bluuebunny/crossref_metadata_2025_split huggingface dataset:
Investigating feasibility of 2021 WHO protocol for cervical cancer screening in underscreened populations: PREvention and SCReening Innovation Project Toward Elimination of Cervical Cancer (PRESCRIP-TEC)
Authors: Sultanov Marat , Zeeuw Janine de , Koot Jaap , der Schans Jurjen van , Beltman Jogchum J. , Fouw Marlieke de , Majdan Marek , Rusnak Martin , Nazrul Naheed , Rahman Aminur , Nakisige Carolyn , Rao Arathi P. , Prasad Keerthana , Guruvare Shyamala , Biesma Regien , Versluis Marco , de Bock Geertruida H. , Stekelenburg Jelle 
Published: July 2022

Abstract
Background
High-risk human papillomavirus (hrHPV) testing has been recommended by the World Health Organization as the primary screening test in cervical screening programs. The option of self-sampling for this screening method can potentially increase women’s participation. Designing screening programs to implement this method among underscreened populations will require contextualized evidence.

Methods
PREvention and SCReening Innovation Project Toward Elimination of Cervical Cancer (PRESCRIP-TEC) will use a multi-method approach to investigate the feasibility of implementing a cervical cancer screening strategy with hrHPV self-testing as the primary screening test in Bangladesh, India, Slovak Republic and Uganda. The primary outcomes of study include uptake and coverage of the screening program and adherence to follow-up. These outcomes will be evaluated through a pre-post quasi-experimental study design. Secondary objectives of the study include the analysis of client-related factors and health system factors related to cervical cancer screening, a validation study of an artificial intelligence decision support system and an economic evaluation of the screening strategy.

Discussion
PRESCRIP-TEC aims to provide evidence regarding hrHPV self-testing and the World Health Organization’s recommendations for cervical cancer screening in a variety of settings, targeting vulnerable groups. The main quantitative findings of the project related to the impact on uptake and coverage of screening will be complemented by qualitative analyses of various determinants of successful implementation of screening. The study will also provide decision-makers with insights into economic aspects of implementing hrHPV self-testing, as well as evaluate the feasibility of using artificial intelligence for task-shifting in visual inspection with acetic acid.

Trial registration
ClinicalTrials.gov, NCT05234112. Registered 10 February 2022
A blended professional learning intervention for early childhood educators to target the promotion of physical activity and healthy eating: the HOPPEL cluster randomized stepped-wedge trial
Authors: ME Peden , MJ Eady , AD Okely , K Patterson , M Batterham , RA Jones 
Published: July 2022

Abstract
Background
Childcare centres are important environments for promoting physical activity and healthy eating. Blended approaches to professional learning may help overcome existing challenges for educators in promoting these behaviours. This study aimed to test the effect of a blended professional learning program on healthy eating and physical activity in childcare.

Methods
Cluster randomized stepped-wedge trial in 15 childcare centres in Tasmania, Australia. Children aged 2-5y who attended at least two days per week were eligible to participate. Random assignment occurred at the centre level. Centre names were drawn out of a hat and then subsequently allocated to one of the three steps. The intervention comprised a 12-week blended professional learning program for educators. The main outcome was centre-level physical activity and healthy eating, assessed using the Environment and Policy Assessment Observation System (EPAO). All data collectors were blinded to step allocation. Analyses were according to intention to treat. The trial was registered with the Australian New Zealand Clinical Trial Registry (ACTRN12618000346279, date registered: 07/03/2018).

Results
Centres were recruited between January 2016 and February 2016. All centres were retained for the duration of the study. A total of 313 children were recruited with 291 analysed at the completion of the study (93%). The difference between groups for the EPAO total score was significant at the end of the maintenance period (adjusted difference = 14.63, 95% CI [1.33, 27.92], p = 0.03). Significant differences were found for the percentage of time children spent in light-intensity physical activity at the end of the intervention (adjusted difference = 0.01, 95% CI [0.00,0.01], p = 0.02) and maintenance periods (adjusted difference = 0.01, 95% CI [0.00,0.02], p = 0.04). To the best of the authors knowledge, there were no adverse events.

Conclusion
This intervention achieved a sustained improvement in physical activity and healthy eating in childcare centres. Further, it can be easily integrated into existing service provision, especially among centres with limited access to professional learning.

