bluuebunny/crossref_metadata_2025_split huggingface dataset:
Factors influencing utilisation of services provided by community midwives and their non-retention in district Thatta, Pakistan: a qualitative study protocol
Authors: Khowaja Bakhtawar M Hanif , Shahil Feroz Anam , Saleem Sarah 
Published: July 2022

IntroductionDrawing on the well-acknowledged evidence of community midwives services to address the issue of high maternal mortality, the Government of Pakistan initiated the Community Midwifery (CMW) programme in 2006 to provide skilled birth attendance to pregnant women living in rural areas. Despite a large investment in CMW programme, the availability of community midwives in rural areas following their training is a constant struggle. The concerns related to the training, support and acceptability of community midwives need to be studied in order to identify gaps in the provision of skilled maternal and newborn healthcare. Therefore, this study aims to explore factors influencing the utilisation of services provided by community midwives and their non-retention in district Thatta, Pakistan.Methods and analysisThe study will use a qualitative exploratory research design. The data will be collected through semistructured interviews and an approach of purposive sampling for the selection of participants for interviews. The study will be conducted in one of the rural districts Thatta of Province Sindh, Pakistan. The data will be collected through key informant interviews (KIIs) and in-depth interviews (IDIs). The KIIs will be conducted with officials of the health department (Thatta), the provincial maternal and newborn child health programme, and the Midwifery Association of Pakistan. The IDIs will be conducted with midwifery students, community midwives working and not working in the district, and community women of district Thatta. Data will be analysed through qualitative data analysis software NVivo V.10 and the thematic analysis approach.Ethics and disseminationEthical approval for this study has been obtained from the Aga Khan University Ethical Review Committee (2020-3391-11138). The results of the study will be disseminated to the scientific community, to policy-makers involved in CMW programme training and implementation, and to the research subjects participating in the study.
Patient preferences for facility-based management of hypertension and diabetes in rural Uganda: a discrete choice experiment
Authors: Moor Sarah EG , Tusubira Andrew K , Wood Dallas , Akiteng Ann R , Galusha Deron , Tessier-Sherman Baylah , Donroe Evelyn Hsieh , Ngaruiya Christine , Rabin Tracy L , Hawley Nicola L , Armstrong-Hough Mari , Nakirya Brenda D , Nugent Rachel , Kalyesubula Robert , Nalwadda Christine , Ssinabulya Isaac , Schwartz Jeremy I 
Published: July 2022

ObjectiveTo explore how respondents with common chronic conditions—hypertension (HTN) and diabetes mellitus (DM)—make healthcare-seeking decisions.SettingThree health facilities in Nakaseke District, Uganda.DesignDiscrete choice experiment (DCE).Participants496 adults with HTN and/or DM.Main outcome measuresWillingness to pay for changes in DCE attributes: getting to the facility, interactions with healthcare providers, availability of medicines for condition, patient peer-support groups; and education at the facility.ResultsRespondents were willing to pay more to attend facilities that offer peer-support groups, friendly healthcare providers with low staff turnover and greater availabilities of medicines. Specifically, we found the average respondent was willing to pay an additional 77 121 Ugandan shillings (UGX) for facilities with peer-support groups over facilities with none; and 49 282 UGX for 1 month of medicine over none, all other things being equal. However, respondents would have to compensated to accept facilities that were further away or offered health education. Specifically, the average respondent would have to be paid 3929 UGX to be willing to accept each additional kilometre they would have to travel to the facilities, all other things being equal. Similarly, the average respondent would have to be paid 60 402 UGX to accept facilities with some health education, all other things being equal.ConclusionsOur findings revealed significant preferences for health facilities based on the availability of medicines, costs of treatment and interactions with healthcare providers. Understanding patient preferences can inform intervention design to optimise healthcare service delivery for patients with HTN and DM in rural Uganda and other low-resource settings.
Gastric cancer incidence, mortality and burden in adolescents and young adults: a time-trend analysis and comparison among China, South Korea, Japan and the USA
Authors: Wu Si Lin , Zhang Yao , Fu Yi , Li Jian , Wang Ji Sheng 
Published: July 2022

