. , van Leerdam Monique E. , Boot Henk , Aalbers Arend G. 
Published: April 2017

BACKGROUND:
Timing of systemic chemotherapy in patients with colorectal peritoneal carcinomatosis treated with cytoreductive surgery and hyperthermic intraperitoneal chemotherapy is controversial. Preoperative systemic chemotherapy may offer benefits.

OBJECTIVE:
The purpose of this study was to evaluate the effect of timing of systemic chemotherapy on survival.

DESIGN:
This was a retrospective cohort study.

SETTINGS:
The study was conducted at a tertiary referral center.

PATIENTS:
Patients undergoing cytoreductive surgery and hyperthermic intraperitoneal chemotherapy from January 2004 until June 2015 were included.

MAIN OUTCOME MEASURES:
The influence of patient-related, tumor-related, and treatment-related factors on survival were investigated using Cox regression models. Main outcome was overall survival.

RESULTS:
A total of 280 consecutive patients underwent cytoreductive surgery and hyperthermic intraperitoneal chemotherapy. In group A, 78 patients (28%) were treated with preoperative or perioperative chemotherapy, cytoreductive surgery, and hyperthermic intraperitoneal chemotherapy. In group B, 169 patients (60%) were intentionally treated with cytoreductive surgery, hyperthermic intraperitoneal chemotherapy, and adjuvant chemotherapy. In group C, 33 patients (12%) had received their chemotherapy before peritoneal carcinomatosis was diagnosed. Median overall survival was 36.9 months (interquartile range, 20.6–79.7 mo) in group A, 43.1 months (interquartile range, 25.7–95.9 mo) in group B, and 34.0 months (interquartile range, 20.0–53.7 mo) in group C (p = 0.19). The extent of peritoneal carcinomatosis (region count of 3–5, HR = 1.58 (95% CI, 1.02–2.45), and 6–7, HR = 3.34 (95% CI, 1.66–6.72) vs 1–2 regions), a higher lymph node ratio (HR = 7.96 (95% CI, 2.16–29.31)), and cycles of systemic chemotherapy (0 cycles, HR = 2.52 (95% CI, 1.48–4.29)) and partial chemotherapy (HR = 2.15 (95% CI, 1.27–3.65) vs complete chemotherapy) were associated with poorer overall survival.

LIMITATIONS:
Selection bias is present because of the retrospective design of this study.

CONCLUSIONS:
Timing of systemic chemotherapy does not appear to have impact on survival in patients with colorectal peritoneal carcinomatosis undergoing cytoreductive surgery and hyperthermic intraperitoneal chemotherapy.
Efficacy of 3-Dimensional Endorectal Ultrasound for Staging Early Extraperitoneal Rectal Neoplasms
Authors: Pinto Rodrigo Ambar , Corrêa Neto Isaac José Felippe , Nahas Sérgio Carlos , Rizkalah Nahas Caio Sérgio , Sparapan Marques Carlos Frederico , Ribeiro Junior Ulysses , Kawaguti Fábio Shiguehissa , Cecconello Ivan 
Published: April 2017

BACKGROUND:
Adequate oncologic staging of rectal neoplasia is important for treatment and prognostic evaluation of the disease. Diagnostic methods such as endorectal ultrasound can assess rectal wall invasion and lymph node involvement.

OBJECTIVE:
The purpose of this study was to correlate findings of 3-dimensional endorectal ultrasound and pathologic diagnosis of extraperitoneal rectal tumors with regard to depth of rectal wall invasion, lymph node involvement, percentage of rectal circumference involvement, and tumor extension.

DESIGN:
Consecutive patients with extraperitoneal rectal tumors were prospectively assessed by 3-dimensional endorectal ultrasound blind to other staging methods and pathologic diagnosis.

PATIENTS:
Patients who underwent endorectal ultrasound followed by surgery were included in the study.

SETTINGS:
The study was conducted at a single academic institution.

MAIN OUTCOME MEASURES:
Sensitivity, specificity, positive and negative predictive values, area under curve, and κ coefficient between 3-dimensional endorectal ultrasound and pathologic diagnosis were determined. Intraclass correlation coefficient was calculated for tumor extension and percentage of rectal wall involvement.

RESULTS:
Forty-four patients (27 women; mean age = 63.5 years) were evaluated between September 2010 and June 2014. Most lesions were malignant (72.7%). For depth of submucosal invasion, 3-dimensional endorectal ultrasound showed sensitivity of 77.3%, specificity of 86.4%, positive predictive value of 85.0%, a negative predictive value of 79.2%, and an area under curve of 0.82. The weighted κ coefficient for depth of rectal wall invasion staging was 0.67, and there was no agreement between 3-dimensional endorectal ultrasound and pathologic diagnosis for lymph node involvement (κ = –0.164). Intraclass correlation coefficient for lesion extension and percentage of rectal circumference involvement were 0.45 and 0.66. A better correlation between 3-dimensional endorectal ultrasound and pathologic diagnosis was observed in tumors <5 cm and with <50% of rectal wall involvement.

