bluuebunny/crossref_metadata_2025_split huggingface dataset:
Gender Differences in the Complications of Sickle Cell Anemia
Authors: Ugwu Angela O. 
Published: December 2021

Background:
The clinical severity of sickle cell anemia (SCA) varies from one individual to another. Several factors, including genetic predisposition, environmental and social factors, are known to modify the clinical presentation and complications of SCA but not much is known about the influence of gender.

Objective:
This study aims at determining the gender differences in the pattern of SCA complications in Enugu, Nigeria.

Materials and Methods:
This is a retrospective analysis of clinical and laboratory data from the folders of patients with SCA at the University of Nigeria Teaching Hospital Enugu, Nigeria between February 2008 and February 2014. A total of 248 folders comprising 151 males and 97 females were retrieved. Data on the age, sex, hematological parameters, number of complications, and frequency of SCA crises were extracted and analyzed. Only the case files of adult patients with SCA were investigated.

Results:
The median age of the participants was 25 (IQR = 22–30) years. The male to female ratio was 1.5:1. A total of 182 out of 248 (73.4%) cases reviewed had one form of complication or the other. Sickle cell leg ulcer was the most common complication seen among the cases (50/182 [27.5%]), followed by avascular necrosis (AVN) (28/182 [15.4%]). The mean frequency of crises was not different between the male and female genders (15.00 ± 9.01 vs. 9.8 ± 6.97; P = 0.293). However, the male gender had more complications than the female gender (116/151 [73.9%] vs. 116/151 [73.9%]; odds ratio [OR] = 2.13; 95% confidence interval [CI] = 1.2–3.7; P = 0.007).

Conclusion:
The male gender is twice more likely to develop complications of SCA and, thus, are more likely to have more morbidity from this condition.
The Prevalence of Stillbirths and the Probable Causes in Low Resource Settings in South-East Nigeria
Authors: Ezugwu Euzebus C. , Eleje George U. , Mba Sunday G. , Ajah Leonard O. , Enechukwu Chukwunonso I. , Ugwu George O. , Agu Polycap U. , Ezegwui Hyginus U. 
Published: December 2021

Background:
Stillbirth is a devastating pregnancy outcome, with resultant emotional and psychological trauma to the affected family.

Objectives:
We investigated the prevalence and probable causes of stillbirths in four tertiary hospitals in south-east Nigeria.

Materials and Methods:
A 5-year multicenter, retrospective descriptive study of all stillbirths delivered in the hospitals from January 2013 to December 2017 was done. Using an already prepared proforma, the sociodemographic characteristics of the mothers and the probable causes of deaths were retrieved from their case files. Data were entered and analyzed using Statistical Package for Social Sciences (SPSS), version 20. A P-value less than 0.05 was considered statistically significant.

Results:
There were 23,101 deliveries within the study period and 1,294 stillbirths giving a stillbirth rate (SBR) of 56.1/1,000 deliveries. More than half (58.7%) of them were intrapartum. More than half of the stillbirths were preterm delivery (58.5%). The commonest probable cause of macerated stillbirth was hypertensive disorders of pregnancy (32.4%).

Conclusion:
The overall SBR was 56.1 per 1000 deliveries. This is higher than 42.9 per 1000 deliveries previously reported in Nigeria. There is an urgent need to improve the quality of antenatal and intrapartum care, if we hope to achieve a significant reduction of the SBR in the region.
Virologic Response to Antiretroviral Therapy Among Human Immunodeficiency Virus-Infected Adults in a Tertiary Healthcare Facility in Enugu State Nigeria
Authors: Obi Izuchukwu F. , Okoronkwo Ijeoma L. , Onyedum Cajetan C. , Fashola Adebayo M. , Onuoha Martins , Nwobi Emmanuel A. , Onodugo Obinna D. , Chukwuka Chinwe 
Published: December 2021

Background:
Early and sustained viral suppression with antiretroviral therapy (ART) has been linked to good clinical outcome in HIV-infected patients. The global target is that at least 90% of the patients on ART should be virally suppressed.

Objectives:
We assessed the virologic response to first-line ART in the first year of treatment in our center and determined the factors influencing early viral load suppression among patients.

Materials and Methods:
We conducted a retrospective study involving review of the records of all eligible HIV-infected adults initiated on ART in our facility between 2009 and 2014, who did not miss any follow-up appointment during the first year on ART. Data were extracted with a proforma and analyzed with Epi Info 7. Frequencies and proportions were used to summarize patients who achieved undetectable viremia (viral load < 400 copies/mL]) at 12 and 24 weeks, whereas χ2 and logistic regression were done at 5% alpha to determine the factors influencing early viral load suppression.

