bluuebunny/crossref_metadata_2025_split huggingface dataset:
Time spent at health facility is a key driver of patient satisfaction, but did not influence retention to HIV care: A serial cross-sectional study in Mozambique
Authors: De Schacht Caroline , Amorim Gustavo , Calvo Lázaro , Ntasis Efthymios , Van Rompaey Sara , Matsimbe Julieta , Martinho Samuel , Graves Erin , Sardella Alvim Maria Fernanda , Green Ann , Kassim Hidayat , Carlos Inoque Carlos , Wester C. William , Audet Carolyn M. 
Published: April 2024

Introduction
Patient satisfaction with clinical services can have an effect on retention in HIV care and adherence to antiretroviral therapy. This study assessed patient satisfaction and its association with retention and viral suppression in Zambézia Province, Mozambique.

Methods
Monthly exit interviews with persons living with HIV were completed from August 2017-January 2019 in 20 health facilities; clinical data were extracted from medical records. Regression analyses assessed the effect of satisfaction scores on retention and viral suppression, adjusting for age, sex, education, civil status, time on treatment, and site. Satisfaction scores were correlated with time spent at health facilities using generalized linear regression models.

Results
Data from 4388 patients were analyzed. Overall median satisfaction score was 75% (IQR 53%-84%); median time spent at facilities (from arrival until completion of clinical services) was 2h54min (IQR 1h48min-4h). Overall satisfaction score was not associated with higher odds of retention or viral suppression, but association was seen between satisfaction regarding attention given to patient and respect and higher odds of viral suppression. Patient satisfaction was negatively associated with time spent in facility (Spearman’s correlation -0.63). Increased time spent at facility (from 1 to 3 hours) was not associated with lower retention in care (OR 0.72 [95%CI:0.52–1.01] and 0.83 [95%CI: 0.63–1.09] at 6- and 12-months, respectively), nor with a lower odds of viral suppression (OR 0.96 [95%CI: 0.71–1.32]).

Conclusions
Strategies to reduce patient wait times at the health facility warrant continued prioritization. Differentiated models of care have helped considerably, but novel approaches are still needed to further decongest crowded health facilities. In addition, a good client-provider communication and positive attitude can improve patient satisfaction with health services, with an overall improved retention.
Protocol for a phase II study to evaluate the efficacy and safety of nivolumab as a postoperative adjuvant therapy for patients with esophageal cancer treated with preoperative docetaxel, cisplatin plus 5-fluorouracil treatment (PENTAGON trial)
Authors: Goto Hironobu , Oshikiri Taro , Kato Takashi , Nagatani Yoshiaki , Funakoshi Yohei , Koterazawa Yasufumi , Sawada Ryuichiro , Harada Hitoshi , Urakawa Naoki , Hasegawa Hiroshi , Kanaji Shingo , Yamashita Kimihiro , Matsuda Takeru , Minami Hironobu , Kakeji Yoshihiro 
Published: April 2024

Background
In Japan, preoperative adjuvant chemotherapy followed by surgical resection is the standard treatment for patients with locally advanced esophageal squamous cell carcinoma. However, the risk of recurrence after surgical resection remains high. Although a randomized controlled trial evaluating the efficacy of nivolumab, a fully human monoclonal anti-programmed death 1 antibody, as postoperative adjuvant therapy after neoadjuvant chemoradiotherapy and surgery established its superior efficacy as adjuvant therapy, the efficacy for patients who received preoperative adjuvant chemotherapy has not been demonstrated. This study aims to elucidate the efficacy and safety of nivolumab as postoperative adjuvant therapy for patients with esophageal squamous cell carcinoma after preoperative adjuvant chemotherapy with docetaxel and cisplatin plus 5-fluorouracil followed by surgical resection.

Methods
This study is a multi-institutional, single-arm, Phase II trial. We plan to recruit 130 esophageal squamous cell carcinoma patients, who have undergone preoperative adjuvant chemotherapy with docetaxel and cisplatin plus 5-fluorouracil followed by surgical resection. If the patient did not have a pathological complete response, nivolumab is started as a postoperative adjuvant therapy within 4–16 weeks after surgery. The nivolumab dose is 480 mg/day every four weeks. Nivolumab is administered for up to 12 months. The primary endpoint is disease-free survival; the secondary endpoints are overall survival, distant metastasis-free survival, and incidence of adverse events.

