bluuebunny/crossref_metadata_2025_split huggingface dataset:
Uptake and correlates of cervical cancer screening among women attending a community-based multi-disease health campaign in Kenya
Authors: Choi Yujung , Ibrahim Saduma , Park Lawrence P. , Cohen Craig R. , Bukusi Elizabeth A. , Huchko Megan J. 
Published: April 2022

Abstract
Introduction
Despite the increased risk of cervical cancer among HIV-positive women, many HIV-care programs do not offer integrated cervical cancer screening. Incorporating self-collected Human Papillomavirus (HPV) testing into HIV programs is a potential strategy to identify women at higher risk for cervical cancer while leveraging the staffing, infrastructure and referral systems for existing services. Community-based HIV and HPV testing has been effective and efficient when offered in single-disease settings.

Methods
This cross-sectional study was conducted within a community outreach and multi-disease screening campaigns organized by the Family AIDS Care and Education Services in Kisumu County, Kenya. In addition to HIV testing, the campaigns provided screening for TB, malaria, hypertension, diabetes, and referrals for voluntary medical male circumcision. After these services, women aged 25–65 were offered self-collected HPV testing. Rates and predictors of cervical cancer screening uptake and of HPV positivity were analyzed using tabular analysis and Fisher’s Exact Test. Logistic regression was performed to explore multivariate associations with screening uptake.

Results
Among the 2016 women of screening age who attended the outreach campaigns, 749 women (35.6%) were screened, and 134 women (18.7%) were HPV-positive. In bivariate analysis, women who had no children (p < 0.01), who were not pregnant (p < 0.01), who were using contraceptives (p < 0.01), who had sex without using condoms (p < 0.05), and who were encouraged by a family member other than their spouse (p < 0.01), were more likely to undergo screening. On multivariable analysis, characteristics associated with higher screening uptake included: women aged 45–54 (OR 1.62, 95% CI 1.05–2.52) compared to women aged 25–34; no children (OR 1.65, 95% CI 1.06–2.56); and family support other than their spouse (OR 1.53, 95% CI 1.09–2.16). Women who were pregnant were 0.44 times (95% CI 0.25–0.76) less likely to get screened. Bivariate analyses with participant characteristics and HPV positivity found that women who screened HPV-positive were more likely to be HIV-positive (p < 0.001) and single (p < 0.001).

Conclusions
The low screening uptake may be attributed to implementation challenges including long waiting times for service at the campaign and delays in procuring HPV test kits. However, given the potential benefits of integrating HPV testing into HIV outreach campaigns, these challenges should be examined to develop more effective multi-disease outreach interventions.
Assessment of an intensive education program for pharmacists on treatment of tobacco use disorder using an objective structured clinical examination: a randomized controlled trial
Authors: El Hajj Maguy Saffouh , Awaisu Ahmed , Nik Mohamed Mohamad Haniki , Saleh Rana Ahmed , Al Hamad Noora Mohammed , Kheir Nadir , Mahfoud Ziyad R. 
Published: April 2022

Abstract
Background
Tobacco use is one of the major public health threats globally. Community pharmacists are uniquely positioned to offer tobacco cessation services owing to their easy accessibility by the public. To prepare Qatar community pharmacists to develop the competencies and skills required to offer smoking cessation services, an intensive tobacco control education program was designed and implemented. The study aimed to assess the impact of the tobacco education program on the pharmacists’ skills and competence.

Methods
A random sample of community pharmacists in Qatar was chosen for participation in the program. Consenting participants were randomly assigned to either intervention or control groups. The intervention group received an intensive education program on treatment of tobacco-use disorder, while a short didactic session on a non-tobacco-related topic was delivered to the control group. The pharmacists’ tobacco cessation skills and competencies were assessed using an Objective Structured Clinical Examination (OSCE).

Results
A total of 54 and 32 community pharmacists in the intervention group and the control group, respectively, completed the OSCE. The intensive tobacco education group achieved significantly higher total scores than the control group in all the OSCE cases. Specifically, the mean total scores for the intervention group were 15.2, 15.3, 14.2, 14.6, 16.3, and 15.2 compared to 8.8, 6.2, 7.7, 9.2, 8.3, and 11.3 for the control group (p < 0.001) for cases one to six respectively.