Results:
The mean age of 478 participants was 38.6 (19.0) years and 310 (64.8%) were females. While 332 (69.5%) patients achieved undetectable viremia at 12 weeks of ART, 356 (74.5%) achieved it at 24weeks. After 24 weeks on ART, 121 (80.7%) of the150 patients on tenofovir/emtricitabine/efavirenz, 195 (71.2%) of the 274 patients on zidovudine/lamivudine/nevirapine, and 35 (71.4%) of the 49 patients on tenofovir/lamivudine+nevirapine achieved undetectable viremia (P = 0.13). Patients’ age, sex, marital status, baseline CD4 count, TB co-infection status, WHO clinical stage of disease, and plasma viral load at ART initiation were not significantly associated with early viral load suppression (p > 0.05).

Conclusion:
Three out of every four participants initiated on first-line ART achieved undetectable viremia after 24 weeks of treatment in our setting. The three ART regimens assessed have comparable effectiveness. The sociodemographic and clinical variables assessed did not influence viral suppression.
Drug related adverse pregnancy outcomes at a tertiary care hospital from the foothills of Himalayas
Authors: Choudhary Chahat , Bandyopadhyay Arkapal , Bahadur Anupama , Chaturvedi Jaya , Handu Shailendra , Dhamija Puneet 
Published: December 2021

Context and Aim:
Safety of drug usage during pregnancy is of utmost importance. Unrestricted usage of drugs may lead to undesirable and unpredictable pregnancy outcomes. This study was designed to detect drug-related adverse pregnancy outcomes, perform prescription audit and develop a pregnancy drug registry.

Methods and Materials:
A prospective observational study was conducted at a tertiary care hospital in northern India. Pregnant females attending antenatal clinic, irrespective of their duration of pregnancy were included in the study over a period of 1 year. The participants were followed up monthly during their pregnancy till the pregnancy outcome. Adverse pregnancy outcomes were evaluated and causality assessment was done using the WHO-UMC scale.

Statistical Analysis:
Descriptive and inferential statistical tools were used for appropriate variables. Regression model was used to establish relationship between factors proposed to be responsible for adverse pregnancy outcomes. Presence of adverse pregnancy outcome was used as an independent variable. Microsoft Excel and Strata (version 12) were used for statistical analysis.

Results:
A total 326 pregnant women were screened out of which 305 were included in the final analysis. Mean age of participants was 27.82 (±4.51) years. Pre-existing comorbidities were present in 4.26% of participants. Average number of drugs per participant was 6.32 (±1.94). Most drugs prescribed to participants were from FDA category B (49.23%) and category A (33.60%). Mean ADR reported per patient was 1.16 (±1.18) with involvement of musculoskeletal (56.42%) and gastrointestinal (7.16%) being most frequent. Adverse pregnancy outcomes were reported in 25 participants among which IUGR (24%) followed by IUD (20%) and ectopic pregnancy (16%) were most frequently observed. Multivariate logistic regression showed number of comorbidities (P = 0.037) and number of drugs consumed during pregnancy (P = 0.02) to be statistically significantly associated with occurrence of adverse pregnancy outcome.

Conclusions:
Pregnancy registries have been instrumental in detection of signals for further research in drug-related adverse outcomes. Inappropriate usage of drugs has been shown to be associated with adverse pregnancy outcomes. Our study warrants need for further well-designed studies on adverse pregnancy outcomes in larger patient populations.
Awareness and usage of personal protective equipment among construction workers and their hearing assessment by pure tone audiometry; A cross-sectional study in South India
Authors: Hameed Shahul , Chethana K , Sunu Zainab , Kiran K. G. 
Published: December 2021

Context:
Occupational hazards at the building construction workplace are enormous. Good compliance to the use of personal protective equipment (PPE) alongside other safety measures is critical in reducing the hazards. Occupational hearing loss is one such occupational hazard among construction workers.

Aims:
This study was conducted for determining the awareness of the benefits of PPE and its usage among construction workers along with hearing assessment.

Settings and Design:
A cross-sectional study was conducted among construction workers in a building project in Mangaluru city in Dakshina Kannada district in South India.

Methods and Material:
After obtaining informed written consent, 110 construction workers were recruited by simple random sampling method. Basic information, awareness, and use of PPE were collected using a semistructured questionnaire through personal interviews. Hearing assessment was done by pure tone audiometry.

