bluuebunny/crossref_metadata_2025_split huggingface dataset:
The Healthy Democracy Kit: design, implementation, uptake, and impact of a novel voter registration toolkit for healthcare settings
Authors: Grade Madeline M. , Reardon Alexander W. T. , Ha Yoonhee P. , Steinhart Adi , Martin Alister F. 
Published: May 2023

AbstractBackgroundAccess to voting is increasingly recognized as a social determinant of health. Health equity could be improved if healthcare workers (HCWs) routinely assessed the voter registration status of patients during clinical encounters and helped direct them towards appropriate resources. However, little consensus exists on how to achieve these tasks efficiently and effectively in healthcare settings. Intuitive and scalable tools that minimize workflow disruptions are needed. The Healthy Democracy Kit (HDK) is a novel voter registration toolkit for healthcare settings, featuring a wearable badge and posters that display quick response (QR) and text codes directing patients to an online hub for voter registration and mail-in ballot requests. The objective of this study was to assess national uptake and impact of the HDK prior to the 2020 United States (US) elections.MethodsBetween 19 May and 3 November 2020, HCWs and institutions could order and use HDKs to help direct patients to resources, free of cost. A descriptive analysis was conducted to summarize the characteristics of participating HCWs and institutions as well as the resultant total persons helped prepare to vote.ResultsDuring the study period, 13,192 HCWs (including 7,554 physicians, 2,209 medical students, and 983 nurses) from 2,407 affiliated institutions across the US ordered 24,031 individual HDKs. Representatives from 604 institutions (including 269 academic medical centers, 111 medical schools, and 141 Federally Qualified Health Centers) ordered 960 institutional HDKs. Collectively, HCWs and institutions from all 50 US states and the District of Columbia used HDKs to help initiate 27,317 voter registrations and 17,216 mail-in ballot requests.ConclusionsA novel voter registration toolkit had widespread organic uptake and enabled HCWs and institutions to successfully conduct point-of-care civic health advocacy during clinical encounters. This methodology holds promise for future implementation of other types of public health initiatives. Further study is needed to assess downstream voting behaviors from healthcare-based voter registration.
Early life factors associated with the experiences of pain in later life: evidence from a population based study in India
Authors: Ahmed Waquar , Pai Manacy , Muhammad T. , Maurya Chanda , Mohanty Parimala , Javed Nargis Begum 
Published: May 2023

Abstract
Background
The influence of early life factors is becoming increasingly apparent as studies investigate how experiences, resources, and constraints in childhood affect health and well-being later in life. The present study contributes to this literature by examining the association between several early life factors and self-reported pain among older adults in India.

Methods
Data come from the 2017-18 wave 1 of the Longitudinal Ageing Study of India (LASI). The sample size includes 28,050 older adults aged 60 and above (13,509 men and 14,541 women). Pain is a self-reported, dichotomous measure where participants responded to whether they were often troubled with pain and whether this experience interfered with their ability to carry out daily household chores. Early life factors, which are retrospective accounts of experiences, included the respondent’s position in birth order, their health status, school absenteeism, being bedridden, family socioeconomic status (SES), and their parent’s experience with chronic disease. Logistic regression analysis is employed to examine the unadjusted and adjusted average marginal effects (AME) of selected domains of early life factors associated with the probability of experiencing pain.

Results
22.8% of men and 32.3% of women reported pain that interfered with daily activities. Pain was higher among men (AME: 0.01, confidence interval (CI): 0.01–0.03) and women (AME: 0.02, CI: 0.01–0.04) with third or fourth birth order compared to counterparts with first birth order. Both men (AME: -0.02, CI: -0.04–0.01) and women (AME: -0.07, CI: -0.09 - -0.04) having a fair childhood health status reported a lower probability of pain. The probability of pain was higher among both men (AME: 0.03, CI: 0.01–0.07) and women (AME: 0.07, CI: 0.03–0.13) who were bedridden due to sickness in their childhood. Similarly, the pain likelihood was higher among men who missed school for more than a month due to health problems (AME: 0.04, CI: -0.01-0.09). Men and women with poor financial condition in their childhood reported (AME: 0.04, CI: 0.01–0.07) a higher probability of experiencing pain relative to their peers who reported a more financially advantaged early life.

