bluuebunny/crossref_metadata_2025_split huggingface dataset:
Trend, determinants, and future prospect of child marriage in the Amhara region, Ethiopia: a multivariate decomposition analysis
Authors: Dessie Anteneh Mengist , Anley Denekew Tenaw , Zemene Melkamu Aderajew , Gebeyehu Natnael Atnafu , Adella Getachew Asmare , Kassie Gizachew Ambaw , Mengstie Misganaw Asmamaw , Seid Mohammed Abdu , Abebe Endeshaw Chekol , Gesese Molalegn Mesele , Tegegne Kirubel Dagnaw , Anteneh Rahel Mulatie , Solomon Yenealem , Moges Natnael , Bantie Berihun , Feleke Sefineh Fenta , Dejenie Tadesse Asmamaw , Geremew Habtamu 
Published: September 2023

BackgroundChild marriage is a harmful traditional practice, which compromises children of their childhood and threatens their lives and health. In Ethiopia, 58% of women and 9% of men get married before the age of 18 years. Surprisingly, parents in the Amhara region make marriage promises of their children before they are even born, which will hinder the region from attaining the Sustainable Development Goal of ending child marriage. Thus, this study aimed to assess the trends, determinants, and future prospects of child marriage in the Amhara region of Ethiopia.MethodsA repeated cross-sectional study was conducted using four consecutive nationally representative Ethiopian demographic and health surveys (2000–2016). A logit-based multivariate decomposition analysis for a non-linear response model was fitted to identify factors that contributed to the change in child marriage over time. Statistical significance was declared at a p-value of &lt; 0.05. The child marriage practice in the Amhara region by the year 2030 was also predicted using different forecasting features of Excel.ResultsThe trend of child marriage over the study period (2000–2016) decreased from 79.9% (76.7, 82.8) to 42.9% (39.1, 46.9), with an annual average reduction rate of 2.9%. Approximately 35.2% of the decline resulted from an increase in the proportion of women who attained secondary and above-secondary education over the two surveys. A decrease in the proportion of rural women and a change in the behavior of educated and media-exposed women also contributed significantly to the decline in child marriage. The prevalence of child marriage in the Amhara region by the year 2030 was also predicted to be 10.1% or 8.8%.ConclusionThough there has been a significant decline in child marriage in the Amhara region over the past 16 years, the proportion is still high, and the region is not going to eliminate it by 2030. Education, residence, and media exposure were all factors associated with the observed change in child marriage in this study. Therefore, additional efforts will be required if child marriage is to be eliminated by 2030, and investing more in education and media access will hasten the region's progress in this direction.
COVID-19 cleaning protocol changes, experiences, and respiratory symptom prevalence among cleaning services personnel
Authors: Wilson Amanda M. , Jung Yoonhee , Mooneyham Sydney A. , Klymko Ivana , Eck Josie , Romo Carlos , Vaidyula Vineeth R. , Sneed Sam J. , Gerald Lynn B. , Beamer Paloma I. 
Published: September 2023

