bluuebunny/crossref_metadata_2025_split huggingface dataset:
Disclosure of same-sex practices and experiences of healthcare stigma among cisgender men who have sex with men in five sub-Saharan African countries
Authors: Wiginton John Mark , Murray Sarah M. , Poku Ohemaa , Augustinavicius Jura , Jackman Kevon-Mark Phillip , Kane Jeremy , Billong Serge C. , Diouf Daouda , Ba Ibrahima , Mothopeng Tampose , Njindam Iliassou Mfochive , Turpin Gnilane , Tamoufe Ubald , Sithole Bhekie , Zlotorzynska Maria , Sanchez Travis H. , Baral Stefan D. 
Published: December 2021

Abstract
Background
For men who have sex with men (MSM) across sub-Saharan Africa (SSA), disclosure of same-sex practices to family and healthcare workers (HCWs) can facilitate access to HIV prevention services and support, but can also lead to experiences of stigma.

Methods
We performed mixed-effects regressions on pooled data from MSM in Cameroon, Senegal, Côte d’Ivoire, Lesotho, and eSwatini to assess associations between disclosure and sexual behavior stigma in healthcare contexts; we used logistic regressions to analyze country-specific data.

Results
Compared to participants who had not disclosed to either family or HCWs, those who had disclosed only to family were more likely to have been gossiped about by HCWs (aOR = 1.70, CI = 1.18, 2.45); the association between having disclosed to family and having felt mistreated in a health center approached, but did not achieve, statistical significance (aOR = 1.56, CI = 0.94, 2.59). Those who had disclosed only to HCWs were more likely to have feared to seek health services (aOR = 1.60, CI = 1.14, 2.25), avoided health services (aOR = 1.74, CI = 1.22, 2.50), and felt mistreated in a health center (aOR = 2.62, CI = 1.43, 4.81). Those who had disclosed to both were more likely to have feared to seek health services (aOR = 1.71, CI = 1.16, 2.52), avoided health services (aOR = 1.59, CI = 1.04, 2.42), been gossiped about by HCWs (aOR = 3.78, CI = 2.38, 5.99), and felt mistreated in a health center (aOR = 3.39, CI = 1.86, 6.20). Country-specific analyses suggested that data from Cameroon drove several of these associations.

Conclusions
Research to determine the factors driving disclosure’s differential effect on healthcare stigma across contexts is needed. Ultimately, supportive environments enabling safe disclosure is critical to understanding HIV-acquisition risks and informing differentiated HIV-prevention, treatment, and testing services for MSM across SSA.
Circumstances and toxicology of violence-related deaths among young people who have had contact with the youth justice system: a data linkage study
Authors: Willoughby Melissa , Young Jesse T. , Hail-Jares Katie , Spittal Matthew J. , Borschmann Rohan , Patton George , Sawyer Susan M. , Janca Emilia , Teplin Linda , Heffernan Ed , Kinner Stuart A. 
Published: December 2021

AbstractBackgroundYoung people who have had contact with the youth justice system have an increased risk of dying from violence. Examining the context of violence-related deaths is essential in informing prevention strategies. We examined the circumstances and toxicology of violence-related deaths among young people who have had contact with the youth justice system in Queensland, Australia.MethodsThis data linkage study linked youth justice records from Queensland, Australia (30 June 1993-1 July 2014) on 48,670 young people to national death and coroner records (1 July 2000-1 January 2017). Circumstances and toxicology of deaths were coded from coroner’s records. We calculated the incidence of violence-related deaths that were reported to a coroner. Fisher’s exact tests were used to examine crude differences in the circumstances and toxicology of violence-related death, according to sex and Indigenous status.ResultsThere were 982 deaths reported to a coroner in the cohort. Of which, 36 (4%) were from violence-related causes (incidence: 6 per 100,000 person-years, 95% confidence interval: 4-8). People who died from violence were most frequently male (n = 28/36; 78%), and almost half were Indigenous (n = 16/36; 44%). The majority of violence-related deaths involved a weapon (n = 24/36; 67%), most commonly a knife (n = 17/36; 47%). Compared to men where the violent incident was most frequently preceded by an altercation (n = 12/28; 43%), for women it was frequently preceded by a relationship breakdown or argument (n < 5;p = 0.004). Substances most commonly present in toxicology reports were cannabis (n = 16/23; 70%) and alcohol (n = 15/23; 65%).ConclusionsTherapeutic alcohol and other drug programs, both in the community and detention, are likely important for reducing violence-related deaths among young people who have had contact with the youth justice system. The majority of violence-related deaths among women were in the context of intimate partner violence, indicating the urgent need for interventions that prevent intimate partner violence in this population. Diversion programs and increased investment in health and social services may reduce the overrepresentation of Indigenous people in the youth justice system and in violence-related deaths.
FeV1 and BMI influence King’s Sarcoidosis Questionnaire score in sarcoidosis patients
Authors: Frye Björn Christian , Potasso Laura , Farin-Glattacker Erik , Birring Surrinder , Müller-Quernheim Joachim , Schupp Jonas Christian 
Published: December 2021