ObjectivesTo evaluate and compare the burden of gastric cancer in adolescents and young adults (GCAYA) among China, South Korea, Japan and the USA, four countries with similar or different rates of gastric cancer (GC) incidence, development levels and cancer control strategies.DesignThis population-based observational study collected the epidemiological data of GCAYA from the Global Burden of Diseases Study 2019. The trend magnitude and directions over time for incidence and mortality of GCAYA were analysed and compared among four countries.Main outcomes and measuresOutcomes included new cases, deaths, mortality-to-incidence ratios (MIRs), disability-adjusted life years, and their age-standardised rates and estimated annual percentage changes (AAPCs).ResultsThere were 49 008 new cases and 27 895 deaths from GCAYA in 2019, nearly half of which occurred in China. The AAPCs for the age-standardised incidence and mortality rate were 0.3 (−0.1 to 0.7), –3.6 (−3.7 to –3.4), −3.2 (−3.8 to –2.6), −0.1 (−0.6 to 0.5) and −2.0 (−2.3 to −1.6), −5.6 (−6.2 to –5.0), −4.4 (−4.7 to –4.1), −0.7 (−1.0 to −0.3) in China, South Korea, Japan and the USA, respectively. The incidence rate for females in the USA rose by 0.4% annually. GC ranks fifth, first, fourth and ninth in China, South Korea, Japan and the USA regarding burdens caused by cancer in adolescents and young adults. The MIRs declined constantly in South Korea and China, and the MIR in the USA became the highest in 2019.ConclusionsAlthough not covered by prevention and screening programmes, variations in disease burden and time trends may reflect variations in risk factors, cancer control strategies and treatment accessibility of GC among the four countries. Investigating the reasons behind the varying disease burden and changing trends of GCAYA across countries will inform recommendations for prevention measures and timely diagnosis specific to this underserved population to further decrease the GC burden.
Longitudinal examination of young married women’s fertility and family planning intentions and how they relate to subsequent family planning use in Bihar and Uttar Pradesh India
Authors: Speizer Ilene S , Zavier A J Francis , Calhoun Lisa , Nanda Priya , Saggurti Niranjan , Hainsworth Gwyn 
Published: July 2022

ObjectivesThis study examines which fertility and family planning (FP) intentions are related to subsequent FP use in a sample of young, married women in India.DesignWe use 3-year longitudinal data from married women ages 15–19 in 2015–2016 (wave 1) who are not using contraception to examine factors associated with any use of FP in 2018–2019 (wave 2).SettingData were collected in the states of Bihar and Uttar Pradesh, India.ParticipantsA representative sample of 4893 young married women ages 15–19 was surveyed in 2015–2016 and 4000 of them were found and interviewed 3 years later. This analysis focused on the 3614 young women who were not using FP at wave 1.Primary outcomesThis study examines FP use at wave 2 as the main outcome variable.ResultsMultivariate analyses demonstrated that young women who wanted to delay childbearing three or more years or who did not want any(more) children at wave 1 were more likely to use contraception at wave 2. Additionally, intention to use FP in the next 12 months at wave 1 was significantly associated with FP use at wave 2 whereas unmet need at wave 1 was not significantly related to subsequent use. A combined measure of fertility desires and intention to use FP demonstrated the importance of both measures on subsequent use. Having any children and being pregnant at wave 1 were both related to FP use at wave 2.ConclusionsIt is important to reach young, married women prior to a first pregnancy with nuanced messages addressing their fertility and FP intentions. Programmes targeting women at antenatal and postpartum visits are important for young women to help support them to use FP to address their desires to delay or limit future childbearing for the health and well-being of themselves and their children.
Household income and maternal education in early childhood and activity-limiting chronic health conditions in late childhood: findings from birth cohort studies from six countries
Authors: Spencer Nicholas James , Ludvigsson Johnny , You Yueyue , Francis Kate , Abu Awad Yara , Markham Wolfgang , Faresjö Tomas , Goldhaber-Fiebert Jeremy , Andersson White Pär , Raat Hein , Mensah Fiona , Gauvin Lise , McGrath Jennifer J 
Published: July 2022