Conclusions
Findings of the present study add to the empirical literature on the association between early life factors and later life health and well-being. They also are pertinent to health care providers and practitioners working in pain management, as this knowledge better positions them to identify older adults most susceptible to pain. Moreover, findings of our study underscore that the interventions to ensure health and well-being in later life must start far earlier in the life course.
Abnormal birth weights for gestational age in relation to maternal characteristics in Sweden: a five year cross-sectional study
Authors: Lwin Min Wai , Timby Erika , Ivarsson Anneli , Eurenius Eva , Vaezghasemi Masoud , Silfverdal Sven-Arne , Lindkvist Marie 
Published: May 2023

AbstractBackgroundAbnormal birth weight – small for gestational age (SGA) and large for gestational age (LGA) – are important indicators for newborn health. Due to changes in lifestyle in recent decades, it is essential to keep up-to-date with the latest information on maternal factors linked to abnormal birth weight. The aim of this study is to investigate SGA and LGA in relation to maternal individual, lifestyle and socioeconomic characteristics. .MethodsThis is a register-based cross-sectional study. Self-reported data from Sweden’s Salut Programme maternal questionnaires (2010–2014) were linked with records in the Swedish Medical Birth Register (MBR). The analytical sample comprised 5089 singleton live births. A Swedish standard method using ultrasound-based sex-specific reference curves defines the abnormality of birth weight in MBR. Univariable and multivariable logistic regressions were used to examine crude and adjusted associations between abnormal birth weights and maternal individual, lifestyle and socioeconomic characteristics. A sensitivity analysis, using alternative definitions of SGA and LGA under the percentile method, was undertaken.ResultsIn multivariable logistic regression, maternal age and parity were associated with LGA (aOR = 1.05, CI = 1.00, 1.09) and (aOR = 1.31, CI = 1.09, 1.58). Maternal overweight and obesity were strongly associated with LGA (aOR = 2.28, CI = 1.47, 3.54) and (aOR = 4.55, CI = 2.85, 7.26), respectively. As parity increased, the odds of delivering SGA babies decreased (aOR = 0.59, CI = 0.42, 0.81) and preterm deliveries were associated with SGA (aOR = 9.46, CI = 5.67, 15.79). The well-known maternal determinants of abnormal birthweight, such as unhealthy lifestyles and poor socioeconomic factors, were not statistically significant in this Swedish setting.ConclusionsThe main findings suggest that multiparity, maternal pre-pregnancy overweight and obesity are strong determinants for LGA babies. Public health interventions should address modifiable risk factors, especially maternal overweight and obesity. These findings suggest that overweight and obesity is an emerging public health threat for newborn health. This might also result in the intergenerational transfer of overweight and obesity. These are important messages for public health policy and decision making.
Quality assessment of global health care system in the shadow of COVID-19: - a systematic review
Authors: Kaur Karuna Nidhi , Niazi Farah , Thakur Ruchi , Saeed Shazina , Rana Shweta , Singh Harpreet 
Published: May 2023

Abstract
Introduction
The healthcare system is critical to the country’s overall growth, which involves the healthy development of individuals, families, and society everywhere. This systematic review focuses on providing an overall assessment of the quality of healthcare delivery during COVID-19.

Methodology
The literature search was conducted from March 2020 till April 2023 utilising the databases “PubMed,“ “Google Scholar,“ and “Embase.“ A total of nine articles were included. Descriptive statistics was performed using Microsoft Excel. PROSPERO registration ID- CRD42022356285.

Results
According to the geographic location of the studies included, four studies were conducted in Asia [Malaysia(n = 1); India (Madhya Pradesh) (n = 1); Saudi Arabia(n = 1); Indonesia (Surabaya) (n = 1)], three in Europe [U.K. (n = 1); Poland (n = 1); Albania (n = 1)] and two in Africa [Ethiopia(n = 1); Tunisia (n = 1)]. Overall patient satisfaction was found highest among studies conducted in Saudi Arabia (98.1%) followed by India (Madhya Pradesh) (90.6%) and the U.K. (90%).