Discussion
To our knowledge this study is the first trial establishing the efficacy of nivolumab as postoperative adjuvant therapy for patients with esophageal squamous cell carcinoma after preoperative adjuvant chemotherapy with docetaxel and cisplatin plus 5-fluorouracil followed by surgical resection. In Japan, preoperative adjuvant chemotherapy followed by surgery is a well-established standard treatment for resectable, locally advanced esophageal squamous cell carcinoma. Therefore, developing an effective postoperative adjuvant therapy has been essential for improving oncological outcomes.
Cervical cancer screening knowledge and associated factors among Eswatini women: A cross-sectional study
Authors: Khumalo Phinda G. , Carey Mariko , Mackenzie Lisa , Sanson-Fisher Rob 
Published: April 2024

Background
Over recent years, cervical cancer incidence and related mortality have steadily increased in Eswatini. Low cervical cancer screening uptake partly explains the situation. Cervical cancer screening-related knowledge is positively associated with screening uptake. Little is known about women’s cervical cancer screening-related knowledge in Eswatini.

Objective
This study aimed to assess cervical cancer screening knowledge and associated factors among Eswatini women eligible for screening.

Methods
A cross-sectional study involving three hundred and seventy-seven women aged 25 to 59 selected from four primary healthcare clinics in Eswatini was conducted. A paper and pen survey assessed knowledge about cervical cancer risk factors, benefits of screening, the meaning of screening results, recommended screening intervals, and socio-demographics. Descriptive analyses were performed to assess participants’ sociodemographic characteristics. Linear regression was applied to examine associations between cervical cancer screening-related knowledge and participants’ sociodemographic characteristics.

Results
Two hundred and twenty-nine (61%) participants answered 80% or more knowledge questions correctly. Compared to HIV-positive participants, HIV-negative participants had 0.61 times lower cervical cancer screening knowledge scores (β = -0.39, 95% CI: -0.56, -0.19, p = 0.03). Participants who travelled more than 30 minutes to the clinic had 0.3 times lower cervical cancer screening knowledge scores (β = -0.70, 95% CI: -1.15, -0.25, p < 0.01) compared to participants who travelled less than 30 minutes to the clinic.

Conclusions
Relatively high overall cervical cancer screening knowledge levels were observed among the study participants. Findings from the current study may inform future educational programs to create and sustain an accurate understanding of cervical cancer screening in Eswatini communities.
Estimates of the incidence, prevalence, and factors associated with common sexually transmitted infections among Lebanese women
Authors: Chemaitelly Hiam , Finan Ramzi R. , Racoubian Eddie , Aimagambetova Gulzhanat , Almawi Wassim Y. 
Published: April 2024

BackgroundWe analyzed the prevalence of active infection with common curable sexually transmitted infections (STIs) includingN.gonorrhea,C.trachomatis,T.vaginalis, andT.pallidum, as well as active infection with HPV, herpes simplex virus types I (HSV-1) and II (HSV-2),M.hominis,M.genitalium,C.albicans, and Ureaplasma in 351 Lebanese women.MethodsA cross-sectional study, involving 351 sexually active women, 40 years or younger, who were recruited from outpatient Obstetrics and Gynecology clinic attendees between September 2016 and November 2017.ResultsThe prevalence of active infection was low at 0.3% forN.gonorrhea, 0.6% for HSV-2, 2.8% forC.trachomatis, and 2.9% for any curable STIs. Prevalence of active HPV infection was high assessed at 15.7% for high-risk and 12.2% for low-risk genotypes. Furthermore, the prevalence was 2.0% forM.genitalium, 6.8% for ureaplasma, 13.7% forCandida albicans, and 20.5% forM.hominis. No active infections withT.vaginalis,T.pallidum, or HSV-1 were observed. Significant age differences were noted in the prevalence of high-risk and low-risk HPV genotypes, but no such differences were noted in the prevalence of other infections. No appreciable variations were identified in the prevalence of key STIs based on smoking, marital status, or the number of sexual partners.ConclusionsThe study documented active infection with substantial prevalence for multiple STIs among women attending outpatient gynecology and obstetrics clinics in Lebanon. These findings underscore the importance of strengthening STI surveillance, linkage to care, and prevention interventions in reducing STI incidence among women.
Gender health gaps in guideline-based inpatient cardiovascular medical and nursing care and implementation strategies to reduce the gap (HeartGap): A mixed methods study protocol
Authors: Sgraja Sophia , Mollenhauer Judith , Kloepfer Martina , Seeland Ute , Kurscheid Clarissa , Amelung Volker 
Published: April 2024

