bluuebunny/crossref_metadata_2025_split huggingface dataset:
Knowledge, attitude, and practice of cervical cancer screening and its associated risk factors among family planning service users at Debre Tabor town health facilities, North Central Ethiopia: A cross-sectional study
Authors: Damtie Shewaneh , Legese Biruk , Berhan Ayenew , Kiros Teklehaimanot , Eyayu Tahir , Mihrete Kefiyalew , Taklual Wubet 
Published: November 2023

Background: The fourth most common cancer in women worldwide is cervical cancer. Over 87% of deaths from cervical cancer occur in developing nations. One of the risks of developing cervical cancer is the use of oral contraceptives. However, there is limited evidence on the knowledge, attitude, and practice of cervical cancer screening among family planning service users in Ethiopia. Objective: To assess the knowledge, attitude, and practice toward cervical cancer screening and its associated factors among family planning service users. Methods: A facility-based cross-sectional study was conducted from January 1 to February 28, 2023. A total of 816 participants were selected using a systematic sampling technique. Data were collected using a pretested, structured, and interviewer-administered questionnaire. The collected data were entered into EPI Data 3.1 and exported to SPSS version 24 (IBM, Armonk, NY, USA) for analysis. Logistic regression was used to identify risk factors. An odds ratio with a 95% confidence interval and a p-value < 0.05 were used to declare statistical significance. Results: Overall, 42.5%, 36.6%, and 20.1% of the participants had good knowledge, a positive attitude, and practiced cervical cancer screening, respectively. Being single (adjusted odds ratio (AOR) = 3.39, 95% confidence intervals: 1.15–6.26), having college or university level of education (AOR = 8.03, 95% confidence intervals: 3.45–19.23), having a family history of cervical cancer (AOR = 3.14, 95% confidence intervals: 1.82–8.84), and having a source of information from the media (AOR = 1.74, 95% confidence intervals: 1.09–2.54) were significantly associated with good knowledge of cervical cancer screening. Women who were aged 15–23 years (AOR = 5.62, 95% confidence intervals: 2.76–14.56), had college- or university-level education (AOR = 3.69, 95% confidence intervals: 1.65–8.22), and had good knowledge of cervical cancer (AOR = 4.71, 95% confidence intervals: 3.08–7.55) were significantly associated with a positive attitude toward cervical cancer screening. An earlier age of first sexual intercourse (AOR = 5.0, 95% confidence intervals: 3.80–9.20) and good knowledge of cervical cancer (AOR = 1.52, 1.21–5.82) were positively associated with good practice of cervical cancer screening. Women who attended high school were negatively associated with good practice in cervical cancer screening (AOR = 0.46, 0.23–0.73). Conclusion: Knowledge, attitude, and practice toward cervical cancer screening were low. As a result, during patient visits for care delivery, healthcare providers should inform and educate patients about cervical cancer screening.
Sequential antigen loss and branching evolution in lymphoma after CD19- and CD20-targeted T-cell–redirecting therapy
Authors: Duell Johannes , Leipold Alexander M. , Appenzeller Silke , Fuhr Viktoria , Rauert-Wunderlich Hilka , Da Via Matteo , Dietrich Oliver , Toussaint Christophe , Imdahl Fabian , Eisele Florian , Afrin Nazia , Grundheber Lars , Einsele Hermann , Weinhold Niels , Rosenwald Andreas , Topp Max S. , Saliba Antoine-Emmanuel , Rasche Leo 
Published: November 2023