Statistical Analysis Used:
Data collected was analyzed. Chi-square test and Fischer’s exact probability test were used to test the association between variables.

Results:
Majority (85.5%) of the construction workers are working for duration of 15 years or less. Difficulty in hearing was reported by 9.6% of them. Awareness regarding benefits of using personal protective devices like helmets, masks, and earplugs/muffs were 58.2%, 56.4%, and 14.5%, respectively. The utilization of at least one PPE among them was 58.1%. The presence of sensory neural hearing loss (SNHL) in both/either ears was detected among 14.5% of the workers. There was a statistically significant association of SNHL among workers and their duration of construction work.

Conclusion:
The current study highlights that awareness and usage of PPE was low and a proportion of them had a hearing impairment. Occupational health and safety training along with a periodic examination of construction workers need to be focused so as to detect and manage occupational health hazards early.
Prevalence of chronic morbidities and healthcare seeking behavior among urban community dwelling elderly population residing in Kalyani Municipality area of West Bengal, India
Authors: Ahamed Farhad , Ghosh Tandra , Kaur Amandeep , Debnath Abantika 
Published: December 2021

Introduction:
Demographic transition has resulted in higher proportion of elderly population in every community. The pattern of chronic morbidity along with healthcare seeking behavior and factors associated with it are important for implementation of national health policies targeted toward elderly population.

Methods:
A community based cross-sectional study was done including 457 urban dwelling elderly population of Kalyani Municipality area of West Bengal. Sociodemographic details, profile of chronic morbidities, and healthcare seeking behavior for chronic morbidities were studied using a pretested semi structured questionnaire.

Results:
The average education and financial independence were high among study participants. The prevalence of chronic morbidities was 82.3% and hypertension was the most common morbidity in both male and female. Around half of the individuals with chronic morbidities (57.7%) sought healthcare advice at least once in last 6 months. Most of the study participants preferred private healthcare setup and allopathic system of medicine. Females have been found to have higher treatment seeking behavior than males in logistic regression.

Conclusion:
We found hypertension and diabetes were more prevalent in the study population. Higher financial independence and education among study participants might have influenced the healthcare seeking behavior, which was mainly from private setup. Implementation of national health policies for elderly has to be accelerated in acceptable ways to promote health among elderly.
Prevalence of acanthosis nigricans and its association with physical activity in adolescents – School-based analytical cross-sectional study from Kochi, Kerala
Authors: Sudevan Remya , Vijay Kumar S , Sunny Clint , Sunand Nanditha , Vasudevan Anu , S Sonu K. , V Apsy P. 
Published: December 2021

Introduction:
Acanthosis nigricans (AN) is a brown to black, poorly defined velvety hyperpigmentation of the skin. It is a predisposition factor for Type 2 diabetes, malignancies and various endocrinopathies. The available data regarding AN from Kerala is limited. Our study aims to estimate the prevalence of AN and to examine its association with physical activity among the adolescents of age 13–14 years.

Methodology:
This analytical cross-sectional study was conducted in two grades of a school in Ernakulam district between June and December 2018 among 400 adolescents of age 13–14 years. The study proforma and the Physical activity questionnaire, Adolescents (PAQ-Adolescents), were self-administered to the students and the data were collected. The principal investigator verified the presence of AN by observation in the neck, elbow and knuckles and recorded in the study proforma. Statistical analysis of the data collected was done using SPSS Software program (version 21).

Results:
The mean age of the group was found to be 13.31 ± 0.46 years. The prevalence of AN was 14.5% in the study population. AN was most prevalent among obese adolescents (61.54%), adolescents with low exercise rate (23.94%), having family history of diabetes (21.18%), family history of hypertension (21.86%) and family history of both diabetes and hypertension (26.32%). The risk factors such as obesity, diabetes, hypertension, family history of diabetes, family history of hypertension and family history of both diabetes and hypertension had a positive association with AN had a negative association with physical activity with p=0.0001. In adolescents with increased exercise rate, there were no reported cases of AN.