Conclusion
The study demonstrated that an intensive tobacco cessation education program can improve pharmacists’ tobacco cessation skills and increase their tobacco cessation counseling abilities.

Trial registration
Clinical Trials NCT03518476 (https://clinicaltrials.gov/ct2/show/NCT03518476) Registration date: May 8, 2018.
Scaling up tobacco cessation within TB programmes: findings from a multi-country, mixed-methods implementation study
Authors: Elsey Helen , Al Azdi Zunayed , Regmi Shophika , Baral Sushil , Fatima Razia , Fieroze Fariza , Huque Rumana , Karki Jiban , Khan Dost Mohammad , Khan Amina , Khan Zohaib , Li Jinshuo , Noor Maryam , Arjyal Abriti , Shrestha Prabin , Ullah Safat , Siddiqi Kamran 
Published: April 2022

Abstract
Background
Brief behavioural support can effectively help tuberculosis (TB) patients quit smoking and improve their outcomes. In collaboration with TB programmes in Bangladesh, Nepal and Pakistan, we evaluated the implementation and scale-up of cessation support using four strategies: (1) brief tobacco cessation intervention, (2) integration of tobacco cessation within routine training, (3) inclusion of tobacco indicators in routine records and (4) embedding research within TB programmes.

Methods
We used mixed methods of observation, interviews, questionnaires and routine data. We aimed to understand the extent and facilitators of vertical scale-up (institutionalization) within 59 health facility learning sites in Pakistan, 18 in Nepal and 15 in Bangladesh, and horizontal scale-up (increased coverage beyond learning sites). We observed training and surveyed all 169 TB health workers who were trained, in order to measure changes in their confidence in delivering cessation support. Routine TB data from the learning sites were analysed to assess intervention delivery and use of TB forms revised to report smoking status and cessation support provided. A purposive sample of TB health workers, managers and policy-makers were interviewed (Bangladesh n = 12; Nepal n = 13; Pakistan n = 19). Costs of scale-up were estimated using activity-based cost analysis.

Results
Routine data indicated that health workers in learning sites asked all TB patients about tobacco use and offered them cessation support. Qualitative data showed use of intervention materials, often with adaptation and partial implementation in busy clinics. Short (1–2 hours) training integrated within existing programmes increased mean confidence in delivering cessation support by 17% (95% CI: 14–20%). A focus on health system changes (reporting, training, supervision) facilitated vertical scale-up. Dissemination of materials beyond learning sites and changes to national reporting forms and training indicated a degree of horizontal scale-up. Embedding research within TB health systems was crucial for horizontal scale-up and required the dynamic use of tactics including alliance-building, engagement in the wider policy process, use of insider researchers and a deep understanding of health system actors and processes.

Conclusions
System-level changes within TB programmes may facilitate routine delivery of cessation support to TB patients. These strategies are inexpensive, and with concerted efforts from TB programmes and donors, tobacco cessation can be institutionalized at scale.
Experiences of teachers, educators, and school counselors about the sexual and reproductive health of educable intellectually disabled adolescent girls: a qualitative study
Authors: Goli Shadi , Rahimi Farzaneh , Goli Marjan 
Published: April 2022