BackgroundWe examined absolute and relative relationships between household income and maternal education during early childhood (<5 years) with activity-limiting chronic health conditions (ALCHC) during later childhood in six longitudinal, prospective cohorts from high-income countries (UK, Australia, Canada, Sweden, Netherlands, USA).MethodsRelative inequality (risk ratios, RR) and absolute inequality (Slope Index of Inequality) were estimated for ALCHC during later childhood by maternal education categories and household income quintiles in early childhood. Estimates were adjusted for mother ethnicity, maternal age at birth, child sex and multiple births, and were pooled using meta-regression.ResultsPooled estimates, with over 42 000 children, demonstrated social gradients in ALCHC for high maternal education versus low (RR 1.54, 95% CI 1.28 to 1.85) and middle education (RR 1.24, 95% CI 1.11 to 1.38); as well as for high household income versus lowest (RR 1.90, 95% CI 1.66 to 2.18) and middle quintiles (RR 1.34, 95% CI 1.17 to 1.54). Absolute inequality showed decreasing ALCHC in all cohorts from low to high education (range: −2.85% Sweden, −13.36% Canada) and income (range: −1.8% Sweden, −19.35% Netherlands).ConclusionWe found graded relative risk of ALCHC during later childhood by maternal education and household income during early childhood in all cohorts. Absolute differences in ALCHC were consistently observed between the highest and lowest maternal education and household income levels across cohort populations. Our results support a potential role for generous, universal financial and childcare policies for families during early childhood in reducing the prevalence of activity limiting chronic conditions in later childhood.
Therapeutic targeting of PD-1/PD-L1 blockade by novel small-molecule inhibitors recruits cytotoxic T cells into solid tumor microenvironment
Authors: Acúrcio Rita C. , Pozzi Sabina , Carreira Barbara , Pojo Marta , Gómez-Cebrián Nuria , Casimiro Sandra , Fernandes Adelaide , Barateiro Andreia , Farricha Vitor , Brito Joaquim , Leandro Ana Paula , Salvador Jorge A R , Graça Luís , Puchades-Carrasco Leonor , Costa Luís , Satchi-Fainaro Ronit , Guedes Rita C. , Florindo Helena F. 
Published: July 2022

BackgroundInhibiting programmed cell death protein 1 (PD-1) or PD-ligand 1 (PD-L1) has shown exciting clinical outcomes in diverse human cancers. So far, only monoclonal antibodies are approved as PD-1/PD-L1 inhibitors. While significant clinical outcomes are observed on patients who respond to these therapeutics, a large proportion of the patients do not benefit from the currently available immune checkpoint inhibitors, which strongly emphasize the importance of developing new immunotherapeutic agents.MethodsIn this study, we followed a transdisciplinary approach to discover novel small molecules that can modulate PD-1/PD-L1 interaction. To that end, we employedin silicoanalyses combined within vitro,ex vivo, andin vivoexperimental studies to assess the ability of novel compounds to modulate PD-1/PD-L1 interaction and enhance T-cell function.ResultsAccordingly, in this study we report the identification of novel small molecules, which like anti-PD-L1/PD-1 antibodies, can stimulate human adaptive immune responses. Unlike these biological compounds, our newly-identified small molecules enabled an extensive infiltration of T lymphocytes into three-dimensional solid tumor models, and the recruitment of cytotoxic T lymphocytes to the tumor microenvironmentin vivo, unveiling a unique potential to transform cancer immunotherapy.ConclusionsWe identified a new promising family of small-molecule candidates that regulate the PD-L1/PD-1 signaling pathway, promoting an extensive infiltration of effector CD8 T cells to the tumor microenvironment.
Impact of clinical domains other than arthritis on composite outcomes in psoriatic arthritis: comparison of treatment effects in the SEAM-PsA trial
Authors: Helliwell Philip S , Mease Phillip J , Kavanaugh Arthur , Coates Laura C , Ogdie Alexis , Deodhar Atul , Strand Vibeke , Kricorian Gregory , Liu Lyrica X H , Collier David , Gladman Dafna D 
Published: July 2022