Conclusion:
The results of our study show that there is a strong association between AN and children with obesity, family history of diabetes mellitus, hypertension and low physical activity. Regular adequate physical activity can prevent the onset of AN and thereby reduce the early onset of diabetes, metabolic syndrome, polycystic ovarian syndrome, coronary artery diseases and certain types of malignancies.
Echocardiography Study of Hypertrophic Cardiomyopathy Phenotypes
Authors: Tandon Rohit , Dutt Shivam , Bansal Namita , Singh Gurbhej , Singh Bhupinder , Goyal Abhishek , Chabbra Sheeba Takkar , Aslam Naved , Mohan Bishav , Wander Gurpreet Singh 
Published: December 2021

Background:
Hypertrophic cardiomyopathy (HCM) is a genetic disorder with a heterogeneous phenotype. Historically, only obstructive and nonobstructive forms have been described. Improvements in imaging techniques have led to elaborative description of various new phenotypes, although there are limited epidemiological data regarding these phenotypes from within our population.

Aims and Objectives:
•To identify HCM patients from a cohort of cardiomyopathy patients. •To describe their demographic profile and mode of presentation based on the presenting symptoms. •To subclassify the selected HCM population into various phenotypes based on echocardiography.

Results:
There were 233 patients of HCM in this study. The mean age of the patients was 53 ± 14.5 years with male preponderance (70%). Thirty-six percent patients were asymptomatic, 37% mildly symptomatic (in class I-II), and 27% severely symptomatic (in class III-IV). Patients were classified into six phenotypes consisting of five classically described phenotypes and one atypical phenotype. Reverse curvature phenotype was most prevalent (49%) and symptomatic phenotype with 19.3% having significant resting left ventricular outflow tract (LVOT) obstruction. Other phenotypes were 19% apical mid, 11% neutral, 6% sigmoid, and 4% atypical. Male: female ratio for reverse curvature phenotype was 3:1, apical (mid) phenotype 2.4:1, and both apical and neutral phenotypes 2:1. Sigmoid phenotype had female-to-male ratio of 2.5:1.

Conclusion:
HCM patients require phenotype specific approach for complete assessment. Transthoracic echocardiography with myocardial contrast plays a pivotal role in identifying morphological phenotypes, effects on cardiac remodeling and hemodynamics which consequently influence mode of presentation. Reverse curvature, apical mid, and sigmoid phenotypes are comparatively more symptomatic, have larger left atrial size and segment thickness compared to less symptomatic apical and neutral phenotypes. Symptom status of the patient seems to be dependent on age, septal contour, severity of LVOT obstruction, left atrial volume, and maximal segment thickness.
Comparison of channel sampling methods and brush heads in surveillance culture of endoscope reprocessing
Authors: Ji Xue-Yue , Ning Pei-Yong , Fei Chun-Nan , Song Jia , Dou Xue-Mei , Zhang Nan-Nan , Liu Jun , Liu He 
Published: December 2021

Background:
Endoscopy-related infections have caused multiple outbreaks. The importance of surveillance culture is gradually recognized, but sampling techniques are not consistent in many guidelines. It is unclear whether the Flush-Brush-Flush sampling method (FBFSM) is more sensitive than the conventional flush sampling method (CFSM) and whether different sampling brushes have different effects.

Methods:
The propensity score matching method was done with two matching ways, 1:1 nearest neighbor propensity score matching and full matching was used to analyze the surveillance culture data collected by FBFSM and CFSM. We fit a confounder-adjusted multiple generalized linear logistic regression model to estimate the marginal odds ratio (OR). A paired study was applied to compare the sampling effect of polyurethane foam (PU) head brush and polyamide (PA) head brush.

Result:
From 2016 to 2020, 316 reprocessed endoscope samples were collected from all 59 endoscopy centers in Tianjin. About 279 (88.3%) reprocessed endoscopes met the threshold of Chinese national standards (<20 CFU/Channel). The qualified rate of reprocessed endoscopes sampling by CFSM (91.8%) and FBFSM (81.6%) was statistically different (p < 0.05). The adjusted OR by full matching for FBFSM was 7.98 (95% confidence interval: 3.35-21.78). Forty one pairs of colonoscopes, after reprocessing from 27 centers, were tested by PA and PU brushes, and no difference was found in microbial recovery.