Conclusion
This review concluded five different aspects of patients satisfaction level i.e. reliability, responsiveness, assurance, empathy, and tangibility. It was found that the empathy aspect had the greatest value of the five factors, i.e., 3.52 followed by Assurance with a value of 3.51.
The impact of the COVID-19 pandemic on enrollment in undergraduate health-related studies in Spain
Authors: March-Amengual Jaume-Miquel , Cambra-Badii Irene , Pineda Galán Consolación , Busquets-Alibés Ester , Masó Aguado Montse , Ramon-Aribau Anna , Feito Grande Lydia , Comella Cayuela Agustí , Terribas i Sala Nuria , Andrade-Gómez Elena , Martínez-Perez Naiara , Jerez-Roig Javier 
Published: May 2023

AbstractThe aim of this study was to determine whether the pandemic has reinforced the choice of pursuing health-related bachelor’s degrees, and to identify underlying factors that could contribute to that impact. This is a cross-sectional study using an online survey of 2,344 students of nursing, physiotherapy, medicine, psychology and podiatry who started health-related bachelor’s degrees after the COVID-19 outbreak in Spanish higher education institutions. The pandemic influenced the choice of these studies by increasing the desire to help others (33.2%), by increasing citizenship values (28.4%), and by increasing the desire to contribute to improving the situation of the country (27.5%). Women had a significantly greater influence on the increase in social values related to the practice of the profession produced by the pandemic, whereas men and the bachelor’s degree in podiatry were more influenced by salary prospects. An increased desire to help others was significantly higher among women and nursing and medical students. Podiatry and psychology were the degrees were most influenced by the pandemic, as more students decided to pursue them, something they had previously doubted, while in nursing, psychology, and medicine the pandemic reinforced their interest in pursuing the degree the most. Students personally affected by COVID-19 reported being more influenced in reconsidering their professional path and in reinforcing their desire to pursue the health-related studies.
Pharmacopeial quality of artemether–lumefantrine anti-malarial agents in Uganda
Authors: Ocan Moses , Nakalembe Loyce , Otike Caroline , Omali Denis , Buzibye Allan , Nsobya Sam 
Published: May 2023

Abstract
Background
Substandard anti-malarial agents pose a significant challenge to effective malaria control and elimination efforts especially in sub-Saharan Africa. The quality of anti-malarials in most low-and-middle income countries (LMICs) is affected by several factors including inadequate regulation and limited resources. In this study, the pharmacopeial quality of artemether–lumefantrine (AL) in low and high malaria transmission settings in Uganda was assessed.

Methods
This was a cross-sectional study conducted among randomly selected private drug outlets. The AL anti-malarials available in drug outlets were purchased using overt method. The samples were screened for quality using visual inspection, weight uniformity, content assay and dissolution tests. The assay test was done using liquid chromatography–mass spectrometry (LC–MS). The samples were considered substandard if the active pharmaceutical ingredient (API) content was outside 90–110% range of the label claim. Dissolution test was conducted following United States Pharmacopoeia (USP) method. Data was analysed using descriptive statistics and presented as means with standard deviations, frequencies, and proportions. Correlation between medicine quality and independent variables was determined using Fisher’s exact test of independence at 95% level of significance.

Results
A total of 74 AL anti-malarial samples were purchased from high (49/74; 66.2%) and low (25/74; 33.8%) malaria transmission settings. The most common batch of AL was LONART, 32.4% (24/74), with 33.8% (25/74) being ‘Green leaf’. Overall prevalence of substandard quality artemether–lumefantrine was 18.9% (14/74; 95% CI: 11.4–29.7). Substandard quality AL was significantly associated with setting (p = 0.002). A total of 10 samples (13.5%) failed artemether content assay test while, 4 samples (5.4%, 4/74) failed the lumefantrine assay test. One sample from a high malaria transmission setting failed both artemether and lumefantrine assay content test. Of the samples that failed artemether assay test, 90% had low (< 90%) artemether content. All the samples passed visual inspection and dissolution tests.

