bluuebunny/crossref_metadata_2025_split huggingface dataset:
Lamellar Hole-associated Epiretinal Proliferation in choroideremia: a case report
Authors: Murro Vittoria , Mucciolo Dario Pasquale , Giorgio Dario , Caporossi Tomaso , Passerini Ilaria , Bani Daniele , Giansanti Fabrizio , Virgili Gianni , Sodi Andrea 
Published: October 2021

Abstract
Background
To report a clinical case of a patient affected with choroideremia (CHM) who underwent macular surgery for a macular hole (MH) with Lamellar Hole-associated Epiretinal Proliferation (LHEP).

Case presentation
We have described a 48-year-old male patient affected with CHM who developed MH with LHEP over a 7-year follow-up. The patient was referred to the Regional Center for Hereditary Retinal Degenerations of the Eye Clinic in Florence (Italy) in April 2012. The patient underwent vitrectomy and Inner Limiting Membrane (ILM) and LHEP peeling with fluid-air exchange. Ultra-structural examination of the excised epiretinal proliferation, carried out using electron microscopy, showed dense amorphous material, mainly composed of abundant clusters of fibrous collagens resembling compact fibrous long spacing collagen (FLSC), embedded in native vitreous collagen (NVC) and type IV collagen. No cells were detected in any of the specimens collected. At the 3rd-week postoperative follow-up the macular hole was closed.

Conclusion
Macular hole with LHEP can be detected in CHM patients; in our patient the macular hole showed tractional and degenerative features, with good anatomical results after macular surgery.
Consistency of the determinants of achieving fertility desires in Ghana: insights from 2003, 2008 and 2014 Ghana Demographic and Health Survey data sets
Authors: Yeboah Isaac , Kwankye Stephen Owusu , Frempong-Ainguah Faustina 
Published: October 2021

AbstractSub-Saharan Africa has entered the early stage of the demographic transition with differences in and between countries. The relation between fertility preference and actual fertility is at the core of the demographic changes during the demographic transition in sub-Saharan Africa. At the current pace of the demographic transition, overachieved fertility (actual fertility being higher than fertility preference) is more prevalent in sub-Saharan Africa although some women do achieve their fertility preference. Our aim is to assess the trends and identify factors that consistently influence women with completed fertility to achieve their fertility desires in Ghana over a 10-year period. We used secondary data from the 2003, 2008 and 2014 Ghana Demographic and Health Surveys for the analysis. The sample size was restricted to currently married/living in union women aged 45–49 years. The results indicate that underachieved fertility has increased from 25.1% in 2003 to 35.8% in 2014. Similarly, achieved fertility has also increased from 23.8% in 2003 to 26.0% in 2014. On the contrary, overachieved fertility has decreased from 51.1% in 2003 to 38.2% in 2014. The most persistent determinants of achieved fertility relative to overachieved fertility in Ghana during the last three rounds of the Ghana Demographic and Health Surveys are child survival status, ethnicity and couple’s fertility preference. The study provides support for programmatic interventions targeting improving child survival and regulating men’s fertility preference.
Bone Strain Index predicts fragility fracture in osteoporotic women: an artificial intelligence-based study
Authors: Ulivieri Fabio Massimo , Rinaudo Luca , Messina Carmelo , Piodi Luca Petruccio , Capra Davide , Lupi Barbara , Meneguzzo Camilla , Sconfienza Luca Maria , Sardanelli Francesco , Giustina Andrea , Grossi Enzo 
Published: October 2021

Abstract
Background
We applied an artificial intelligence-based model to predict fragility fractures in postmenopausal women, using different dual-energy x-ray absorptiometry (DXA) parameters.

Methods
One hundred seventy-four postmenopausal women without vertebral fractures (VFs) at baseline (mean age 66.3 ± 9.8) were retrospectively evaluated. Data has been collected from September 2010 to August 2018. All subjects performed a spine x-ray to assess VFs, together with lumbar and femoral DXA for bone mineral density (BMD) and the bone strain index (BSI) evaluation. Follow-up exams were performed after 3.34 ± 1.91 years. Considering the occurrence of new VFs at follow-up, two groups were created: fractured versus not-fractured. We applied an artificial neural network (ANN) analysis with a predictive tool (TWIST system) to select relevant input data from a list of 13 variables including BMD and BSI. A semantic connectivity map was built to analyse the connections among variables within the groups. For group comparisons, an independent-samples t-test was used; variables were expressed as mean ± standard deviation.