Background
A growing body of evidence has demonstrated that a gender-sensitive approach to healthcare is needed in all areas of medicine. Although medical and nursing guidelines include gender-sensitive care (GSC+) recommendations, the level of implementation in health care practice is unknown. This study aims to examine the current level of implementation and acceptance of GSC+ among physicians and nurses and to identify potential gaps between guidelines and practice and barriers and facilitators of GSC+ implementation, taking the perceptions of all relevant stakeholders into account. The overarching aim is to develop holistic recommended actions to strengthen GSC+.

Methods
This study has a mixed methods triangulation design. The preparation phase consisting of a literature review and a two-part (qualitative and quantitative) data analysis will be conducted in the cardiology department of 9 pilot hospitals in Berlin, North Rhine-Westphalia, Lower Saxony, Rhineland-Palatinate, Germany. 18 focus groups with clinicians and nurses as well as interviews with experts in other relevant fields will be performed. In the national roll-out phase, a questionnaire survey will be conducted with hospital clinicians (n = 382), nurses (n = 386) and patients (n = 388).

Discussion
This study will provide comprehensive insights into the implementation and acceptance of GSC+ in cardiology from the perspective of doctors, nurses, patients, stakeholders and experts in relevant fields, such as policy and education. A focus will also be on the extent to which age or gender of health professionals, region and hospital type influence the implementation of GSC+. The identification of GSC+ implementation barriers and facilitators should help to improve the standard of care for cardiology patients of all genders. The outcomes from this study can be used to develop measures and recommended actions for the successful and sustainable implementation of gender-sensitive care.

Trial registration
The study is registered in the German Register of Clinical Studies (DRKS) under study number DRKS00031317.
Through the big top: An exploratory study of circus-based artistic knowledge translation in rural healthcare services, Québec, Canada
Authors: Théberge Julie , Smithman Mélanie Ann , Turgeon-Pelchat Catherine , Tounkara Fatoumata Korika , Richard Véronique , Aubertin Patrice , Léonard Patrick , Alami Hassane , Singhroy Diane , Fleet Richard 
Published: April 2024

Background
The conventional methods and strategies used for knowledge translation (KT) in academic research often fall short in effectively reaching stakeholders, such as citizens, practitioners, and decision makers, especially concerning complex healthcare issues. In response, a growing number of scholars have been embracing arts-based knowledge translation (ABKT) to target a more diverse audience with varying backgrounds and expectations. Despite the increased interest, utilization, and literature on arts-based knowledge translation over the past three decades, no studies have directly compared traditional knowledge translation with arts-based knowledge translation methods. Thus, our study aimed to evaluate and compare the impact of an arts-based knowledge translation intervention–a circus show–with two traditional knowledge translation interventions (webinar and research report) in terms of awareness, accessibility, engagement, advocacy/policy influence, and enjoyment.

Methods
To conduct this exploratory convergent mixed method study, we randomly assigned 162 participants to one of the three interventions. All three knowledge translation methods were used to translate the same research project: "Rural Emergency 360: Mobilization of decision-makers, healthcare professionals, patients, and citizens to improve healthcare and services in Quebec’s rural emergency departments (UR360)."

Results
The findings revealed that the circus show outperformed the webinar and research report in terms of accessibility and enjoyment, while being equally effective in raising awareness, increasing engagement, and influencing advocacy/policy. Each intervention strategy demonstrates its unique array of strengths and weaknesses, with the circus show catering to a diverse audience, while the webinar and research report target more informed participants. These outcomes underscore the innovative and inclusive attributes of Arts-Based Knowledge translation, showcasing its capacity to facilitate researchers’ engagement with a wider array of stakeholders across diverse contexts.