LIMITATIONS:
The relatively small sample size of patients with early rectal lesions referred directly for surgery could represent a potential selection bias.

CONCLUSIONS:
Three-dimensional endorectal ultrasound was effective for determining rectal wall invasion and lesion extension in tumors <5 cm and with <50% of rectal wall invasion but was limited for detecting lymph node involvement in early rectal lesions.
Long-term Outcomes After Continent Ileostomy Creation in Patients With Crohn’s Disease
Authors: Aytac Erman , Dietz David W. , Ashburn Jean , Remzi Feza H. 
Published: April 2017

BACKGROUND:
Patients with Crohn’s disease have a higher failure rate after ileal pouch surgery compared with their counterparts with ulcerative colitis.

OBJECTIVE:
We hypothesized that risk of continent ileostomy failure can be stratified based on the timing of Crohn’s disease diagnosis and aimed to assess long-term outcomes.

DESIGN:
This was a retrospective cohort study.

SETTINGS:
The investigation took place in a high-volume, specialized colorectal surgery department.

PATIENTS:
Patients with Crohn’s disease who underwent continent ileostomy surgery between 1978 and 2013 were evaluated.

MAIN OUTCOME MEASURES:
Functional outcomes, postoperative complications, requirement of revision surgery, and continent ileostomy failure were analyzed.

RESULTS:
There were 48 patients (14 male patients) with a median age of 33 years at the time of continent ileostomy creation. Crohn’s disease diagnosis was before continent ileostomy (intentional) in 15 or made in a delayed fashion at a median 4 years after continent ileostomy in 33 patients. Median follow-up was 19 years (range, 1–33 y) after index continent ileostomy creation. Major and minor revisions were performed in 40 (83%) and 13 patients (27%). Complications were fistula (n = 20), pouchitis (n = 16), valve slippage (n = 15), hernia (n = 9), afferent limb stricture (n = 9), difficult intubation (n = 8), incontinence (n = 7), bowel obstruction (n = 7), valve stricture (n = 5), leakage (n = 4), bleeding (n = 3), and valve prolapse (n = 3). Median Cleveland global quality-of-life score was 0.8. Continent ileostomy failure occurred in 22 patients (46%). Based on Kaplan–Meier estimates, continent ileostomy survival was 48 % (95% CI, 33%–63%) at 20 years. Continent ileostomy failure was similar regardless of timing of diagnosis of Crohn’s disease (p = 0.533).

LIMITATIONS:
This study was limited by its retrospective and nonrandomized nature.

CONCLUSIONS:
Outcomes of continent ileostomy in patients with Crohn’s disease are poor, regardless of the timing of diagnosis. Very careful consideration should be given by both the surgeon and the patient before undertaking this procedure in patients with Crohn’s disease. See Video Abstract at http://links.lww.com/DCR/A327.
Time Window Is Important for Adenosine Preventing Cold-induced Injury to the Endothelium
Authors: Li Yan , Hu Xiao-Xia , Fu Li , Chen Jing , Lu Li-he , Liu Xiang , Xu Zhe , Zhou Li , Wang Zhi-Ping , Zhang Xi , Ou Zhi-Jun , Ou Jing-Song 
Published: April 2017

Abstract:
Cold cardioplegia is used to induce heart arrest during cardiac surgery. However, endothelial function may be compromised after this procedure. Accordingly, interventions such as adenosine, that mimic the effects of preconditioning, may minimize endothelial injury. Herein, we investigated whether adenosine prevents cold-induced injury to the endothelium. Cultured human cardiac microvascular endothelial cells were treated with adenosine for different durations. Phosphorylation and expression of endothelial nitric oxide synthase (eNOS), p38MAPK, ERK1/2, and p70S6K6 were measured along with nitric oxide (NO) production using diaminofluorescein-2 diacetate (DAF-2DA) probe. Cold-induced injury by hypothermia to 4°C for 45 minutes to mimic conditions of cold cardioplegia during open heart surgery was induced in human cardiac microvascular endothelial cells. Under basal conditions, adenosine stimulated NO production, eNOS phosphorylation at serine 1177 from 5 minutes to 4 hours and inhibited eNOS phosphorylation at threonine 495 from 5 minutes to 6 hours, but increased phosphorylation of ERK1/2, p38MAPK, and p70S6K only after exposure for 5 minutes. Cold-induced injury inhibited NO production and the phosphorylation of the different enzymes. Importantly, adenosine prevented these effects of hypothermic injury. Our data demonstrated that adenosine prevents hypothermic injury to the endothelium by activating ERK1/2, eNOS, p70S6K, and p38MAPK signaling pathways at early time points. These findings also indicated that 5 minutes after administration of adenosine or release of adenosine is an important time window for cardioprotection during cardiac surgery.