Trial registration
The study was registered with the Australian and New Zealand Clinical Trials Registry (ACTRN12618000346279, date registered: 07/03/2018).
Achieving health equity in US suicides: a narrative review and commentary
Authors: Perry Seth W. , Rainey Jacob C. , Allison Stephen , Bastiampillai Tarun , Wong Ma-Li , Licinio Julio , Sharfstein Steven S. , Wilcox Holly C. 
Published: July 2022

AbstractSuicide rates in the United States (US) reached a peak in 2018 and declined in 2019 and 2020, with substantial and often growing disparities by age, sex, race/ethnicity, geography, veteran status, sexual minority status, socioeconomic status, and method employed (means disparity). In this narrative review and commentary, we highlight these many disparities in US suicide deaths, then examine the possible causes and potential solutions, with the overarching goal of reducing suicide death disparities to achieve health equity.The data implicate untreated, undertreated, or unidentified depression or other mental illness, and access to firearms, as two modifiable risk factors for suicide across all groups. The data also reveal firearm suicides increasing sharply and linearly with increasing county rurality, while suicide rates by falls (e.g., from tall structures) decrease linearly by increasing rurality, and suicide rates by other means remain fairly constant regardless of relative county urbanization. In addition, for all geographies, gun suicides are significantly higher in males than females, and highest in ages 51–85 + years old for both sexes. Of all US suicides from 1999–2019, 55% of male suicides and 29% of female suicides were by gun in metropolitan (metro) areas, versus 65% (Male) and 42% (Female) suicides by gun in non-metro areas. Guns accounted for 89% of suicides in non-metro males aged 71–85 + years old. Guns (i.e., employment of more lethal means) are also thought to be a major reason why males have, on average, 2–4 times higher suicide rates than women, despite having only 1/4—1/2 as many suicide attempts as women. Overall the literature and data strongly implicate firearm access as a risk factor for suicide across all populations, and even more so for male, rural, and older populations.To achieve the most significant results in suicide prevention across all groups, we need 1) more emphasis on policies and universal programs to reduce suicidal behaviors, and 2) enhanced population-based strategies for ameliorating the two most prominent modifiable targets for suicide prevention: depression and firearms.
What differentiates youths who use e-cigarettes from those who smoke traditional tobacco products?
Authors: Torregrossa Hugo , Dautzenberg Bertrand , Birkui Pierre , Rieu Nicole , Dautzenberg Marie-Dominique , Melchior Maria , Mary-Krause Murielle 
Published: July 2022

AbstractBackgroundElectronic cigarette (e-cigarette) use has spread among adolescents in many countries, however users’ characteristics are not well known. We aimed to compare characteristics of exclusive e-cigarette users to those of exclusive tobacco users and dual users.MethodsData come from a representative sample of 11–19 years old students in Paris, surveyed each year between 2013 and 2017. Current e-cigarette and tobacco use were ascertained in the preceding 30 days. Data were analyzed using random intercept multinomial logistic regression models, exclusive tobacco smokers being the reference group.ResultsAmong the 17,435 students included, 2.3% reported exclusive e-cigarette use, 7.9% exclusive tobacco use and 3.2% dual e-cigarette and tobacco use. Compared to exclusive tobacco smokers, e-cigarette users were: a) less likely to use cannabis (adjusted Odds-Ratio (aOR) = 0.15, 95% confidence interval (95% CI) = 0.09–0.25); b) more likely to initiate smoking with an e-cigarette or a hookah rather than traditional cigarettes (aOR = 2.91, 95% CI = 1.74–4.87 and aOR = 15.99, 95% CI = 8.62–29.67, respectively). Additionally, exclusive e-cigarette users are younger with an aOR = 0.29 (95% CI = 0.17–0.49) among 13–15 years and aOR = 0.11 (95% CI = 0.06–0.21) among > 17 years as compared to 11–13 years. The probability of being an exclusive e-cigarette user is lower among participants whose best friend smokes tobacco (aOR = 0.30, 95% CI = 0.20–0.44). Exclusive tobacco users and dual users have similar profiles.ConclusionsAdolescents who only used e-cigarettes had intermediate levels of risk compared to nonusers and those who used tobacco and/or e-cigarettes, suggesting that e-cigarettes use extends to young people at low-risk of using tobacco products.
The impact of coalition characteristics on outcomes in community-based initiatives targeting the social determinants of health: a systematic review
Authors: Nagorcka-Smith Phoebe , Bolton Kristy A. , Dam Jennifer , Nichols Melanie , Alston Laura , Johnstone Michael , Allender Steven 
Published: July 2022

Abstract
Background
Coalitions are a popular mechanism for delivering community-based health promotion. The aim of this systematic review was to synthesize research that has quantitatively analyzed the association between coalition characteristics and outcomes in community-based initiatives targeting the social determinants of health. Coalition characteristics described elements of their structure or functioning, and outcomes referred to both proximal and distal community changes.

Methods
Authors searched six electronic databases to identify peer reviewed, published studies that analyzed the relationship between coalition characteristics and outcomes in community-based initiatives between 1980 and 2021. Studies were included if they were published in English and quantitatively analyzed the link between coalition characteristics and outcomes. Included studies were assessed for quality using the Joanna Briggs Institute analytical cross-sectional studies assessment tool.