Abstract
Background
Sarcoidosis is granulomatous disease of unknown origin affecting organ function and quality of life. The King’s Sarcoidosis Questionnaire (KSQ) serves as a tool to assess quality of life in sarcoidosis patients with general health and organ specific domains. A German translation has been validated in a German cohort. In this study we assessed, whether clinical parameters influence KSQ scores.

Methods
Clinical data (e.g. lung function, organ impairment, serological parameters) for the German validation cohort were extracted from clinical charts and investigated by correlation and linear regression analyses.

Results
KSQ subdomain scores were generally lower in patients with respective organ manifestation or on current therapy. LUNG subdomain was significantly predicted by lung functional parameters, however for general health status, only FeV1 exerted significant influence. GHS was not influenced by serological parameters, but was significantly negatively correlated with body mass index (BMI). KSQ provides additional information beyond lung function, clinical or serological parameters in sarcoidosis patients. Notably, high BMI is significantly negatively associated with patients’ well-being as measured by KSQ-GHS.

Conclusion
This observation may direct further studies investigating the effect of obesity on sarcoidosis-related quality of life and strategies to intervene with steroid-sparing therapies and measures of life style modifications.
Trial registration This study was registered in the German Clinical Trials Register (reference number DRKS00010072). Registered January 2016.
Ethics experts and fetal patients: a proposal for modesty
Authors: Schmitz Dagmar , Clarke Angus 
Published: December 2021

AbstractBackgroundEthics consultation is recognized as an opportunity to share responsibility for difficult decisions in prenatal medicine, where moral intuitions are often unable to lead to a settled decision. It remains unclear, however, if the general standards of ethics consultation are applicable to the very particular setting of pregnancy.Main textWe sought to analyze the special nature of disagreements, conflicts and value uncertainties in prenatal medicine as well as the ways in which an ethics consultation service (ECS) could possibly respond to them and illustrated our results with a case example. Ethics facilitation and conflict mediation, currently, have no broadly consented normative framework encompassing prenatal diagnosis and therapy as well as reproductive choice to draw on. Even so, they can still be helpful instruments for ethically challenging decision-making in prenatal medicine provided two additional rules are respected: For the time being, ECSs should (a) refrain from issuing content-heavy recommendations in prenatal medicine and (b) should not initiate conflict mediations that would involve the pregnant woman or couple as a conflict party.ConclusionIt seems to be vital that ethics consultants as well as health care professionals acknowledge the current limitations and pitfalls of ethics consultation in prenatal medicine and together engage in the advancement of standards for this particularly complex setting.
Regular use of proton-pump inhibitors and risk of stroke: a population-based cohort study and meta-analysis of randomized-controlled trials
Authors: Yang Man , He Qiangsheng , Gao Fang , Nirantharakumar Krish , Veenith Tonny , Qin Xiwen , Page Amy T. , Wong Martin C. S. , Huang Junjie , Kuo Zi Chong , Xia Bin , Zhang Changhua , He Yulong , Meng Wenbo , Yuan Jinqiu , Pan Yihang 
Published: December 2021

Abstract
Background
Although randomized controlled trials (RCTs) have suggested a non-significant increased risk of stroke among proton pump inhibitor (PPI) users, the association has not been confirmed. We evaluated the association between regular use of PPIs and incident stroke and identified population groups at high net risk.