Conclusion
As a relevant first step and a complementary asset, arts-based knowledge translation holds immense potential in increasing awareness and mobilization around crucial health issues.
Birth preparedness and complication readiness among recently delivered women in Hargeisa town, Somaliland: A community-based cross-sectional study
Authors: Ahmed Abdeta Muktar , Ahmed Mohamed Abdilahi , Ahmed Mohammed Hassen 
Published: April 2024

Background
About 287,000 mothers lost their lives due to pregnancy and delivery in 2020 worldwide. Birth preparedness and complication readiness (BPCR) is an approach used to utilize the timely use of skilled maternal and neonatal services. Preparing mothers for childbirth and against its dangers has great importance in reducing maternal mortality. Little is known about BPCR and influencing factors in Hargeisa town, Somaliland.

Objective
To assess the level of BPCR and its associated factors among recently delivered women in Hargeisa.

Methods
A community-based cross-sectional study was carried out in September 2022 among 300 women who delivered in the one-year time interval before the study period. A census was done to identify the women, and then they were selected by simple random sampling. Face-to-face interviews were conducted using a pre-structured questionnaire. A woman was considered prepared for birth if she made preparations for at least three of the BPCR components. Data were cleaned, entered, and analyzed using SPSS V.25. Bivariate and multivariate logistic regression analyses were performed with a cut-point of 0.05 significance level.

Results
From a total of 300 women, 38.3% had good knowledge of BPCR, and only one-fourth (25%) were prepared for birth and its complications. Access and media usage (AOR = 9.64, CI 1.09–82.248), receiving health education about BPCR (AOR = 3.75, CI 1.01–13.87), giving birth at health institutions (AOR = 6.02, CI 1.39–25.95), and good knowledge of key danger signs of pregnancy (AOR = 0.017, CI 0.004–0.069) were factors significantly associated with BPCR practice.

Conclusion
The study identified that the BPCR level was very low compared to many other studies. Such a low BPCR level may have a negative impact on maternal health and lives, hindering interventions conducted to reduce maternal mortality rates. All concerned bodies should consider the importance of awareness creation regarding BPCR in their core interventions.
Activated rate-response is associated with increased mortality risk in cardiac device carriers with acute heart failure
Authors: Huttelmaier Moritz T. , Münsterer Sascha , Morbach Caroline , Sahiti Floran , Scholz Nina , Albert Judith , Gabel Alexander , Angermann Christiane , Ertl Georg , Frantz Stefan , Störk Stefan , Fischer Thomas H. 
Published: April 2024

Aims
This study investigated whether an activated R-mode in patients carrying a cardiac implantable electronic device (CIED) is associated with worse prognosis during and after an episode of acutely decompensated heart failure (AHF).

Methods
Six hundred and twenty-three patients participating in an ongoing prospective cohort study that phenotypes and follows patients admitted for AHF were studied. We compared CIED carriers with activated R-mode stimulation (CIED-R) to CIED carriers not in R-mode (CIED-0) and patients without CIEDs (no-CIED). The independent impact of R-mode activation on 12-month all-cause death was examined using uni- and multivariable Cox proportional hazards regression taking into account potential confounders, and hazard ratios (HR) with their 95% confidence intervals (CI) were reported.

Results
Mean heart rate on admission was lower in CIED-R (n = 37, 16% women) vs. CIED-0 (n = 64, 23% women) or no-CIED (n = 511, 43% women): 70 bpm vs. 80 bpm or 82 bpm; both p<0.001. In-hospital mortality was similar across groups, but age- and sex-adjusted all-cause 12-month mortality risk was differentially affected by R-mode activation; CIED-R vs. CIED-0: HR 2.44, 95%CI 1.25–4.74; CIED-R vs. no-CIED: HR 2.61, 95%CI 1.59–4.29. These effects persisted after multivariable adjustment for potential confounders. Within CIED-R, mortality risk was similar in patients with pacemakers vs. ICDs and in subgroups with left ventricular ejection fraction (LVEF) <50% vs. ≥50%.