Results
The search returned 10,030 unique records. After screening, 26 studies were included from six countries. Initiatives targeted drug use, health equity, nutrition, physical activity, child and youth development, crime, domestic violence, and neighbourhood improvement. Community outcomes measured included perceived effectiveness (n=10), policy, systems or environment change (n=9), and community readiness or capacity (n=7). Analyses included regression or correlation analysis (n=16) and structural equation or pathway modelling (n=10). Studies varied in quality, with a lack of data collection tool validation presenting the most prominent limitation to study quality. Statistically significant associations were noted between community outcomes and wide range of coalition characteristics, including community context, resourcing, coalition structure, member characteristics, engagement, satisfaction, group facilitation, communication, group dynamics, relationships, community partnership, and health promotion planning and implementation.

Conclusion
Existing literature demonstrates that coalition characteristics, including best practice health promotion planning and evaluation, influence community outcomes. The field of coalition research would benefit from more consistent description and measurement of coalition characteristics and outcomes, and efforts to evaluate coalitions in a wider range of countries around the world. Further research using empirical community outcome indicators, and methods that consider the interrelationship of variables, is warranted.

Trial registration
A protocol for this review was registered with PROSPERO (CRD42020205988).
“When you live in good health with your husband, then your children are in good health ….” A qualitative exploration of how households make healthcare decisions in Maradi and Zinder Regions, Niger
Authors: Chace Dwyer Sara , Mathur Sanyukta , Kirk Karen , Dadi Chaibou , Dougherty Leanne 
Published: July 2022

Abstract
Background
Gender dynamics influence household-level decision-making about health behaviors and subsequent outcomes. Health and development programs in Niger are addressing gender norms through social and behavior change (SBC) approaches, yet not enough is known about how health care decisions are made and if gender-sensitive programs influence the decision-making process.

Methods
We qualitatively explored how households make decisions about family planning, child health, and nutrition in the Maradi and Zinder regions, Niger, within the context of a multi-sectoral integrated SBC program. We conducted 40 in-depth interviews with married women (n = 20) and men (n = 20) between 18 and 61 years of age.

Results
Male heads of household were central in health decisions, yet women were also involved and expressed the ability to discuss health issues with their husbands. Participants described three health decision-making pathways: (1st pathway) wife informs husband of health issue and husband solely decides on the solution; (2nd pathway) wife informs husband of health issue, proposes the solution, husband decides; and (3rd pathway) wife identifies the health issue and both spouses discuss and jointly identify a solution. Additionally, the role of spouses, family members, and others varied depending on the health topic: family planning was generally discussed between spouses, whereas couples sought advice from others to address common childhood illnesses. Many participants expressed feelings of shame when asked about child malnutrition. Participants said that they discussed health more frequently with their spouses’ following participation in health activities, and some men who participated in husbands’ schools (a group-based social and behavior change approach) reported that this activity influenced their approach to and involvement with household responsibilities. However, it is unclear if program activities influenced health care decision-making or women’s autonomy.

Conclusions
Women are involved to varying degrees in health decision-making. Program activities that focus on improving communication among spouses should be sustained to enhance women role in health decision-making. Male engagement strategies that emphasize spousal communication, provide health information, discuss household labor may enhance couple communication in Niger. Adapting the outreach strategies and messages by healthcare topic, such as couples counseling for family planning versus community-based nutrition messaging, are warranted.
Efficacy of 3% hydrogen peroxide solution in cleaning tongue coating before and after surgery: a randomized phase II study
Authors: Soutome Sakiko , Otsuru Mitsunobu , Hayashida Saki , Naruse Tomofumi , Morishita Kota , Kurihara Kazumi , Kawashita Yumiko , Funahara Madoka , Umeda Masahiro , Taniguchi Hideki , Saito Toshiyuki 
Published: July 2022

Abstract
Background
Increased bacterial presence in the tongue coating and thereby, the saliva, may be a risk factor for postoperative complications such as surgical site infection or postoperative pneumonia after cancer surgery. However, no method for cleaning tongue coating has been established experimentally. The purpose of this study was to verify the effect of brushing with 3% hydrogen peroxide on suppression of the number of bacteria in tongue coating.

Methods
Sixteen patients with gastric cancer or colorectal cancer undergoing surgery were randomly allocated to control and intervention groups. In the control group, the tongue was brushed for 30 s with a water-moistened toothbrush, while in the intervention group, the tongue was brushed for 30 s with a toothbrush moistened with 3% hydrogen peroxide. Bacterial counts on tongue coating were measured before and 30 s after cleaning the tongue coating using the Rapid Oral Bacteria Quantification System.

Results
In the control group, the number of bacteria on the tongue did not decrease significantly after tongue cleaning on the day before surgery, but did on the day after surgery. In contrast, in the intervention group, the number of bacteria on the tongue decreased significantly after tongue cleaning both on the day before and the day after surgery. Furthermore, when comparing the control and intervention groups, the intervention group had a greater reduction effect.