Conclusion
Artemether–lumefantrine agents, the recommended first-line treatment for uncomplicated malaria with APIs outside the recommended pharmacopeial content assay limit is common especially in high malaria transmission settings. There is need for continuous surveillance and monitoring of the quality of artemisinin-based anti-malarials across the country by the drug regulatory agency.
Evolution and biogeography of apple stem grooving virus
Authors: Shokri Shohreh , Shujaei Kamal , Gibbs Adrian J. , Hajizadeh Mohammad 
Published: May 2023

AbstractBackgroundApple stem grooving virus (ASGV) has a wide host range, notably including apples, pears, prunes and citrus. It is found worldwide.MethodIn this study, two near complete genomes, and seven coat protein (CP) sequences of Iranian isolates from apple were determined. Sequences added from GenBank provided alignments of 120 genomic sequences (54 of which were recombinant), and 276 coat protein genes (none of them recombinant).ResultThe non-recombinant genomes gave a well supported phylogeny with isolates from diverse hosts in China forming the base of the phylogeny, and a monophyletic clade of at least seven clusters of isolates from around the world with no host or provenace groupings among them, and all but one including isolates from China. The six regions of the ASGV genome (five in one frame, one − 2 overlapping) gave significantly correlated phylogenies, but individually had less statistical support. The largest cluster of isolates contained those from Iran and had isolates with worldwide provenances, and came from a wide range of mono- and dicotyledonous hosts. Population genetic comparisons of the six regions of the ASGV genome showed that four were under strong negative selection, but two of unknown function were under positive selection.ConclusionASGV most likely originated and spread in East Asia in one or more of various plant species, but not in Eurasia; the ASGV population of China had the greatest overall nucleotide diversity and largest number of segregating sites.
High-risk human papillomavirus genotype distribution among women living with HIV; implication for cervical cancer prevention in a resource limited setting
Authors: Akakpo Patrick Kafui , Ken-Amoah Sebastian , Enyan Nancy Innocentia Ebu , Agyare Elizabeth , Salia Emmanuel , Baidoo Ibrahim , Derkyi-Kwarteng Leonard , Asare Matthew , Adjei George , Addo Stephen Ayisi , Obiri-Yeboah Dorcas 
Published: May 2023

Abstract
Background
For women living with HIV (WLHIV), the burden of persistent HPV infection, cervical pre-cancerous lesions and cancer have been demonstrated to be higher than among HIV-negative women. As Ghana and other lower-middle-income countries (LMIC) work toward developing national cervical cancer programmes, it is essential that local scientific evidence be provided to guide policy decisions, especially for such special populations. The objective of this study was to determine the distribution of high-risk HPV genotype and related factors among WLHIV and its implication for the prevention of cervical cancer prevention efforts.

Methods
A cross-sectional study was conducted at the Cape Coast Teaching Hospital in Ghana. WLHIV, aged 25–65 years, who met the eligibility criteria were recruited through a simple random sampling method. An interviewer-administered questionnaire was used to gather socio-demographic, behavioural, clinical and other pertinent information. The AmpFire HPV detection system (Atila BioSystem, Mointain View, CA was used to detect 15 high-risk HPV genotypes from self-collected cervico-vaginal samples. The data collected were exported to STATA 16.0 for statistical analysis.

Results
In all, 330 study participants, with mean age of 47.2 years (SD ± 10.7), were involved. Most (69.1%, n = 188/272) had HIV viral loads < 1000 copies/ml and 41.2% (n = 136) had ever heard of cervical screening. The overall hr-HPV prevalence was 42.7% (n = 141, 95% CI 37.4–48.1) and the five commonest hr-HPV types among screen positives were HPV59 (50.4%), HPV18 (30.5%), HPV35 (26.2%), HPV58 (17%) and HPV45 (14.9%). Most infected women (60.3%, n = 85) had multiple hr-HPV infections, with about 57.4% (n = 81) having 2–5 h-HPV types, while 2.8% (n = 4) had more than five hr-HPV types. A total of 37.6% (n = 53) had HPV16 and/or18, while 66.0% (n = 93) had the hr-HPV genotypes covered by the nonavalent vaccine. Women with HIV viral load ≥ 1000copies/ml (AOR = 5.58, 95% CI 2.89–10.78, p < 0.001) had a higher likelihood of being co-infected.