Results
For each patient, we evaluated a total of n = 6 exams. At follow-up, n = 69 (39.6%) women developed a VF. ANNs reached a predictive accuracy of 79.56% within the training testing procedure, with a sensitivity of 80.93% and a specificity of 78.18%. The semantic connectivity map showed that a low BSI at the total femur is connected to the absence of VFs.

Conclusion
We found a high performance of ANN analysis in predicting the occurrence of VFs. Femoral BSI appears as a useful DXA index to identify patients at lower risk for lumbar VFs.
Antibiotic resistance and ESBL production in Escherichia coli from various sources in Aba metropolis, Nigeria
Authors: Ajuga Martha Uzoaru , Otokunefor Kome , Agbagwa Obakpororo Ejiro 
Published: October 2021

Abstract
Background
The increase in multidrug resistance (MDR) among pathogenic bacteria responsible for infectious diseases has led to lack of effectiveness of some antibiotics. The ability of Escherichia coli to harbor resistant genes has made the treatment of infections a major challenge. This study was carried out to assess antibiotic resistance and extended-spectrum beta-lactamase (ESBL) production of E. coli from various sources in Aba metropolis, Nigeria.

Results
From a total of 350 samples collected from clinical and non-clinical sources, 137 were presumptively identified as E. coli by standard phenotypic methods and 83 were confirmed as E. coli by the detection of E. coli specific 16S rRNA gene fragments. The majority of these isolates (52, 62.7%) were from non-clinical sources. The clinical isolates, however, exhibited a higher level of resistance against 62.5% of tested antibiotics. Both group of isolates exhibited similar levels (58.1% vs 53.9%) of MDR, though. A low rate of ESBL production was observed (1.2%) following phenotypic detection of ESBL-producing abilities using the double-disc synergy test. An assessment of the presence of three beta-lactamase gene genotypes (blaTEM, blaSHV and blaCTX-M) revealed that none of the three predominant ESBL genotypes was identified in this study.

Conclusions
This study reports high levels of antibiotic resistance in both clinical and non-clinical E. coli isolates. Though higher rates of resistance were observed among the non-clinical isolates, both group of organisms had similar levels of MDR. Strikingly, however, was the low level of ESBL producers detected in this study and the absence of the three main genotypes associated with ESBL production in this study.
Effects of fermentation and drying durations on the quality of cocoa (Theobroma cacao L.) beans during the rainy season in the Juaboso District of the Western-North Region, Ghana
Authors: Ackah Emmanuel , Dompey Eric 
Published: October 2021

Abstract
Background
Postharvest treatments are crucial to the quality of cocoa finished products. This study aimed at investigating the effects of durations of fermentation and drying on the quality of cocoa (Theobroma cacao) beans during the rainy season. The study employed a 4 × 3 factorial with four fermentation durations of 5, 6, 7 and 8 days and three drying periods of 4, 5 and 6 days, resulting in a total of 12 treatment combinations, laid in a Completely Randomized Design with three replications. Bean quality data were collected on bean count/100 g, moisture content and cut test attributes including mouldy, slaty and purple, as well as percentage purity.

Results
The study showed that the applied fermentation and drying periods single handedly resulted in moisture content higher than the recommended, coupling 8 days fermentation with 6 days drying period resulted in a moisture content of 5.6% which falls below the acceptable standard (7.5%) recommended. Number of beans/100 g increased with increasing fermentation and drying periods. Coupling any of the fermentation periods with 5 or 6 days drying duration resulted in mould content within the acceptable grade 1 limit (3%). Longer fermentation period coupled with any of the drying durations resulted in very encouraging and minimal values of purple, while coupling 6, 7 or 8 days fermentation period with 6 days drying resulted in slaty content within the grade 1 limit (3%).