Abstract
CD19 chimeric antigen receptor (CAR) T cells and CD20 targeting T-cell–engaging bispecific antibodies (bispecs) have been approved in B-cell non-Hodgkin lymphoma lately, heralding a new clinical setting in which patients are treated with both approaches, sequentially. The aim of our study was to investigate the selective pressure of CD19- and CD20-directed therapy on the clonal architecture in lymphoma. Using a broad analytical pipeline on 28 longitudinally collected specimen from 7 patients, we identified truncating mutations in the gene encoding CD20 conferring antigen loss in 80% of patients relapsing from CD20 bispecs. Pronounced T-cell exhaustion was identified in cases with progressive disease and retained CD20 expression. We also confirmed CD19 loss after CAR T-cell therapy and reported the case of sequential CD19 and CD20 loss. We observed branching evolution with re-emergence of CD20+ subclones at later time points and spatial heterogeneity for CD20 expression in response to targeted therapy. Our results highlight immunotherapy as not only an evolutionary bottleneck selecting for antigen loss variants but also complex evolutionary pathways underlying disease progression from these novel therapies.
Regulation of kynurenine metabolism by blood donor genetics and biology impacts red cell hemolysis in vitro and in vivo
Authors: Nemkov Travis , Stephenson Daniel , Erickson Christopher , Dzieciatkowska Monika , Key Alicia , Moore Amy , Earley Eric J. , Page Grier P. , Lacroix Ian S. , Stone Mars , Deng Xutao , Raife Thomas , Kleinman Steven , Zimring James C. , Roubinian Nareg , Hansen Kirk C. , Busch Michael P. , Norris Philip J. , D’Alessandro Angelo 
Published: November 2023

Abstract
In the field of transfusion medicine, the clinical relevance of the metabolic markers of the red blood cell (RBC) storage lesion is incompletely understood. Here, we performed metabolomics of RBC units from 643 donors enrolled in the Recipient Epidemiology and Donor Evaluation Study, REDS RBC Omics. These units were tested on storage days 10, 23, and 42 for a total of 1929 samples and also characterized for end-of-storage hemolytic propensity after oxidative and osmotic insults. Our results indicate that the metabolic markers of the storage lesion poorly correlated with hemolytic propensity. In contrast, kynurenine was not affected by storage duration and was identified as the top predictor of osmotic fragility. RBC kynurenine levels were affected by donor age and body mass index and were reproducible within the same donor across multiple donations from 2 to 12 months apart. To delve into the genetic underpinnings of kynurenine levels in stored RBCs, we thus tested kynurenine levels in stored RBCs on day 42 from 13 091 donors from the REDS RBC Omics study, a population that was also genotyped for 879 000 single nucleotide polymorphisms. Through a metabolite quantitative trait loci analysis, we identified polymorphisms in SLC7A5, ATXN2, and a series of rate-limiting enzymes (eg, kynurenine monooxygenase, indoleamine 2,3-dioxygenase, and tryptophan dioxygenase) in the kynurenine pathway as critical factors affecting RBC kynurenine levels. By interrogating a donor-recipient linkage vein-to-vein database, we then report that SLC7A5 polymorphisms are also associated with changes in hemoglobin and bilirubin levels, suggestive of in vivo hemolysis in 4470 individuals who were critically ill and receiving single-unit transfusions.
Dynamic Investigations on the Wear Behavior of a 3D Revolute Joint Considering Time-Varying Contact Stiffness: Simulation and Experiment
Authors: Zhang Li , Fang Yining , Bai Guanghan , Tao Junyong 
Published: November 2023

AbstractThe existence of the relative radial and axial movements of a revolute joint’s journal and bearing is widely known. The three-dimensional (3D) revolute joint model considers relative radial and axial clearances; therefore, the freedoms of motion and contact scenarios are more realistic than those of the two-dimensional model. This paper proposes a wear model that integrates the modeling of a 3D revolute clearance joint and the contact force and wear depth calculations. Time-varying contact stiffness is first considered in the contact force model. Also, a cycle-update wear depth calculation strategy is presented. A digital image correlation (DIC) non-contact measurement and a cylindricity test are conducted. The measurement results are compared with the numerical simulation, and the proposed model’s correctness and the wear depth calculation strategy are verified. The results show that the wear amount distribution on the bearing’s inner surface is uneven in the axial and radial directions due to the journal’s stochastic oscillations. The maximum wear depth locates where at the bearing’s edges the motion direction of the follower shifts. These findings help to seek the revolute joints’ wear-prone parts and enhance their durability and reliability through improved design.
Core atoms escape from the shell: reverse segregation of Pb–Al core–shell nanoclusters via nanoscale melting
Authors: Wu Wenkai , Pavloudis Theodoros , Palmer Richard E. 
Published: November 2023