AbstractBackgroundAdolescents with intellectual disabilities are probably twice as many people without intellectual disabilities to be sexually abused by family members, caregivers, close relatives, and others in the community. Sex education and training are essential components of children's and teenagers' education and human rights, as well as a source of worry for parents and society. While the parents are thought to be the most accessible choice as sexual educators, they often do not fulfill this role. Therefore, professional teachers and trainers who have undergone sex education courses for mentally retarded adolescents are more reliable sources to provide the sexual information in terms of their educational role. This study aimed to determine the experiences of teachers, educators, and school counselor parents regarding the sexual and reproductive health of educable intellectually disabled adolescent girls.MethodsThis was a qualitative content analysis study. 35 participants were selected via purposive sampling with maximum variation, and data were collected through in-depth individual interviews, focus group discussions and field notes, and analyzed using the conventional qualitative content analysis method simultaneously.ResultsThree subcategories have emerged: “knowledge and professional experience of teachers, educators, and school counselors with how to educate and care for adolescent sexual health”, “proficiency of teachers, educators, and school counselors in guiding families in solving their child's sexual problems”, “attitude of teachers, educators, and school counselors towards sexual behaviors and sexual education of adolescents” which formed the main category of “teachers, educators, and school counselors’ inefficiency in maintaining ID adolescent girls’ sexual and reproductive health”.ConclusionsTeachers, educators, and school counselors encounter a variety of issues related to the sexual and reproductive health of intellectually impaired teenage females, as a consequence of the findings. As a result, efforts should be made to enhance knowledge and skill development, as well as the evolution of negative attitudes. Therefore, the teaching of sexual guidelines for teenagers with mental impairments should be included in the agenda of the country's educational policies. Teachers and educators should be taught by health experts via the holding of in-service training courses.
The impact of provider restrictions on abortion-related outcomes: a synthesis of legal and health evidence
Authors: de Londras Fiona , Cleeve Amanda , Rodriguez Maria I. , Farrell Alana , Furgalska Magdalena , Lavelanet Antonella F. 
Published: April 2022

AbstractMany components of abortion care in early pregnancy can safely be provided on an outpatient basis by mid-level providers or by pregnant people themselves. Yet, some states impose non-evidence-based provider restrictions, understood as legal or regulatory restrictions on who may provide or manage all or some aspects of abortion care. These restrictions are inconsistent with the World Health Organization’s support for the optimization of the roles of various health workers, and do not usually reflect evidence-based determinations of who can provide abortion. As a matter of international human rights law, states should ensure that the regulation of abortion is evidence-based and proportionate, and disproportionate impacts must be remedied. Furthermore, states are obliged take steps to ensure women do not have to undergo unsafe abortion, to reduce maternal morbidity and mortality, and to effectively protect women and girls from the physical and mental risks associated with unsafe abortion. States must revise their laws to ensure this. Where laws restrict those with the training and competence to provide from participating in abortion care, they are prima facie arbitrary and disproportionate and thus in need of reform. This review, developed by experts in reproductive health, law, policy, and human rights, examined the impact of provider restrictions on people seeking abortion, and medical professionals. The evidence from this review suggests that provider restrictions have negative implications for access to quality abortion, contributing inter alia to delays and recourse to unsafe abortion. A human rights-based approach to abortion regulation would require the removal of overly restrictive provider restrictions. The review provides evidence that speaks to possible routes for regulatory reform by expanding the health workforce involved in abortion-related care, as well as expanding health workers' roles, both of which could improve timely access to first trimester surgical and medical abortion, reduce costs, save time, and reduce the need for travel.
Movement and storage of nematocysts across development in the nudibranch Berghia stephanieae (Valdés, 2005)
Authors: Goodheart Jessica A. , Barone Vanessa , Lyons Deirdre C. 
Published: April 2022

Abstract
Background
Intracellular sequestration requires specialized cellular and molecular mechanisms allowing a predator to retain and use specific organelles that once belonged to its prey. Little is known about how common cellular mechanisms, like phagocytosis, can be modified to selectively internalize and store foreign structures. One form of defensive sequestration involves animals that sequester stinging organelles (nematocysts) from their cnidarian prey. While it has been hypothesized that nematocysts are identified by specialized phagocytic cells for internalization and storage, little is known about the cellular and developmental mechanisms of this process in any metazoan lineage. This knowledge gap is mainly due to a lack of genetically tractable model systems among predators and their cnidarian prey.

Results
Here, we introduce the nudibranch Berghia stephanieae as a model system to investigate the cell, developmental, and physiological features of nematocyst sequestration selectivity. We first show that B. stephanieae, which feeds on Exaiptasia diaphana, selectively sequesters nematocysts over other E. diaphana tissues found in their digestive gland. Using confocal microscopy, we document that nematocyst sequestration begins shortly after feeding and prior to the formation of the appendages (cerata) where the organ responsible for sequestration (the cnidosac) resides in adults. This finding is inconsistent with previous studies that place the formation of the cnidosac after cerata emerge. Our results also show, via live imaging assays, that both nematocysts and dinoflagellates can enter the nascent cnidosac structure. This result indicates that selectivity for nematocysts occurs inside the cnidosac in B. stephanieae, likely in the cnidophage cells themselves.