IntroductionCleaning protocols were changed in response to the COVID-19 pandemic with unknown occupational health impacts. There is evidence that COVID-19 transmission risks from contaminated surfaces are low and that exposure to cleaning products can increase risks of work-related asthma. The study objective was to investigate relationships between reported COVID-19-related changes in cleaning protocols and prevalence of asthma-related respiratory symptoms for asthmatic and non-asthmatic janitors and maids. A secondary objective was to characterize experiences of respiratory symptoms associated with cleaning and barriers to personal protective equipment (PPE) use.MethodsEmployees from two Tucson-based maid service companies (approximately 30 personnel in total) and one Phoenix-based school district (&gt;300 janitors/custodians) were invited to participate in a written survey and/or a one-on-one interview in Spanish or English. Fisher’s exact tests (α = 0.05) were used to test for statistically significant associations between reported respiratory symptoms by self-reported physician-diagnosed asthma status and changes in cleaning protocols. Interviews were transcribed and then analyzed by at least two researchers in English or Spanish.ResultsEighty-three percent reported that cleaning protocols had changed during COVID-19, with the two most reported changes including increased cleaning frequency (92%) and change of application type (e.g., fog, spray, wipe) (53%). There was a statistically significant association between multiple respiratory symptoms and self-reported physician diagnosed asthma. Reporting a type of application change (e.g., fog, spray, wipe) and being awakened during the night by attack/episode of cough were statistically significantly associated (p = 0.04). Interviews elucidated respiratory issues related to fogging devices.DiscussionThis study provides preliminary evidence that changes in cleaning and disinfection protocols during COVID-19 (namely, the use of fogging/mechanical spraying devices) may have had negative impacts on the health of workers in the cleaning industry with little benefit to reducing COVID-19 risks. Further research is needed to evaluate the generalizability of our findings across larger geographical areas and to develop guidance for employers and employees on how to protect and promote respiratory health.
Healthcare professionals’ and patients’ assessments of listed mobile health apps in China: a qualitative study
Authors: Liu PeiYu , Li XueYun , Zhang Xiao Man 
Published: September 2023

BackgroundIn recent years, mobile health (mHealth) has gradually developed in China, and intelligent medicine has become an important research topic. However, there are still significant problems in mHealth applications (apps). Although healthcare professionals and patients are the main users, few studies have focused on their perceptions of the quality of mHealth apps.ObjectiveThis study aimed to (1) understand the respective perceptions of healthcare professionals and patients regarding mHealth apps, (2) assess what barriers exist that influence the user experience, and (3) explore how to improve the quality of mHealth apps and the development of the mHealth market in China. The study aims to promote the standardization of mHealth apps and provide effective information for the improvement and development of mHealth apps in the future.MethodsSemistructured interviews with 9 patients and 14 healthcare professionals were conducted from January 2022 to April 2022 in the Affiliated Hospital of Xuzhou Medical University. The participants used mHealth apps for more than 3 months, including the “Good Mood” and “Peace and Safe Doctors” apps and apps developed by the hospital that were popular in China. Interview transcripts were analysed using thematic analysis.ResultsThe following five themes were extracted: different concerns, hidden medical dangers, distance and insecurity, barriers for older people, and having positive perceptions of mHealth apps. Healthcare professionals prioritized simplicity in regard to mHealth apps, whereas patients rated effectiveness as the most crucial factor. The study also revealed several problems with mHealth apps, including insufficient information about physician qualifications, inaccurate medical content, nonstandard treatment processes, and unclear accountability, which led to a sense of distance and insecurity among participants. Older individuals faced additional obstacles when using mHealth apps. Despite these issues, the participants remained optimistic about the future of mHealth app development.ConclusionThe utilization, advantages, and obstacles of mHealth applications for healthcare professionals and patients were explored through semistructured interviews. Despite the promising prospects for mHealth apps in China, numerous issues still need to be addressed. Enhancing the safety monitoring system and developing user-friendly mHealth apps for older adult patients are essential steps to bridge the gap between healthcare providers and patients.
Morbidity and mortality in a prospective cohort of people who were homeless during the COVID-19 pandemic
Authors: Loubiere Sandrine , Hafrad Ikrame , Monfardini Elisabetta , Mosnier Marine , Bosetti Thomas , Auquier Pascal , Mosnier Emilie , Tinland Aurélie 
Published: September 2023