AbstractMelting is a phase transition that profoundly affects the fabrication and diverse applications of metal nanoclusters. Core–shell clusters offer distinctive properties and thus opportunities compared with other classes of nano-alloys. Molecular dynamics simulations have been employed to investigate the melting behaviour of Pb–Al core–shell clusters containing a fixed Pb147 core and varying shell thickness. Our results show that the core and shell melt separately. Surprisingly, core melting always drives the core Pb atoms to break out the shell and coat the nanoclusters in a reversed segregation process at the nanoscale. The melting point of the core increases with the shell thickness to exceed that of the bare core cluster, but the thinnest shell always supresses the core melting point. These results can be a reference for the future fabrication, manipulation, and exploitation of the core–shell nanoalloys chosen. The system chosen is ideally suited for experimental observations.
Turkish translation, cross-cultural adaptation and reliability of the Groningen Frailty Indicator
Authors: Güner Merve , Ceylan Serdar , Okyar Baş Arzu , Koca Meltem , Doğu Burcu Balam , Halil Meltem Gülhan , Cankurtaran Mustafa , Balcı Cafer 
Published: November 2023

Abstract
Background
Frailty is an important geriatric syndrome that can be seen as a way of recognizing and distinguishing the complex health conditions of older people. Due to the time limitation, short and simple instruments are most feasible in clinical practice, and several quick screening tools have been developed and validated, Groningen frailty indicator (GFI) is one of these scales. We aimed to validate and evaluate the reliability of the GFI in outpatient older adults in the Turkish population.

Methods
A total of 101 older patients were enrolled to the study. GFI was scored by a geriatrician for every patient at first admission to the geriatric outpatient clinic. Fried Physical Frailty Phenotype (FPFP) was performed as a reference test.

Results
The median age (IQR) was 72.0 (10.0) and 62.4% of the study population (n = 63) was female. Based on the GFI, 34 patients (33.7%) were defined as robust, and 67 patients (66.3%) were defined as living with frailty. There was a statistically significant concordance between GFI and FPFP (Cohen’s kappa: 0.415 p < 0.001). GFI had excellent consistency in inter-rater reliability (Cronbach’s alpha: 0.99, 95% CI 0.97-1.00) and in intra-rater reliability (Cronbach’s alpha: 0.99, 95% CI 0.96-1.0).

Conclusion
Our study showed that GFI is a valid and reliable scale in the Turkish older population.
Informing about childbirth without increasing anxiety: a qualitative study of first-time pregnant women and partners’ perceptions and needs
Authors: Diezi Anne-Sylvie , Vanetti Mélanie , Robert Marie , Schaad Béatrice , Baud David , Horsch Antje 
Published: November 2023

Abstract
Background
Complications requiring medical interventions during childbirth are far from rare, even after uncomplicated pregnancies. It is often a challenge for maternity healthcare professionals to know how to prepare future parents for these eventualities without causing unnecessary anxiety. Studies on traumatic birth experiences have shown that feelings of loss of control, insufficient information, and lack of participation in medical decisions during childbirth are factors of difficult experiences. However, little is known about the information and communication needs of expectant parents about childbirth during the prenatal period. To gain a deeper understanding of the information and communication needs of first-time pregnant women and partners, we explored their perceptions and expectations for their upcoming childbirth, and the actions they initiated to prepare for it.

Methods
Semi-structured interviews were conducted individually with first-time pregnant women and partners of pregnant women aged 18 years or older, with an uncomplicated pregnancy. Thematic analysis was used to identify themes and sub-themes.

Results
Twenty expectant parents (15 pregnant women and five partners of pregnant women) were interviewed. Six themes were identified: Childbirth event; Childbirth experience; Childbirth environment; Organisation of care; Participation in decision making; Roles within the couple and transition to parenthood.