Methods
This is a prospective analysis of 492,479 participants free of stroke from the UK biobank. Incident stroke was identified through linkage to hospital admission and death registries using the International Classification of Diseases (ICD)-10 codes (I60, I61, I63, and I64). We evaluated hazard ratios (HRs) adjusting for demographic factors, lifestyle habits, prevalent comorbidities, concomitant use of medications, and indications of PPIs. We assessed the risk differences (RDs) according to the baseline Framingham Stroke Risk Score. In the meta-analysis, we searched PubMed, EMBASE, and the Cochrane Central Register of Controlled Trials (from 1988 to 1 June 2020) for randomized trials comparing PPIs with other interventions, placebo, or no treatment on stroke risk. Results were combined using a fix-effect meta-analysis (Mantel-Haenszel method).

Results
We documented 5182 incident strokes over 3,935,030 person-years of follow-up. Regular PPI users had a 16% higher risk of stroke than non-users (HR 1.16, 95% CI 1.06 to 1.27). The estimated effect was similar to our meta-analysis of nine RCTs (case/participants 371/26,642; RR 1.22, 95% CI 1.00 to 1.50; quality of evidence: moderate). The absolute effect of PPI use on stroke increased with the baseline Framingham Stroke Risk Score, with an RD of 1.34‰, 3.32‰, 4.83‰, and 6.28‰ over 5 years for the lowest, quartile 2, quartile 3, and the highest quartile, respectively.

Conclusions
Regular use of PPIs was associated with an increased risk of stroke, with a higher absolute risk observed in individuals with high baseline stroke risk. Physicians should therefore exercise caution when prescribing PPIs. An assessment of the underlying stoke risk is recommended for individualized use of PPIs.
Reconstruction of medium-size defects of the oral cavity: Radial forearm free flap vs facial artery musculo-mucosal flap
Authors: Ibrahim Badr , Rahal Akram , Bissada Eric , Christopoulos Apostolos , Guertin Louis , Ayad Tareck 
Published: December 2021

Background The radial forearm free flap (RFFF) is the most commonly used flap for defects of the oral cavity. The facial artery musculomucosal (FAMM) is a safe and effective method to reconstruct medium sized defects of the oral cavity. No comparison exists between the FAMM flap and RFFF. Methods 1) Retrospective chart review from 2007 to 2016. 2) Cost difference analysis. Results Thirteen FAMM flap cases and 18 RFFF met inclusion criteria. The FAMM flap showed a tendency to lower rates of return to the operating room ( p = 0.065) as well as lower rates of complications not requiring return to the OR with 1 complication in 1 patient as opposed to 10 patients with 15 complications ( p = 0.008). Also, FAMM flap had shorter operative times compared to the RFFF group (7.2HR and 8.9 HR respectively, p = 0.002). The average operative room related costs for a FAMM flap were 6510 CAD vs 10,703 CAD for RFFF ( p < 0.0005). Speech and swallowing outcomes were similar ( p > 0.05). Conclusion The FAMM flap can be used for reconstruction of medium-size defects of the oral cavity with functional outcomes similar to the RFFF while decreasing the associated costs and morbidity. Graphical Abstract
A phenomenographic study on language assessment literacy: hearing from Iranian university teachers
Authors: Rezai Afsheen , Alibakhshi Gudarz , Farokhipour Sajjad , Miri Mowla 
Published: December 2021

AbstractThis study aims to disclose the Iranian university teachers’ perceptions of the fundamentals of language assessment literacy (LAL). To this aim, using purposive sampling, eighteen university teachers from two Iranian universities were invited to participate in semi-structured interviews. Their viewpoints were audio-recorded, transcribed, and subjected to a phenomenographic analysis. Findings yielded two overarching LAL domains: knowledge (e.g., having an acceptable level of digital LAL, satisfying ethical requirements, benefiting more from performance assessment, considering students’ individual differences, making assessment valid, assuring that tests are reliable, and having an acceptable level of pedagogical content knowledge) and skills (e.g., involving students in assessment, using alternative assessment methods, employing logically traditional assessment methods, informing students about test results, administering tests in standardized ways, using valid grading procedures, and bringing positive wash-back effects). After discussing the results, the study concludes with proposing a range of implications for different testing stakeholders and highlighting some avenues for further research.
Vitamin D supplementation in systemic lupus erythematosus: relationship to disease activity, fatigue and the interferon signature gene expression
Authors: Magro Rosalie , Saliba Christian , Camilleri Liberato , Scerri Christian , Borg Andrew A. 
Published: December 2021

Abstract
Background
In addition to the well-known role of vitamin D in calcium homeostasis and bone metabolism, vitamin D is important in the modulation of the immune system and inflammatory processes. Vitamin D deficiency is common in patients with systemic lupus erythematosus (SLE), possibly as a result of sun avoidance. The aim of this prospective open-label study was to assess the effect of the treatment of vitamin D deficiency and insufficiency in SLE patients, particularly with regards to disease activity, fatigue and interferon signature gene expression.