Conclusion
The overall effect of the treatments on the quality attributes from the cut test revealed that 8 days fermentation with the traditional leave heap method, coupled with 6 days sun drying during the rainy season, resulted in superior bean quality with a percentage purity of 98.00%.
Polyethylene-coffee husk eco-composites for production of value-added consumer products
Authors: Jaramillo Leyla Y. , Vásquez-Rendón Mauricio , Upegui Sergio , Posada Juan C. , Romero-Sáez Manuel 
Published: October 2021

AbstractThe annual worldwide production of coffee exceeds 10 million tons, and more than 90% of this production is waste, including the husk. On the other hand, plastic consumption increases every year, and sustainable alternatives are necessary to decrease it. This work arises to solve these two problems, and seeks to produce products at an industrial level from polyethylene/coffee husk eco-composites. Both Low Density Polyethylene and High Density Polyethylene were used, and the amounts of coffee husk added as filler were 20 and 40 wt%. The composites were characterized by different morphological, thermal and mechanical techniques. Scanning Electron Microscopy images showed husk particles embedded in the polymer matrix, but with some gaps between the polymer and the filler, because no compatibilizer agent was used. The addition of large amounts of natural filler negatively affected the tensile strength and elongation at break, but increases eco-composites crystallinity, and hence, their Young modulus and hardness. The industrial applicability of the eco-composites was verified through the production of five different consumer products by extrusion and injection processes, using mixtures with 40 wt% coffee husks. All products were obtained without significant defects. If only 3.25 wt% of the polyethylene products produced each year in Colombia did so with the eco-composites developed in this work, all the coffee husk produced in the country would be used, and the emission of about 5.390 million m3of greenhouse gases would be avoided.
Cementing the relationship between conventional and advanced semen parameters
Authors: Ayad Bashir M. , Oyeyipo Ibukun P. , Van der Horst Gerhard , Du Plessis Stefan S. 
Published: October 2021

AbstractBackgroundAffordable conventional semen analysis remains a fundamental procedure to be performed routinely during the diagnosis of male infertility. Advanced semen analyses provide valuable clinical insights in treatment-related decision-making, but these are highly expensive and lack universal standardization. This study aimed at determining the relationship between conventional semen parameters, measured with assistance of computer-aided sperm analysis (CASA), and a set of advanced semen tests. Basic semen analysis (n= 124) was performed according to the World Health Organization (WHO) guidelines. Sperm DNA fragmentation and intracellular superoxide (O2−•) levels were assessed by flow cytometry. Seminal plasma thiobarbituric acid reactive substances (TBARS) levels as well as superoxide dismutase (SOD) and catalase (CAT) activity were measured by spectrophotometry. Spearman’s rank correlation coefficient was used, with significance set atp< 0.05.ResultsSemen pH correlated negatively with TBARS (p< 0.01). The proportions of total and progressively motile as well as rapid spermatozoa correlated positively with CAT activity (p< 0.05). Sperm viability correlated negatively with both O2−•(p< 0.05) and DNA fragmentation (p= 0.01), while normal morphology correlated negatively with O2−•levels (p< 0.05) and positively with CAT activity (p< 0.05). Straight-line velocity (VCL) and average-path velocity (VAP) correlated negatively with both O2−•(p< 0.01) and TBARS (p< 0.01). Amplitude of lateral head displacement (ALH) correlated negatively with O2−•(p< 0.01) and DNA fragmentation (p< 0.01), while its correlation with SOD activity was positive (p< 0.05).ConclusionThe results obtained from this study support the validity of some CASA parameters as sensitive indicators of changes in sperm oxidative status and DNA integrity. Predicting advanced from conventional parameters through the building of linear regression models should be considered for future studies.
An implementation intervention to increase the routine provision of antenatal care addressing gestational weight gain: study protocol for a stepped-wedge cluster trial
Authors: Kingsland Melanie , Hollis Jenna , Farragher Eva , Wolfenden Luke , Campbell Karen , Pennell Craig , Reeves Penny , Tully Belinda , Daly Justine , Attia John , Oldmeadow Christopher , Hunter Mandy , Murray Henry , Paolucci Francesco , Foureur Maralyn , Rissel Chris , Gillham Karen , Wiggers John 
Published: October 2021

Abstract
Background
Weight gain during pregnancy that is outside of recommended levels is associated with a range of adverse outcomes for the mother and child, including gestational diabetes, pre-eclampsia, preterm birth, and obesity. Internationally, 60–80% of pregnant women report gaining weight outside of recommended levels. While guideline recommendations and RCT evidence support the provision of antenatal care that supports healthy gestational weight gain, less than 10% of health professionals routinely weigh pregnant women; discuss weight gain, diet, and physical activity; and provide a referral for additional support. This study aims to determine the effectiveness of an implementation intervention in increasing the provision of recommended gestational weight gain care by maternity services.