Conclusion
In patients admitted with AHF, R-mode stimulation was associated with a significantly increased 12-month mortality risk. Our findings shed new light on “admission heart rate” as a potentially treatable target in AHF. Our data are compatible with the concept that chronotropic incompetence contributes to an adverse outcome in these patients and may not be adequately treated through accelerometer-based R-mode stimulation.
”När vi rider tillsammans känns hon mer som en kompis än som en mamma”
Authors: Asklund Helen , Manderstedt Lena , Persson Ann-Sofie 
Published: April 2024

Theme: Motherhood and Mothering. Ill. ©Stina Wirsén
”When We Ride Together, She’s More like a Friend than a Mum”: Mothering Variations in Three Horse Story Series by Pia Hagmar
This article analyzes how the horse story setting problematizes the conception of the good mother and normative mothering, by elucidating how the gazes of the young main characters on their mothers function in relation to the notion of the good mother, how this influences the mothering and how the mothering characters challenge this notion. Mothering is seen here as caring practices, which can be performed by people other than mothers. The analysis of three horse story series by Pia Hagmar, the books on Klara (1999–2008), the books on Millan (2012–2014) and the books on Juli (2019–2021), shows that the series depict motherhood and mothering at the intersection between the conception of the good mother and the good horse person. The common denominator is nurturing traits that make personal needs take the back seat – for the traditional good mother to the benefit of her children, for the good horse person to the benefit of the horse. Hagmar normalizes the presence of several mothering characters in addition to their mothers around the horse girls. Furthermore, these characters, who function as mothering variations, contribute to the creation of a solid caring environment, reducing the demands on mothers who try to be everything to their children. Although the daughters’ views of their mothers are sometimes critical, Hagmar allows the mothers to be imperfect, partly incompetent, or simply women with their own agency,interests and needs outside of motherhood. In addition, a mother-daughter relationship built on a common interest in horses allows for a friendship with a common focus – the horse.
Metric quasiconformality and Sobolev regularity in non-Ahlfors regular spaces
Authors: Lahti Panu , Zhou Xiaodan 
Published: April 2024

Abstract
Given a homeomorphism

f
:
X
→
Y

f:X\to Y

between

Q

Q

-dimensional spaces

X
,
Y

X,Y

, we show that

f

f

satisfying the metric definition of quasiconformality outside suitable exceptional sets implies that

f

f

belongs to the Sobolev class

N

loc

1
,
p

(

X
;

Y

)

{N}_{{\rm{loc}}}^{1,p}\left(X;\hspace{0.33em}Y)

, where

1
≤
p
≤
Q

1\le p\le Q

, and also implies one direction of the geometric definition of quasiconformality. Unlike previous results, we only assume a pointwise version of Ahlfors

Q

Q

-regularity, which in particular enables various weighted spaces to be included in the theory. Notably, even in the classical Euclidean setting, we are able to obtain new results using this approach. In particular, in spaces including the Carnot groups, we are able to prove the Sobolev regularity

f
∈

N

loc

1
,
Q

(

X
;

Y

)

f\in {N}_{{\rm{loc}}}^{1,Q}\left(X;\hspace{0.33em}Y)

without the strong assumption of the infinitesimal distortion

h

f

{h}_{f}

belonging to

L

∞

(

X

)

{L}^{\infty }\left(X)

.
Mitigating digestive disorders: Action mechanisms of Mediterranean herbal active compounds
Authors: Kmail Abdalsalam 
Published: April 2024

Abstract
This study explores the effects of the Mediterranean diet, herbal remedies, and their phytochemicals on various gastrointestinal conditions and reviews the global use of medicinal plants for common digestive problems. The review highlights key plants and their mechanisms of action and summarizes the latest findings on how plant-based products influence the digestive system and how they work. We searched various sources of literature and databases, including Google Scholar, PubMed, Science Direct, and MedlinePlus. Our focus was on gathering relevant papers published between 2013 and August 2023. Certain plants exhibit potential in preventing or treating digestive diseases and cancers. Notable examples include Curcuma longa, Zingiber officinale, Aloe vera, Calendula officinalis, Lavandula angustifolia, Thymus vulgaris, Rosmarinus officinalis, Ginkgo biloba, Cynodon dactylon, and Vaccinium myrtillus. The phytochemical analysis of the plants showed that compounds such as quercetin, anthocyanins, curcumin, phenolics, isoflavones glycosides, flavonoids, and saponins constitute the main active substances within these plants. These natural remedies have the potential to enhance the digestive system and alleviate pain and discomfort in patients. However, further research is imperative to comprehensively evaluate the benefits and safety of herbal medicines to use their active ingredients for the development of natural and effective drugs.