Conclusions
Our work highlights the utility of B. stephanieae for future research, because: (1) this species can be cultured in the laboratory, which provides access to all developmental stages, and (2) the transparency of early juveniles makes imaging techniques (and therefore cell and molecular assays) feasible. Our results pave the way for future studies using live imaging and targeted gene editing to identify the molecular mechanisms involved in nematocyst sequestration. Further studies of nematocyst sequestration in B. stephanieae will also allow us to investigate how common cellular mechanisms like phagocytosis can be modified to selectively internalize and store foreign structures.
Lupus nephritis correlates with B cell interferon-β, anti-Smith, and anti-DNA: a retrospective study
Authors: Alduraibi Fatima , Fatima Huma , Hamilton Jennie A. , Chatham W. Winn. , Hsu Hui-Chen , Mountz John D. 
Published: April 2022

Abstract
Background
In systemic lupus erythematosus (SLE), detection of interferon-β (IFNβ) in B cells was found to be most prominent in patients with high anti-Smith (Sm) and renal disease, but a mechanistic connection was not clear. The objective of the present study is to determine the association of IFNβ in peripheral blood naïve B cells with the histopathological features of lupus nephritis (LN).

Methods
The percentage of IFNβ+ cells in IgD+CD27− naïve CD19+ B cells (B cell IFNβ) among peripheral blood mononuclear cells (PBMCs) from 80 SLE patients were analyzed using flow cytometry. Serological and clinical data were collected. The correlations of B cell IFNβ with LN classification and with histopathological findings (light, electron, and immunofluorescence [IF] microscopic analyses for deposition of IgM, IgG, IgA, C1q, and C3) were determined in 23 available biopsy specimens.

Results
B cell IFNβ is positively associated with anti-Sm (p = 0.001), anti-DNA (p = 0.013), and LN (p < 0.001) but was negatively associated with oral/nasal ulcer (p = 0.003) and photosensitivity (p = 0.045). B cell IFNβ positively correlated with immune complex (IC) deposit in the glomerular basement membrane (GBM) (p = 0.002) but not in the mesangial (p = 0.107) or tubular region (p = 0.313). Patients with high B cell IFNβ had statistically increased development of the proliferative LN (Classes III, IV and/or V), compared to patients with low B cell IFNβ (p < 0.0001). Histopathological features positively associated with increased B cell IFNβ included active glomerular lesions as determined by fibrocellular crescents (p = 0.023), chronic glomerular lesions indicated by segmental sclerosis (p = 0.033), and a membranous pattern of renal damage indicated by spike/holes (p = 0.015).

Conclusion
B cell IFNβ correlates with history of severe LN, glomerular basement membrane (GBM) IC deposition, and anatomical features of both active and chronic glomerular lesions.
Community-level interventions for mitigating the risk of waterborne diarrheal diseases: a systematic review
Authors: Meki Chisala D. , Ncube Esper J. , Voyi Kuku 
Published: April 2022

Abstract
Background
Waterborne diarrhea diseases are among the leading causes of morbidity and mortality globally. These diseases can be mitigated by implementing various interventions. We reviewed the literature to identify available interventions to mitigate the risk of waterborne diarrheal diseases.

Methods
We conducted a systematic database review of CINAHL (Cumulative Index to Nursing and Allied Health Literature), PubMed, Web of Science Core Collection, Cochrane library, Scopus, African Index Medicus (AIM), and LILACS (Latin American and Caribbean Health Sciences Literature). Our search was limited to articles published between 2009 and 2020. We conducted the review using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement checklist. The identified studies were qualitatively synthesized.