Conclusions
Tongue brushing with 3% hydrogen peroxide is a useful method to reduce the number of bacteria on the tongue in patients with gastrointestinal cancer undergoing surgery.
Trial registrationjRCTs071200020 (July 3, 2020).
Ginsenoside Rg3 induces apoptosis and inhibits proliferation by down-regulating TIGAR in rats with gastric precancerous lesions
Authors: Lv Shangbin , Chen Xiaodong , Chen Yu , Gong Daoyin , Mao Gang , Shen Caifei , Xia Ting , Cheng Jing , Luo Zhaoliang , Cheng Yu , Li Weihong , Zeng Jinhao 
Published: July 2022

AbstractBackgroundGinsenoside Rg3 (GRg3) is one of the main active ingredients in Chinese ginseng extract and has various biological effects, such as immune-enhancing, antitumour, antiangiogenic, immunomodulatory and anti-inflammatory effects. This study aimed to investigate the therapeutic effect of GRg3 on gastric precancerous lesion (GPL) induced by N-methyl-N′-nitro-N-nitrosoguanidine (MNNG) and the potential mechanism of action.MethodsThe MNNG–ammonia composite modelling method was used to establish a rat model of GPL. Histopathological changes in the rat gastric mucosa were observed by pathological analysis using haematoxylin–eosin staining to assess the success rate of the composite modelling method. Alcian blue–periodic acid Schiff staining was used to observe intestinal metaplasia in the rat gastric mucosa. Apoptosis was detected in rat gastric mucosal cells by terminal deoxynucleotidyl transferase-mediated dUTP nick end labelling staining. The production level of reactive oxygen species (ROS) was determined by the dihydroethidium fluorescent probe method, and that of TP53-induced glycolysis and apoptosis regulator (TIGAR) protein was determined by immunohistochemical staining and western blotting. The production levels of nicotinamide adenine dinucleotide phosphate (NADP) and glucose-6-phosphate dehydrogenase (G6PDH) were determined by an enzyme-linked immunosorbent assay, and that of glutathione (GSH) was determined by microanalysis.ResultsGRg3 significantly alleviated the structural disorganization and cellular heteromorphism in the form of epithelial glands in the gastric mucosa of rats with GPL and retarded the progression of the disease. Overexpression of TIGAR and overproduction of NADP, GSH and G6PDH occurred in the gastric mucosal epithelium of rats with GPL, which in turn led to an increase in the ROS concentration. After treatment with GRg3, the expression of TIGAR and production of NADP, GSH G6PDH decreased, causing a further increase in the concentration of ROS in the gastric mucosal epithelium, which in turn induced apoptosis and played a role in inhibiting the abnormal proliferation and differentiation of gastric mucosal epithelial cells.ConclusionGrg3 can induce apoptosis and inhibit cell proliferation in MNNG-induced GPL rats. The mechanism may be related to down-regulating the expression levels of TIGAR and production levels of GSH, NADP and G6PD, and up-regulating the concentration of ROS.
Perceptions of Polish and German physiotherapists about their professional education and development: a cross-sectional nonrandomized questionnaire cohort study
Authors: Handkiewicz Krzysztof , Drużbicki Mariusz , Guzik Agnieszka , Stachura Artur , Makiewicz Małgorzata 
Published: July 2022

Abstract
Background
The approach to the education and professional advancement of physiotherapists is particularly relevant today. To date, no studies have compared the perceptions of physiotherapists regarding professional issues in geographically close European countries such as Poland and Germany. Therefore, this study’s purpose was to compare Polish and German physiotherapists’ perceptions related to their profession, entry-level education, and career opportunities.

Methods
We recruited 565 physiotherapists from Poland and 560 physiotherapists from Germany. An opinion polling method based on a questionnaire was applied in the study. The survey was conducted in 48 facilities located throughout the territories of the two countries. The assessment focused on the following three issues: 1) professional education (form and content of educational programs, organizational aspects, and effects of education); 2) professional development and career opportunities; and 3) the relationship between years of service and perceptions of professional education, career satisfaction and advancement opportunities.

Results
German respondents rated specific aspects of their education, development opportunities and professional careers more highly than their Polish counterparts (p = 0.001). A highly significant negative correlation was identified in both groups between all the assessed aspects of professional education and years of service (0.9 ≤ |R| < 1, p = 0.001).

Conclusions
Opinions on their professions expressed by physiotherapists from closely neighboring countries, namely, Poland and Germany, were surprisingly disparate. Compared to their Polish colleagues, German physiotherapists viewed their experiences more favorably vis-a-vis entry-level education, career opportunities, and professional status. Further study is needed to establish whether these findings reflect actual differences, sampling bias, or other factors.