IntroductionCertain living conditions, such as homelessness, increase health risks in epidemic situations. We conducted a prospective observational cohort study to investigate the impact of the COVID-19 pandemic on morbidity and mortality in adult people who were homeless.MethodsThe study population comprised around 40% of the entire population experiencing homelessness in Marseille. They were enrolled at 48 different locations during the first pandemic wave (June to August 2020) and were followed up 3 and 6 months later. Rapid serological screening for SARS-CoV-2 was performed by community outreach teams at each follow-up, who also conducted interviews. Death registers and hospital administrative databases were consulted.ResultsA total of 1,332 participants [mean age 40.1 years [SD 14.2], women 339 (29.9%)] were enrolled in the cohort. Of these, 192 (14.4%) participants were found positive for COVID-19 and were propensity score matched (1:3) and compared with 553 non-COVID-19 cases. Living in emergency shelters was associated with COVID-19 infection. While 56.3% of the COVID-19-infected cohort reported no symptoms, 25.0% were hospitalized due to the severity of the disease. Presence of three or more pre-existing comorbidities was associated with all-cause hospitalization. Among COVID-19 cases, only older age was associated with COVID-19 hospitalization. Three deaths occurred in the cohort, two of which were among the COVID-19 cases.ConclusionThe study provides new evidence that the population experiencing homelessness faces higher risks of infection and hospitalization due to COVID-19 than the general population. Despite the efforts of public authorities, the health inequities experienced by people who are homeless remained major. More intensive and appropriate integrated care and earlier re-housing are needed.
Oral/oropharyngeal “selfies” in gay and bisexual men: a pilot study exploring oropharyngeal screening for HPV-related possible malignancies
Authors: Ross Michael W. , Bennis Sarah L. , Nichols C. Mark , Zoschke I. Niles , Wilkerson J. Michael , Rosser B. R. Simon , Stull Cyndee L. , Nyitray Alan G. , Flash Charlene , Khariwala Samir S. 
Published: September 2023

ObjectivesThis study aims to determine the potential uptake and quality of oropharyngeal “selfies” taken by gay/bisexual men as a screening approach for HPV-associated oropharyngeal cancer.MethodsFrom 1,699 gay/bisexual men in the US, surveyed about knowledge and attitudes to HPV-associated oropharyngeal cancer, a random sample of 320 men were invited to take an oropharyngeal “selfie” by smartphone and send it to the study website: 113 (35.5%) did so. Images were rated for quality by three healthcare professional raters blinded to each other's rating, with an otolaryngologist as the gold standard. In the second wave, those whose images were rated as unacceptable were sent a short instructional video and asked to send another image. Of the 65 invited, 46 did so. An additional 15.2% sent acceptable images, and a total of 28.3% of the sample was acceptable.ResultsA total of 1,121 men willing to participate in the future study who believed they could take a quality “oral selfie” were potentially eligible for this activity. A random sample of 320 participated: 153 participants started (47.8%) and 113 participants (35.3%) submitted an image. Responders were more likely to be younger, have higher knowledge scores on oropharyngeal HPV-related cancer, and have had HPV vaccination. There was high agreement between the three raters. Images of good/acceptable quality were 22.1%; oropharynx partially occluded images were 29.2%; oropharynx not visible images were 18.6%; images too dark were 21.2%; and images too small were 8.8%. From the second wave of requests with instructional videos, an additional 15.2% sent in quality images, with the remaining issues being partial occlusion of the tonsils by the tongue.ConclusionOne-third of the invited gay and bisexual men sent oropharyngeal selfie images to the study website and a total of 28.3% were of clinically acceptable quality. Following an instructional video on poorer-quality images, additional quality images were received. One barrier, i.e., partial occlusion of the oropharynx by the tongue remained. Quality oropharyngeal “selfies” are obtainable online.
Two vicious circles associated with the aging of the immune system in the development of severe forms of COVID-19
Authors: Vrbic Miodrag , Milinkovic Ana 
Published: September 2023