Conclusions
This study contributes to a better understanding of the information needs of future parents expecting their first child. Results highlighted that the notion of “childbirth risks” went beyond the prospect of complications during birth, but also encompassed concerns related to a feeling of loss of control over the event. Expectant parents showed an ambivalent attitude towards consulting risk information, believing it important to prepare for the unpredictability of childbirth, while avoiding information they considered too worrying. They expressed a desire to receive concrete, practical information, and needed to familiarise themselves in advance with the birth environment. Establishing a respectful relationship with the healthcare teams was also considered important. The findings suggest that information on childbirth should not be limited to the transmission of knowledge, but should primarily be based on the establishment of a relationship of trust with healthcare professionals, taking into account each person’s individual values and expectations.
HPV testing in Polish population-based cervical cancer screening programme (HIPPO project)—study protocol of a randomised healthcare policy trial
Authors: Glinska Patrycja , Komerska Katarzyna , Janik Beata , Olkowicz Julia , Jedrzejewska Ilona , Macios Anna , Wieszczy Paulina , Kaminski Michal F. , Arbyn Marc , Nowakowski Andrzej 
Published: November 2023

Abstract
Background
An Organised Cervical Cancer Screening Programme (OCCSP) was started in Poland in 2006/2007. Each woman aged 25 to 59 is eligible for a free Pap test every 3 years in OCCSP. Despite implementation of the OCCSP, the age-standardised cervical cancer (CC) incidence and mortality rates in 2019 were 7.3/100 000 and 3.9/100 000 respectively and were still higher than those in Western European countries with well-organised screening programmes. Apart from low coverage of the OCCSP, suboptimal performance of the screening test (conventional cytology) may be partially responsible for this situation. Several countries have already incorporated high risk Human Papillomavirus (hrHPV) testing in CC screening as a more sensitive tool reducing the risk of missing precancerous lesions and allowing for extension of screening intervals. The European Guidelines for Quality Assurance in Cervical Cancer Screening recommend pilot evaluation of a new screening test in country-specific conditions before its implementation.

Methods
The HIPPO project (HPV testing In Polish POpulation-based cervical cancer screening program) is a randomised health services study nested in the OCCSP in Poland. The project will randomise 33 000 women aged 30–59 years to cytology or hrHPV testing (ratio: 1:1) with age stratification. In the cytology arm women with repeated Atypical Squamous Cells of Undetermined Significance (ASC-US) or ≥ Low–Grade Squamous Intraepithelial Lesions (LSIL) are referred for colposcopy. In the other arm, hrHPV ( +) women with ≥ ASC-US reflex Liquid-Based Cytology (LBC) are referred for colposcopy. Primary endpoints include detection rates of histologically confirmed high grade intraepithelial lesions or worse (CIN2 +) in each arm.

Discussion
This pilot randomised healthcare study nested in the OCCSP in Poland will assess and compare the performance of hrHPV testing to current standard—cytology in order to make decisions on implementation of HPV-based screening in the country.

Trial registration
This randomised healthcare service study was prospectively registered at https://clinicaltrials.gov/ (identifier: NCT04111835, protocol ID 28/2019) on 19th of September 2019.
Neonatal near-miss audits: a systematic review and a call to action
Authors: Medeiros P.B. , Bailey C. , Pollock D. , Liley H. , Gordon A. , Andrews C. , Flenady V. 
Published: November 2023

Abstract
Background
Neonatal near-miss (NNM) can be considered as an end of a spectrum that includes stillbirths and neonatal deaths. Clinical audits of NNM might reduce perinatal adverse outcomes. The aim of this review is to evaluate the effectiveness of NNM audits for reducing perinatal mortality and morbidity and explore related contextual factors.

Methods
PubMed, Embase, Scopus, CINAHL, LILACS and SciELO were searched in February/2023. Randomized and observational studies of NNM clinical audits were included without restrictions on setting, publication date or language. Primary outcomes: perinatal mortality, morbidity and NNM. Secondary outcomes: factors contributing to NNM and measures of quality of care. Study characteristics, methodological quality and outcome were extracted and assessed by two independent reviewers. Narrative synthesis was performed.

Results
Of 3081 titles and abstracts screened, 36 articles had full-text review. Two studies identified, rated, and classified contributing care factors and generated recommendations to improve the quality of care. No study reported the primary outcomes for the review (change in perinatal mortality, morbidity and NNM rates resulting from an audit process), thus precluding meta-analysis. Three studies were multidisciplinary NNM audits and were assessed for additional contextual factors.