Methods
A stepped-wedge controlled trial, with a staggered implementation intervention, will be conducted across maternity services in three health sectors in New South Wales, Australia. The implementation intervention will consist of evidence-based, locally-tailored strategies including guidelines and procedures, reminders and prompts, leadership support, champions, training, and monitoring and feedback. Primary outcome measures will be the proportion of women who report receiving (i) assessment of gestational weight gain; (ii) advice on gestational weight gain, dietary intake, and physical activity; and (iii) offer of referral to a telephone coaching service or local dietetics service. Measurement of outcomes will occur via telephone interviews with a random sample of women who attend antenatal appointments each week. Economic analyses will be undertaken to assess the cost, cost-consequence, cost-effectiveness, and budget impact of the implementation intervention. Receipt of all care elements, acceptance of referral, weight gain during pregnancy, diet quality, and physical activity will be measured as secondary outcomes. Process measures including acceptability, adoption, fidelity, and reach will be reported.

Discussion
This will be the first controlled trial to evaluate the effectiveness of a implementation intervention in improving antenatal care that addresses gestational weight gain. The findings will inform decision-making by maternity services and policy agencies and, if the intervention is demonstrated to be effective, could be applied at scale to benefit the health of women and children across Australia and internationally.

Trial registration
Australian and New Zealand Clinical Trials Registry, ACTRN12621000054819. Registered on 22 January 2021
Initial validation of a self-report questionnaire based on the Theoretical Domains Framework: determinants of clinician adoption of a novel colorectal cancer screening strategy
Authors: Zhu Xuan , Lee Minji K. , Weiser Emily , Griffin Joan M. , Limburg Paul J. , Finney Rutten Lila J. 
Published: October 2021

Abstract
Background
Colorectal cancer (CRC) screening for average risk adults age 45 and older continues to be underutilized in the USA. One factor consistently associated with CRC screening completion is clinician recommendation. Understanding the barriers and facilitators of clinical adoption of emerging CRC screening strategies is important in developing effective intervention strategies to improve CRC screening rates. We aimed to develop a questionnaire based on the Theoretical Domains Framework (TDF) to assess determinants of clinical adoption of novel CRC screening strategies, using the multi-target stool DNA test (mt-sDNA; Cologuard®) as an example, and test the psychometric properties of this questionnaire on a sample of US clinicians.

Methods
A web survey was administered between November and December 2019 to a national panel of clinicians including primary care clinicians (PCCs) and gastroenterologists (GIs) to assess 10 TDF constructs with 55 items. Confirmatory factor analysis (CFA) was used to examine whether the a priori domain structure was supported by the data. Discriminant validity of domains was tested with Heterotrait-Monotrait ratio (HTMT). Internal consistency for each scale was assessed using Cronbach’s alpha. Criterion validity was assessed with self-reported mt-sDNA use and mt-sDNA recommendation as the outcomes.

Results
Complete surveys were received from 814 PCCs and 159 GIs (completion rate, 24.7% of 3299 PCCs and 29.6% of 538 GIs). Providers were excluded from analysis if they indicated not recommending CRC screening to average-risk patients (final N = 973). The final questionnaire consisted of 38 items covering 5 domains: (1) knowledge; (2) skills; (3) identity and social influence; (4) optimism, beliefs about consequences, and intentions; and (5) environmental context and resources. CFA results confirmed a reasonable fit (CFI = 0.948, SRMR = 0.057, RMSEA = 0.080). The domains showed sufficient discriminant validity (HTMT < 0.85), good internal consistency (McDonald’s omega > 0.76), and successfully differentiated providers who reported they had ordered mt-sDNA from those who never ordered mt-sDNA and differentiated providers who reported routinely recommending mt-sDNA from those who reported not recommending mt-sDNA.