Conclusion
This study found out that the prevalence of hr-HPV still remains high in women with HIV, with a notable occurrence of multiple infections and infection with genotypes 16 and/or18. Additionally, an association was established between hr-HPV and infection HIV viral load.. Therefore, comprehensive HIV care for these women should include awareness of cervical cancer, consideration of vaccination and implementation of screening and follow-up protocols. National programmes in LMIC, such as Ghana, should consider using HPV-based screen-triage-treat approach with partial genotyping.
Therapeutic targeting of P2X4 receptor and mitochondrial metabolism in clear cell renal carcinoma models
Authors: Rupert Christofer , Dell’ Aversana Carmela , Mosca Laura , Montanaro Vittorino , Arcaniolo Davide , De Sio Marco , Bilancio Antonio , Altucci Lucia , Palinski Wulf , Pili Roberto , de Nigris Filomena 
Published: May 2023

Abstract
Background
Clear cell renal cell carcinoma (ccRCC) is the most common subtype of renal cancer. Large-scale metabolomic data have associated metabolic alterations with the pathogenesis and progression of renal carcinoma and have correlated mitochondrial activity with poor survival in a subset of patients. The aim of this study was to determine whether targeting mitochondria-lysosome interaction could be a novel therapeutic approach using patient-derived organoids as avatar for drug response.

Methods
RNAseq data analysis and immunohistochemistry were used to show overexpression of Purinergic receptor 4 (P2XR4) in clear cell carcinomas. Seahorse experiments, immunofluorescence and fluorescence cell sorting were used to demonstrate that P2XR4 regulates mitochondrial activity and the balance of radical oxygen species. Pharmacological inhibitors and genetic silencing promoted lysosomal damage, calcium overload in mitochondria and cell death via both necrosis and apoptosis. Finally, we established patient-derived organoids and murine xenograft models to investigate the antitumor effect of P2XR4 inhibition using imaging drug screening, viability assay and immunohistochemistry.

Results
Our data suggest that oxo-phosphorylation is the main source of tumor-derived ATP in a subset of ccRCC cells expressing P2XR4, which exerts a critical impact on tumor energy metabolism and mitochondrial activity. Prolonged mitochondrial failure induced by pharmacological inhibition or P2XR4 silencing was associated with increased oxygen radical species, changes in mitochondrial permeability (i.e., opening of the transition pore complex, dissipation of membrane potential, and calcium overload). Interestingly, higher mitochondrial activity in patient derived organoids was associated with greater sensitivity to P2XR4 inhibition and tumor reduction in a xenograft model.

Conclusion
Overall, our results suggest that the perturbed balance between lysosomal integrity and mitochondrial activity induced by P2XR4 inhibition may represent a new therapeutic strategy for a subset of patients with renal carcinoma and that individualized organoids may be help to predict drug efficacy.
No significant effect of mortality salience on unconscious ethnic bias among the Japanese
Authors: Otsubo Kai , Yamaguchi Hiroyuki 
Published: May 2023

Abstract
Objective
Terror management theory posits that when mortality is salient, individuals attempt to defend their cultural worldviews. Although numerous studies have confirmed this hypothesis, some recent studies have suggested that East Asians do not engage in worldview defense. We conducted a pre-registered experiment with 895 Japanese adults to investigate whether they exhibited worldview defense at an unconscious level. Participants performed the Implicit Association Test using Japanese and Korean surnames as stimuli after being primed with thoughts about mortality.

Results
The results revealed that mortality salience had no influence on implicit ethnic bias. These findings support the notion that East Asians do not engage in worldview defense, in accord with recent criticism of the validity of terror management theory. We discuss the limitations and implications of our findings.
Pneumocephalus secondary to epidural analgesia: a case report
Authors: Ahmad Maira , Bellamy Shannay , Ott William , Mekhail Rany 
Published: May 2023

Abstract
Introduction
Epidural anesthesia is commonly used for analgesia during labor, and headache is a common complaint following this procedure. Pneumocephalus, on the other hand, is a rare and potentially serious complication of epidural anesthesia, which is most often caused by accidental puncture of the dura with the introduction of air into intrathecal space.

Case presentation
We present the case of a 19-year-old Hispanic female who developed a severe frontal headache and neck pain eight hours following epidural catheter placement to deliver analgesia during labor. Physical examination was within normal limits without any neurological deficits. Computed tomography of the head and neck would later demonstrate small to moderate amounts of pneumocephalus, predominantly within the frontal horn of the lateral ventricles, and a moderate amount of air within the spinal canal. She was treated conservatively with analgesia. Though headache recurred after discharge, repeat imaging showed improvement in the volume of pneumocephalus and conservative management was continued.

Conclusions
Although a rare complication and an uncommon cause of headache following epidural anesthesia, a high index of suspicion must remain for pneumocephalus as it may cause significant morbidity and, in some cases, be potentially life-threatening.