ObjectiveWe used the Study of Etanercept And Methotrexate in Combination or as Monotherapy in Subjects with Psoriatic Arthritis (SEAM-PsA) data set to examine the impact of presence of enthesitis, dactylitis, nail disease and/or psoriasis on treatment response in patients with early psoriatic arthritis (PsA).MethodsThis post hoc analysis evaluated the effect of baseline Spondyloarthritis Research Consortium of Canada (SPARCC) Enthesitis Index (EI), Leeds Enthesitis Index (LEI), Leeds Dactylitis Index (LDI), modified Nail Psoriasis Severity Index (mNAPSI) scores and body surface area (BSA) on composite outcomes of minimal disease activity (MDA) responses, Psoriatic Arthritis Disease Activity Score (PASDAS) low disease activity (LDA), PASDAS changes and Good Responses and Disease Activity Index for Psoriatic Arthritis (DAPSA) scores at Week 24.ResultsOverall, 851 patients completed the SEAM-PsA trial and were included in the analysis. Baseline enthesitis (SPARCC EI>0 vs SPARCC EI=0 or LEI>0 vs LEI=0) was not associated with improved outcomes. Baseline dactylitis (LDI>0 vs LDI=0) was positively associated with improved MDA (OR: 1.4, p=0.0457), PASDAS LDA (OR: 1.8, p=0.0014) and Good Responses (OR: 1.6, p=0.0101) and greater reductions in PASDAS (estimate: –0.9, p<0.0001) and DAPSA scores (estimate: –3.8, p=0.0155) at Week 24. Similarly, baseline nail disease (mNAPSI >1 vs mNAPSI≤1) was positively associated with improved MDA (OR: 1.8, p=0.0233) and PASDAS LDA (OR: 1.8, p=0.0168) responses and greater reduction in PASDAS (estimate: –0.7, p=0.0005) at Week 24.ConclusionsResults from our analysis suggest that presence of dactylitis and nail disease, but not enthesitis, are associated with improved outcomes in patients with early PsA who were treated with methotrexate and/or etanercept.
Assessment of formal tobacco treatment and smoking cessation in dual users of cigarettes and e-cigarettes
Authors: Heiden Brendan T , Baker Timothy B , Smock Nina , Pham Giang , Chen Jingling , Bierut Laura J , Chen Li-Shiun 
Published: July 2022

BackgroundThe utility of electronic cigarettes (‘e-cigarettes’) as a smoking cessation adjunct remains unclear. Similarly, it is unclear if formal tobacco treatment (pharmacotherapy and/or behavioural support) augments smoking cessation in individuals who use both cigarettes and e-cigarettes.MethodsWe performed a longitudinal cohort study of adult outpatients evaluated in our tertiary care medical centre (6/2018–6/2020). E-cigarette use, smoking status and formal tobacco treatment (deterrent pharmacotherapy and/or behavioural support) were assessed in 6-month blocks (eg, cohort 1 (C1)=6/2018–12/2018, C2=1/2019–6/2019 and so on) using our electronic health record. We assessed the relationship between e-cigarette use (either with or without formal tobacco treatment) and point prevalence of smoking cessation at 6 and 12 months.Results111 823 unique patients were included in the study. The prevalence of dual use of cigarettes and e-cigarettes increased significantly over the study period (C1=0.8%; C2=1.1%; C3=1.8%; C4=2.3%; p<0.001). The prevalence of smoking cessation at 12 months was higher among e-cigarette users (20.8%) compared with non-users (16.8%) (risk difference, 4.0% (95% CI 2.5% to 5.5%); adjusted relative risk (aRR) 1.354, 95% CI 1.252 to 1.464, p<0.0001). Further, among dual users of cigarettes and e-cigarettes, the prevalence of smoking cessation at 12 months was higher among individuals who received tobacco treatment (29.1%) compared with individuals who did not receive tobacco treatment (19.6%) (risk difference, 9.5% (95% CI, 4.6% to 14.4%); aRR 1.238, 95% CI 1.071 to 1.432, p=0.004).InterpretationThese results suggest that dual users of cigarettes and e-cigarettes benefit from formal tobacco treatment. Clinicians should consider offering formal tobacco treatment to such patients, though future trials are needed.
Laparoscopic extraperitoneal technique versus open inguinal herniotomy in children: historical controlled intervention study
Authors: Suttiwongsing Arada , Khorana Jiraporn , Ruangwongroj Patchara , Niruttiwat Korakot 
Published: July 2022