Conclusions
Findings provide initial evidence for the validity and internal consistency of this TDF-based questionnaire in measuring potential determinants of mt-sDNA adoption for average-risk CRC screening. Further investigation of validity and reliability is needed when adapting this questionnaire to other novel CRC screening strategy contexts.
Prevalence of complex post-traumatic stress disorder in refugees and asylum seekers: systematic review
Authors: de Silva Umanga , Glover Naomi , Katona Cornelius 
Published: October 2021

BackgroundRefugees and asylum seekers often report having experienced numerous complex traumas. It is important to understand the prevalence of complex post-traumatic stress disorder (CPTSD), which can follow complex traumas.AimsThis systematic review aims to summarise the available literature reporting the prevalence in refugees and asylum seekers of three operationalised definitions of CPTSD: the ICD-11 diagnostic criteria, the ICD-10 criteria (for enduring personality change after catastrophic experience) and the DSM-IV criteria (for disorders of extreme stress not otherwise specified).MethodSix electronic databases were searched for studies reporting the prevalence of CPTSD in adult refugee and/or asylum-seeking samples. Owing to heterogeneity between the studies, a narrative synthesis approach was used to summarise studies. Methodological quality was assessed using the Joanna Briggs Critical Appraisal Checklist for Prevalence Studies. This systematic review has been registered with PROSPERO (registration number CRD42020188422,https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=188422).ResultsSystematic searches identified 15 eligible studies, with 10 examining treatment-seeking samples and five using population samples. CPTSD prevalence in treatment-seeking samples was between 16 and 38%. Prevalence in population samples ranged from 2.2 to 9.3% in four studies, with the fifth reporting a much higher estimate (50.9%).ConclusionsThis review highlights both the high prevalence of CPTSD in treatment samples and the lack of research aiming to establish prevalence of CPTSD in refugee and asylum-seeking populations. Understanding the prevalence of these disabling disorders has implications for policy and healthcare services for the appropriate promotion, planning and provision of suitable treatment and interventions for this highly traumatised population.
Evidence of extreme events in wind-induced normal stress of the columns of low- and medium-rise building structures
Authors: Suresh R. , Gopal R. , Pillai S. Nadaraja , Chandrasekar V. K. 
Published: October 2021

Abstract
We designed models for low- and medium-rise building structures with square and rectangular plans and tested the wind-induced normal stress of the building columns. We demonstrate the structures' normal stress response due to the wind load is non-Gaussian and shows evidence of extreme events, which are four to seven times larger than the mean standard deviation. We have estimated the probability distribution function to corroborate the long-tail nature of the extreme events, and randomness of the events is confirmed by plotting inter-event intervals and return maps. Further, the number of extreme events is calculated, which validates the exponentially decaying fit as a function of the number of standard deviations.
HumanSRYExpression at the Sex-determining Period is Insufficient to Drive Testis Development in Mice
Authors: Tsuji-Hosokawa Atsumi , Ogawa Yuya , Tsuchiya Iku , Terao Miho , Takada Shuji 
Published: October 2021

AbstractThe sex-determining region of the Y chromosome, Sry/SRY, is an initiation factor for testis development in both humans and mice. Although the functional compatibility between murine SRY and human SRY was previously examined in transgenic mice, their equivalency remains inconclusive. Because molecular interaction and timeline of mammalian sex determination were mostly described in murine experiments, we generated a mouse model in which Sry was substituted with human SRY to verify the compatibility. The mouse model had the human SRY open reading frame at the locus of murine Sry exon 1—Sry(SRY) mice—and was generated using the CRISPR/Cas9 system. The reproductive system of the mice was analyzed. The expression of human SRY in the fetal gonadal ridge of Sry(SRY) mice was detected. The external and internal genitalia of adult Sry(SRY) mice were similar to those of wild-type females, without any significant difference in anogenital distance. Sry(SRY) mice obtained gonads, which were morphologically considered as ovaries. Histological analysis revealed that the cortical regions of gonads from adult Sry(SRY) mice contained few follicles. We successfully replaced genes on the Y chromosome with targeted genome editing using the CRISPR/Cas9 system. Because the Sry(SRY) XY mice did not develop testis, we concluded that human SRY was insufficient to drive testis development in mouse embryos. The difference in response elements and lack of glutamine-rich domains may have invalidated human SRY function in mice. Signal transduction between Sry/SRY expression and Sox9/SOX9 activation is possibly organized in a species-specific manner.