Conclusion
There was little data available to determine the effectiveness of clinical audits of NNM. While trials randomised at patient level to test our research question would be difficult or unethical for both NNM and perinatal death audits, other strategies such as large, well-designed before-and-after studies within services or comparisons between services could contribute evidence. This review supports a Call to Action for NNM audits. Adoption of formal audit methodology, standardised NNM definitions, evaluation of parent’s engagement and measurement of the effectiveness of quality improvement cycles for improving outcomes are needed.
Intricate role of intestinal microbe and metabolite in schizophrenia
Authors: Shi Li , Ju Peijun , Meng Xiaojing , Wang Zhongxian , Yao Lihui , Zheng Mingming , Cheng Xialong , Li Jingwei , Yu Tao , Xia Qingrong , Yan Junwei , Zhu Cuizhen , Zhang Xulai 
Published: November 2023

Abstract
Background
The brain-gut axis has gained increasing attention due to its contribution to the etiology of various central nervous system disorders. This study aims to elucidate the hypothesis that schizophrenia is associated with disturbances in intestinal microflora and imbalance in intestinal metabolites. By exploring the intricate relationship between the gut and the brain, with the goal of offering fresh perspectives and valuable insights into the potential contribution of intestinal microbial and metabolites dysbiosis to the etiology of schizophrenia.

Methods
In this study, we used a 16S ribosomal RNA (16S rRNA) gene sequence–based approach and an untargeted liquid chromatography-mass spectrometry-based metabolic profiling approach to measure the gut microbiome and microbial metabolites from 44 healthy controls, 41 acute patients, and 39 remission patients, to evaluate whether microbial dysbiosis and microbial metabolite biomarkers were linked with the severity of schizophrenic symptoms.

Results
Here, we identified 20 dominant disturbances in the gut microbial composition of patients compared with healthy controls, with 3 orders, 4 families, 9 genera, and 4 species. Several unique bacterial taxa associated with schizophrenia severity. Compared with healthy controls, 145 unusual microflora metabolites were detected in the acute and remission groups, which were mainly involved in environmental information processing, metabolism, organismal systems, and human diseases in the Kyoto encyclopedia of genes and genomes pathway. The Sankey diagram showed that 4 abnormal intestinal and 4 anomalous intestinal microbial metabolites were associated with psychiatric clinical symptoms.

Conclusions
These findings suggest a possible interactive influence of the gut microbiota and their metabolites on the pathophysiology of schizophrenia.
Living alone and the risk of depressive symptoms: a cross-sectional and cohort analysis based on the China Health and Retirement Longitudinal Study
Authors: Zheng Guangjun , Zhou Biying , Fang Zhenger , Jing Chunxia , Zhu Sui , Liu Mingliang , Chen Xia , Zuo Lei , Chen Haiyan , Hao Guang 
Published: November 2023

Abstract
Background
There were a few studies that examined the longitudinal association between living alone and depressive symptoms, and the vast majority of them were conducted in patients with certain diseases, such as heart failure, cancer, and glaucoma. This study aimed to examine the association between living alone and depressive symptoms in a large representative older Chinese population.

Methods
The China Health and Retirement Longitudinal Study (CHARLS) data from 2015 to 2018 were used. Living alone was defined as participants who did not live with others ever or more than 11 months in the past year at baseline. Depressive symptoms were measured using the 10-item Center for Epidemiological Studies-Depression Scale (CES-D10). The multivariate logistic regression was used to estimate the relationship between living alone and depressive symptoms.

Results
There were 5,311 and 2,696 participants ≥ 60 years old included in the cross-sectional and cohort analysis, respectively. The risk of depressive symptoms in participants who lived alone was significantly higher than those who lived with others in both cross-sectional (OR:1.33; 95%CI:1.14,1.54) and cohort analysis (OR:1.23; 95%CI:0.97,1.55). There was a significant interaction between financial support and living alone (Pinteraction = 0.008) on the risk of depressive symptoms. Stratified analyses showed that, compared to those who lived with others, the risk of depressive symptoms in participants who lived alone increased by 83% (OR:1.83; 95%CI:1.26,2.65) in participants receiving lower financial support. However, we did not find statistically significant associations in participants with medium (OR:1.10; 95%CI: 0.74,1.63) and higher financial support (OR: 0.87; 95%CI: 0.53,1.41).

Conclusion
Living alone was associated with a higher risk of depressive symptoms in the Chinese older population, and this association was moderated by the receipt of financial support. Living alone may be an effective and easy predictor for early identification of high-risk populations of depression in the older population.