Background: The immune-inflammatory response is the basis of the pathophysiology of SARS-Cov-2 infection. In severe cases of COVID-19 uncontrolled systemic inflammatory response causes multiorgan dysfunction (MODS), as the most common immediate cause of death. Unfavorable outcome of the COVID-19 most often occurs in elderly patients. The aim of the study was to establish parameters with prognostic significance in severe cases of COVID-19 according to life years, laboratory markers of sepsis and MODS, as well as the number of peripheral CD4+ and CD8+T lymphocytes in 20 consecutively selected critically ill patients.Results: Eleven subjects were male, 9 female, mean age 73.45 ± 11.59, among which the oldest patient was 94 and the youngest 43 years. All the patients met the sepsis and MODS criteria. Increased age and low CD4+ and CD8+T cell counts were identified as independent predictors of death. Only the two youngest patients (43 and 50 years old) survived 28 days, and they are the only ones with a CD4 lymphocyte count above 500 cells/mm3.Conclusion: Senescence of the immune system is mostly characterized by reduced regenerative capacity of adaptive immunity with diminished ability to respond to new antigens and a manifested proinflammatory phenotype. Additional reduction of protective capacity by further deterioration of T cell quantity and quality due to sepsis itself and mutual interaction of senescent T cells and vascular endothelial cells in the induction of cytokine storm represent two complementary vicious cycles in the development of sepsis-related multiorgan dysfunction.
Life experiences leading to the choice of surgery—A qualitative study exploring reasons behind the choice of undergoing gender affirmative surgery
Authors: Bjørnson Lene Kjelkenes , Sagbakken Mette 
Published: September 2023

ObjectiveGender dysphoria is frequently accompanied by physical dissatisfaction and body image issues. The primary objective of this study is to explore subjective experiences and perceptions among those who has undergone gender reassignment surgery, as well as their retrospective path to that decision.MethodSixteen qualitative in-depth interviews were conducted with 9 participants. The participants were accepted for gender affirming surgery and interviewed before and after surgery.ResultsCultural norms, and values in relation to time and context were highlighted as significant in reference to the opportunity one had to display a gender identity that corresponded to prevailing expectations. Participants gradually began to recognize their differences and divergence from others in social interactions and experiencing “wrong” bodily changes during puberty created even greater discrepancy. Several impression control measures, such as avoiding certain situations and using concealing techniques, were employed to prevent what was described as both felt and enacted stigma. The significance of having genital organs that accurately reflect one's gender identity was emphasized to prevent emotional distress and dysphoria caused by this discrepancy.ConclusionSocio-cultural expectations, combined with enacted stigma, seem to cause, or re-enforce self-stigma as people internalize these attitudes and suffer from physical and mental consequences as a result. Thus, societal, and cultural trends seem to have a strong influence and feed the idea of being born in the wrong body. However, even though several participants underwent socially inspired alterations, they all experienced dysphoria in the extent that they continued to see reassignment surgery as a solution.
Injury and performance related biomechanical differences between recreational and collegiate runners
Authors: Evans Ryan J. , Moffit Tyler J. , Mitchell Peter K. , Pamukoff Derek N. 
Published: September 2023

IntroductionRunning related injuries (RRI) are common, but factors contributing to running performance and RRIs are not commonly compared between different types of runners.MethodsWe compared running biomechanics previously linked to RRIs and performance between 27 recreational and 35 collegiate runners. Participants completed 5 overground running trials with their dominant limb striking a force plate, while outfitted with standardised footwear and 3-dimensional motion capture markers.ResultsPost hoc comparisons revealed recreational runners had a larger vertical loading rate (194.5 vs. 111.5 BW/s, p &lt; 0.001) and shank angle (6.80 vs. 2.09, p &lt; 0.001) compared with the collegiate runners who demonstrated greater vertical impulse (0.349 vs. 0.233 BWs, p &lt; 0.001), negative impulse (−0.022 vs. −0.013 BWs, p &lt; 0.001), positive impulse (0.024 vs. 0.014 BWs, p &lt; 0.001), and propulsive force (0.390 vs. 0.333 BW, p = 0.002). Adjusted for speed, collegiate runners demonstrated greater total support moment (TSM), plantar flexor moment, knee extensor moment, hip extensor moment, and had greater proportional plantar flexor moment contribution and less knee extensor moment contribution to the TSM compared with recreational runners. Unadjusted for speed, collegiate runners compared with recreational had greater TSM and plantar flexor moment but similar joint contributions to the TSM.DiscussionGreater ankle joint contribution may be more efficient and allow for greater capacity to increase speed. Improving plantarflexor function during running provides a strategy to improve running speed among recreational runners. Moreover, differences in joint kinetics and ground reaction force characteristics suggests that recreational and collegiate runners may experience different types of RRI.
A longitudinal study of bovine viral diarrhea virus in a semi-closed management dairy cattle herd, 2020–2022
Authors: Al-Mubarak Abdullah I. A. , Al-Kubati Anwar A. G. , Skeikh Abdullah , Hussen Jamal , Kandeel Mahmoud , Flemban Baraa , Hemida Maged Gomaa 
Published: September 2023