Results
Our initial search returned 28 773 articles of which 56 studies met the inclusion criteria. The included studies reported interventions, including vaccines for rotavirus disease (monovalent, pentavalent, and Lanzhou lamb vaccine); enhanced water filtration for preventing cryptosporidiosis, Vi polysaccharide for typhoid; cholera 2-dose vaccines, water supply, water treatment and safe storage, household disinfection, and hygiene promotion for controlling cholera outbreaks.

Conclusion
We retrieved few studies on interventions against waterborne diarrheal diseases in low-income countries. Interventions must be specific to each type of waterborne diarrheal disease to be effective. Stakeholders must ensure collaboration in providing and implementing multiple interventions for the best outcomes.

Systematic review registration
PROSPERO CRD42020190411.
‘Hunger in early life’: exploring the prevalence and correlates of child food insecurity in Canada
Authors: Kansanga Moses Mosonsieyiri 
Published: April 2022

Abstract
Background
Although food is a basic human right, food insecurity remains a major problem in the Global North including Canada. Children constitute a subgroup that is particularly vulnerable to food insecurity, with recent evidence showing that 1 in 6 Canadian children are food insecure. The rising rate of child food insecurity alongside its links with several adverse health outcomes reinforce the need to pay attention to its determinants. Although food insecurity is a multidimensional phenomenon shaped by diverse factors, in the Global North, including Canada, it is generally framed as a financial problem. Consequently, food policy has largely prioritized income support programs to the neglect of potentially important non-monetary factors. These non-monetary factors are also rarely explored in the literature despite their potentially relevant role in shaping policy responses to child food insecurity. Drawing data from the Canadian Community Health Survey (N = 21,455 households with children) and broadening the scope of potential predictors, this paper examined the correlates of child food insecurity in Canada.

Results
Findings show children in visible minority households (OR = 1.12, p < 0.01), single-parent households (OR = 1.55, p < 0.001), households with five or more members (OR = 1.35, p < 0.001), households with the highest level of education being secondary education or lower (OR = 1.14, p < 0.05), households where the adult respondent reported a very weak sense of community belonging (OR = 1.32, p < 0.001), poor physical health (OR = 1.61, p < 0.001) and poor mental health (OR = 1.61, p < 0.001) had higher odds of being food insecure. Children in lower income households were also more likely to be food insecure.

Conclusions
This study demonstrates the multidimensional nature of child food insecurity and highlights the need for food policy to pay attention to relevant social factors. Although commonly highlighted economic factors such as household income and employment status remain important correlates of child food insecurity in Canada, non-monetary factors such as visible minority status, sense of community belonging and living arrangement of parents/guardians are noteworthy predictors of child food insecurity that need equal policy attention.
Shanghai fever, a fatal enteric illness, in an adult patient with neutropenia caused by treatment-related myelodysplastic syndrome: a case report
Authors: Horino Taichi , Miyata Tatsunori , Inoue Mitsuhiro , Ono Kosuke , Ono Asuka , Tagayasu Yoshiyuki , Nomoto Daichi , Mizumoto Takao , Kubota Tatsuo , Miyanari Nobutomo , Baba Hideo 
Published: April 2022

Abstract
Background
Shanghai fever is a rare community-acquired enteric illness with sepsis caused by Pseudomonas aeruginosa. Cases of Shanghai fever in pediatric patients have been reported; however, to the best of our knowledge, there are no reports of adult cases.

Case presentation
A 65-year-old man visited the emergency department with sudden onset of abdominal pain. He was diagnosed as treatment-related myelodysplastic syndrome after treatment of follicular lymphoma. Moderate tenderness in the middle right abdominal quadrants was noted. Computed tomography showed abdominal free air with a small amount of effusion to the surrounding edematous small intestine, and we performed emergency exploration. During operation, we found multiple bowel perforations with patchy necrotic lesions. The patient was admitted to an intensive care unit postoperatively. Blood culture showed Pseudomonas aeruginosa. His condition improved; however, on the 8th postoperative day, the abdominal drain tube showed turbid drainage. We performed re-operation and found anastomotic leakage with two new bowel perforations. After the re-operation, the patient showed signs of septic shock and his general condition got worse, and the patient died due to multiple organ failure on the 12th postoperative day.

Conclusion
Shanghai fever may occur in an adult patient with neutropenia.