Methods
31 SLE patients, 13 with vitamin D deficiency and 18 with vitamin D insufficiency were treated with vitamin D3. They were supplemented with vitamin D3 8000 IU daily for 8 weeks if they were vitamin D deficient, or 8000 IU daily for 4 weeks if they were insufficient. This was followed by 2000 IU daily maintenance. They were assessed at baseline, after 6 and 12 months by means of an interview, filling in questionnaires and blood tests. The expression of 12 interferon signature genes in RNA extracted from whole blood was measured by using QuantiGene Plex technology.

Results
An improvement in disease activity measured by systemic lupus erythematosus disease activity index-2K (SLEDAI-2K; p = 0.028) and fatigue measured by fatigue severity scale (FSS; p = 0.071) at 12 months were noted. A significant decrease in anti-double stranded deoxyribonucleic acid (dsDNA) titre (p = 0.045) was also noted. The mean interferon signature gene expression score decreased from baseline to 6 months, however statistical significance was not achieved (p = 0.165).

Conclusions
Improved disease activity and fatigue have been noted when Vitamin D has been supplemented in vitamin D deficient/insufficient SLE patients. One possible mechanism could be the suppression of the interferon signature gene expression.
Trial registration: The study was registered with the ISRCTN registry on 12/04/2021 (Trial ID: ISRCTN59058825).
The epidemiology of common mental disorders in Libya: a systematic review
Authors: Abdulshafea Mansour , Rhouma Abdul Hakim , Gire Nadeem , AlMadhoob Ali , Arshad Usman , Husain Nusrat 
Published: December 2021

Abstract
Introduction
There has been a global increase in the prevalence of common mental disorders (CMD), particularly in conflict hotspots. The limited amount of resources is one of the key barriers to effective treatment within Low- and Middle-income countries (LAMICs). The lack of service provision for mental health disorders in LAMICs has resulted in limited opportunities to conduct mental health research. Libya is a North African country that has suffered from ongoing conflict with the current political unrest in Libya further impacting the mental health of the population.

Main text
The aim of this review is to conduct a synthesis of evidence regarding the estimated prevalence and associated risk factors of CMD in Libya. A search was completed in the academic databases; PubMed, Medline, EMBASE, PsychINFO, CINHAL, and the Institute for Development, Research, Advocacy and Applied Care (IDRAAC) from inception to March 2020. Only studies that investigated prevalence and associated risk factors of CMD in Libya were included. A total of 219 studies were identified of which 15 met the inclusion criteria for the review. There were (n = 3) papers investigated the prevalence of depression, (n = 4) studies were focused on stress-related disorders and the remaining papers looked at both anxiety and depression. Statistically, sample sizes of the included studies ranged from (n = 41–13,031) for the prevalence studies (mean = 1188.6, median = 233).

Conclusion
The status of Libya as a conflict hotspot has led to a reduced level of epidemiological data on mental health, with a vital need to conduct research in CMD. Libya requires better clinical governance which can allow for more scientific research into CMD and enabling the Libyan government to develop evidence-based policy initiatives for CMD.
Undernutrition and associated factors among children aged 5–10 years in West Bengal, India: a community-based cross-sectional study
Authors: Pal Amitava , Manna Sourav , Dalui Rishna , Mukhopadhyay Rupanjan , Dhara Prakash C. 
Published: December 2021

Abstract
Background
In the previous few decades, India has made significant progress in reducing child mortality and fertility rates; yet, undernutrition remains one of the country’s primary public health issues. The goal of this study was to determine the extent of child malnutrition in West Bengal, India, as well as the risk factors linked with it. In diverse districts of West Bengal, a community-based cross-sectional study was undertaken utilizing multi-stage stratified cluster sampling followed by systematic random sampling. Anthropometric, individual, and household characteristics were collected from 2070 children in this study. Height-for-age, weight-for-age, and BMI-for-age z-scores were calculated. The levels and factors related with child undernutrition were studied using univariate and multivariate logistic regression analysis.