IntroductionBovine viral diarrhea virus (BVDV) brings great economic loss to the cattle industry worldwide. Developing a control/prevention strategy requires the prior assessment of certain epidemiological parameters. To determine the BVD incidence rate and associated risk factors, a dairy cattle herd in the eastern region of Saudi Arabia was monitored between 2020 and 2022.MethodsNasal swabs (n = 190), rectal swabs (n = 190), and sera (n = 190) were collected from 79 cows in this herd. Collected sera and swabs were tested using the commercially available ELISAs for the BVDV antibodies and antigens, respectively. Collected sera were also tested for the presence of BVDV nucleic acids using commercial real-time RT-PCR kits.Results and discussionOur data show BVDV seroprevalence (18.8%, 15%, and 8.2%) in the tested animals in 2020–2022, respectively. None of the collected nasal swabs, rectal swabs, or sera tested positive for the BVDV antigen, whereas 10.1%, 10%, and 18.1% of the tested sera were positive for BVDV nucleic acid in 2020–2022, respectively. The incidence rate was estimated at 0.02446 new cases/year despite the detection of BVDV in seronegative animals on single or two occasions at ≥6-month intervals. Young calves and bulls remained apparently unexposed to BVDV despite their presence with BVDV-infected females, with no significant physical separation. Both seropositivity and nucleic acid detectability showed significant positive and negative correlations, respectively, with reproductive performance. Collectively, the present study provides useful clues about the transmissibility of BVDV in the presence of possibly persistently infected animals. To the best of our knowledge, this is the first longitudinal study of BVDV in the Eastern Region of Saudi Arabia. Further detailed characterization of the circulating BVDVs is encouraged.
EHS Rapid Guideline: Evidence-Informed European Recommendations on Parastomal Hernia Prevention—With ESCP and EAES Participation
Authors: Stabilini Cesare , Muysoms Filip E. , Tzanis Alexander A. , Rossi Lisa , Koutsiouroumpa Ourania , Mavridis Dimitris , Adamina Michel , Bracale Umberto , Brandsma Henk-Thijs , Breukink Stéphanie O. , López Cano Manuel , Cole Samantha , Doré Suzanne , Jensen Kristian Kiim , Krogsgaard Marianne , Smart Neil J. , Odensten Christoffer , Tielemans Chantal , Antoniou Stavros A. 
Published: September 2023

Background: Growing evidence on the use of mesh as a prophylactic measure to prevent parastomal hernia and advances in guideline development methods prompted an update of a previous guideline on parastomal hernia prevention.Objective: To develop evidence-based, trustworthy recommendations, informed by an interdisciplinary panel of stakeholders.Methods: We updated a previous systematic review on the use of a prophylactic mesh for end colostomy, and we synthesized evidence using pairwise meta-analysis. A European panel of surgeons, stoma care nurses, and patients developed an evidence-to-decision framework in line with GRADE and Guidelines International Network standards, moderated by a certified guideline methodologist. The framework considered benefits and harms, the certainty of the evidence, patients’ preferences and values, cost and resources considerations, acceptability, equity and feasibility.Results: The certainty of the evidence was moderate for parastomal hernia and low for major morbidity, surgery for parastomal hernia, and quality of life. There was unanimous consensus among panel members for a conditional recommendation for the use of a prophylactic mesh in patients with an end colostomy and fair life expectancy, and a strong recommendation for the use of a prophylactic mesh in patients at high risk to develop a parastomal hernia.Conclusion: This rapid guideline provides evidence-informed, interdisciplinary recommendations on the use of prophylactic mesh in patients with an end colostomy. Further, it identifies research gaps, and discusses implications for stakeholders, including overcoming barriers to implementation and specific considerations regarding validity.