ObjectiveTo compare surgical outcomes of percutaneous extraperitoneal simple purse string method of laparoscopic hernia (LH) repair with a traditional open inguinal hernia (OH) repair in children with indirect inguinal hernia in a single center.MethodsThis study is a historical-controlled intervention study of two groups of patients: patients in the controlled group had OH repair performed from January 2016 to December 2017, and patients in the study group had LH repair from January 2018 to December 2019 at a single institution. Outcomes of the OH and LH groups, in terms of operative time, recurrence, complications, incidence of metachronous contralateral inguinal hernia (MCIH) and contralateral patent processus vaginalis (CPPV) were analyzed.ResultsThree hundred and five patients were enrolled in the study. Among them, 95 cases underwent laparoscopic percutaneous extraperitoneal closure herniotomy (LH group), and 210 cases underwent conventional open herniotomy (OH group). In terms of operative time, only unilateral herniotomy in females of the OH group was significantly less than that of the LH group (15.7±7.1 vs 20.5±7.4 min, p=0.004). No significant difference in overall complication was observed between the two groups of patients. The incidence of CPPV in the LH group was 15.7% (15/95), and MCIH in OH group was 10.9% (23/210).ConclusionsLaparoscopic herniotomy may prevent the need for a second operation of metachronous contralateral hernia. Both open and laparoscopic techniques are equivalent in pro and cons.
More on the outer connected geodetic number of a graph
Authors: Ganesamoorthy K. , Jayanthi D. 
Published: July 2022

For a connected graph [Formula: see text] of order at least two, a total outer connected geodetic set [Formula: see text] of a graph [Formula: see text] is an outer connected geodetic set such that the subgraph induced by [Formula: see text] has no isolated vertices. The minimum cardinality of a total outer connected geodetic set of [Formula: see text] is the total outer connected geodetic number of [Formula: see text] and is denoted by [Formula: see text]. We determine bounds for it and also find the total outer connected geodetic number for some special classes of graphs. It is shown that for positive integers [Formula: see text] and [Formula: see text] with [Formula: see text] there exists a connected graph [Formula: see text] with [Formula: see text] [Formula: see text] and [Formula: see text]. It is proved that for each triple [Formula: see text] and [Formula: see text] of positive integers with [Formula: see text], [Formula: see text] and [Formula: see text], there exists a connected graph [Formula: see text] of order [Formula: see text] such that [Formula: see text] and [Formula: see text]. It is also shown that for positive integers [Formula: see text] such that [Formula: see text] with [Formula: see text], there exists a connected graph [Formula: see text] such that [Formula: see text] and [Formula: see text], where [Formula: see text] is the outer connected geodetic number of a graph [Formula: see text].
Advancing in the technical hierarchy
Authors: Meil Doug 
Published: July 2022

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Convectively Generated Negative Potential Vorticity Enhancing the Jet Stream through an Inverse Energy Cascade during the Extratropical Transition of Hurricane Irma
Authors: Prince Kevin C. , Evans Clark 
Published: July 2022

Abstract
A tropical cyclone (TC) that recurves into the midlatitudes can lead to significant downstream flow amplification by way of a favorable interaction with the midlatitude waveguide. Current conceptualizations emphasize the role of the meso-α- to synoptic-scale diabatically enhanced vertical redistribution of potential vorticity in facilitating downstream flow amplification following the interaction of a TC with the midlatitude waveguide. Less understood, however, is the extent to which this downstream flow amplification may be facilitated by the convective-scale diabatically enhanced horizontal redistribution of potential vorticity. Consequently, this study aims to diagnose the role that deep, moist convection in an associated predecessor rain event north of the TC played in influencing the midlatitude waveguide and potentially the downstream evolution. A convection-allowing numerical simulation is performed on a predecessor rain event that precedes the interaction of North Atlantic TC Irma in September 2017 with the midlatitude waveguide. Horizontal gradients in microphysical heating result in intense convective-scale potential vorticity dipoles aligned perpendicular to the vertical wind shear vector, with the negative anomaly poleward (and thus closer to the midlatitude waveguide) of the large-scale southwesterly vertical wind shear vector. Regions of intensely negative potential vorticity persist for multiple hours after their formation as they become deformed by the large-scale strain field that is aligned parallel to the background vertical wind shear vector. The deformation-driven thinning of the negative potential vorticity is associated with a transfer of energy to the large-scale flow, suggesting a nonnegligible impact to the TC–midlatitude waveguide interaction by the collection of convective cells embedded in the predecessor rain event.