Results
Stunting, underweight, and thinness were shown to be prevalent in 25.48%, 33%, and 26.88% of children, respectively. With age, the likelihood of a child becoming malnourished increased. In comparison with girls, boys had a greater chance of being malnourished. Separately, parental educational and occupational statuses were linked to child malnutrition. Undernourished children were more likely to have a mother who was uneducated or undereducated (stunting: OR = 1.46; underweight: OR = 1.49; thinness: OR = 1.49). Children from economically disadvantaged families were more likely to be malnourished. Children from households with untreated drinking water and poor sanitation were more likely to be malnourished.

Conclusions
The current study showed that there are several risk variables linked to child malnutrition. Undernutrition was caused by illiteracy, filthy drinking water, and poor sanitation, all of which were independent risk factors.
Analysis of the impact of antidepressants and other medications on COVID-19 infection risk in a chronic psychiatric in-patient cohort
Authors: Clelland Catherine L. , Ramiah Krista , Steinberg Louisa , Clelland James D. 
Published: December 2021

BackgroundDuring the first wave of the coronavirus disease 2019 (COVID-19) pandemic, patients with confirmed cases in New York State accounted for roughly 25% of total US cases, with psychiatric hospital in-patients at particularly high risk for COVID-19 infection.AimsThe beneficial effects of mental health medications, such as selective serotonin reuptake inhibitors (SSRIs), on the severity of COVID-19 disease outcomes have been documented. Protective effects against infection have also been suggested for these medications. We therefore tested the hypothesis that medication use modifies the risk of COVID-19 infection in a long-stay, chronic in-patient psychiatry setting, where the potential for exposure was likely uniform across the facility, and where these medications were routinely prescribed.MethodThis was a retrospective cohort study of an adult psychiatric facility operated by the New York State Office of Mental Health. Current medication information and COVID-19 status was collected from electronic medical records for 165 people who were in-patients during the period January to July 2020, and logistic regression was employed to model the main effects of medication use on COVID-19 infection.ResultsA significant protective association was observed between antidepressant use and COVID-19 infection (odds ratio (OR) = 0.33, 95% CI 0.15–0.70, adjusted P < 0.05). Analysis of individual antidepressant classes showed that SSRI, serotonin-norepinephrine reuptake inhibitor and the serotonin-2 antagonist reuptake inhibitor classes of antidepressants, drove this protective effect. Exploratory analyses of individual antidepressants demonstrated an association between lower risk of infection and fluoxetine use (P = 0.023), as well as trazodone use (P = 0.001).ConclusionsThe novel finding of reduced COVID-19 infection risk for psychiatric in-patients taking antidepressants, suggests that antidepressants may be an important weapon in the continued fight against COVID-19 disease. This finding may become particularly salient for in-patient settings if vaccine-resistant strains of the virus appear.
From heterogeneous morphogenetic fields to homogeneous regions as a step towards understanding complex tissue dynamics
Authors: Yamashita Satoshi , Guirao Boris , Graner François 
Published: December 2021

ABSTRACT
Within developing tissues, cell proliferation, cell motility and other cell behaviors vary spatially, and this variability gives a complexity to the morphogenesis. Recently, novel formalisms have been developed to quantify tissue deformation and underlying cellular processes. A major challenge for the study of morphogenesis now is to objectively define tissue sub-regions exhibiting different dynamics. Here, we propose a method to automatically divide a tissue into regions where the local deformation rate is homogeneous. This was achieved by several steps including image segmentation, clustering and region boundary smoothing. We illustrate the use of the pipeline using a large dataset obtained during the metamorphosis of the Drosophila pupal notum. We also adapt it to determine regions in which the time evolution of the local deformation rate is homogeneous. Finally, we generalize its use to find homogeneous regions for cellular processes such as cell division, cell rearrangement, or cell size and shape changes. We also illustrate it on wing blade morphogenesis. This pipeline will contribute substantially to the analysis of complex tissue shaping, and the biochemical and biomechanical regulations driving tissue morphogenesis.