Conclusion:
FBFSM was confirmed to be a more sensitive sampling technique. PU and PA brushes had no significant difference in sampling effect.
Generalized torsion for knots with arbitrarily high genus
Authors: Motegi Kimihiko , Teragaito Masakazu 
Published: December 2021

AbstractLet G be a group, and let g be a nontrivial element in G. If some nonempty finite product of conjugates of g equals the identity, then g is called a generalized torsion element. We say that a knot K has generalized torsion if
$G(K) = \pi _1(S^3 - K)$
admits such an element. For a
$(2, 2q+1)$
-torus knot K, we demonstrate that there are infinitely many unknots
$c_n$
in
$S^3$
such that p-twisting K about
$c_n$
yields a twist family
$\{ K_{q, n, p}\}_{p \in \mathbb {Z}}$
in which
$K_{q, n, p}$
is a hyperbolic knot with generalized torsion whenever
$|p|> 3$
. This gives a new infinite class of hyperbolic knots having generalized torsion. In particular, each class contains knots with arbitrarily high genus. We also show that some twisted torus knots, including the
$(-2, 3, 7)$
-pretzel knot, have generalized torsion. Because generalized torsion is an obstruction for having bi-order, these knots have non-bi-orderable knot groups.
COVID-19 PANDEMİ SÜRECİNİN KÜRESEL EKONOMİK GÖSTERGELERİ VE TÜRKİYE’DE BANKACILIK VE FİNANS SEKTÖRÜNE ETKİLERİ
Authors: KÜÇÜKOĞLU Sami 
Published: December 2021

Çin’in Wuhan kentinde 2019 yılının sonunda başlayan Covid-19 salgını 2020 yılının mart ayında pandemi durumuna dönüşerek tüm dünyayı etkisi altına almıştır. Küresel boyutta yaşanan bu salgının 2020 yılında ve devamında tüm dünya ekonomilerinde daralmaya neden olacağı tahmin edilmektedir. Salgına karşı gelişmiş ve gelişmekte olan tüm ülkelerin merkez bankaları faiz oranlarında değişikliklere giderek piyasalara likidite desteği sağlamış ve kredi koşullarını desteklemeye yönelik genişleyici para ve maliye politikaları uygulamaya başlamışlardır. Bu bağlamda Türkiye’de TCMB tarafından 17 Mart 2020 tarihli Para Politikası Kurulu toplantısında politika faiz oranında indirime gidilmiş ve bu karara ek olarak, 17 Mart, 31 Mart ve 17 Nisan 2020 tarihlerinde Covid-19 salgının ekonomik ve finansal etkilerini sınırlamak amacıyla alınan tedbir paketleri duyurulmuştur. Bu çalışmada Covid-19 salgınının küresel ekonomik göstergeleri ve Türkiye’de bankacılık ve finans sektörü üzerine etkileri, kapsamlı bir alan yazın araştırması ile uzman kurumların raporları ve sektörel veriler kullanılarak analiz edilmiştir.
Amaç: Covid-19 pandemi sürecinde ortaya çıkan ekonomik koşulların küresel göstergeleri ile birlikte Türkiye’de bankacılık ve finans sektörüne olan etkilerini tespit etmektir.
Yöntem/Tasarım / Metodoloji / Yaklaşım: Alan yazın taraması eşliğinde bankacılık ve finans sektöründe faaliyet gösteren ulusal ve uluslararası uzman kuruluşlardan elde edilen nitel ve nicel sektörel verilerin Microsoft Office programlarında işlenerek çıktılarının kullanıldığı Covid-19 pandemi süreci içerisinde bir çalışmadır.
Bulgular: Tüm dünya ekonomilerinde ve ülkemizde ekonomik daralmaların yaşanacağı ve Türkiye’de daralma etkisini sınırlandırmak amacıyla merkez bankasının piyasalara likidite desteği sağladığı görülmüştür.
Özgünlük: Covid-19 pandemisi dünyadaki tüm ülke ekonomilerinin hazırlıksız yakalandıkları ve geçmişte yaşanan ekonomik krizlerden farklı olarak direkt insan sağlığına yönelik olması nedeniyle çok daha kapsamlı etkileri olan bir sağlık ve ekonomik krizdir. Salgının ve neden olduğu krizin etkileri çalışmanın yapıldığı dönem itibariyle devam etmekte olup ne kadar süreceği belirsizlik içermektedir. Dolayısıyla devam eden süreç içerisinde nihai sonuçları tespit etmek için salgının sona ermesini beklemek gereklidir. Bu çalışma salgının başladığı andan itibaren Türkiye’ de bankacılık ve finans sektöründe yarattığı etkiler ve sermaye piyasalarının buna karşı geliştirdiği tepkiler belirlenmiş, incelenmiş ve değerlendirilmiştir. Çalışma bu bakımdan ileride salgından kaynaklı oluşabilecek kriz dönemlerinde uygulanacak ekonomi politikaları için bir kaynak rehber ve arşiv olma amacını taşımaktadır.
Paul Lazarsfeld's Contributions to the History of Empirical Social Research
Authors: Jeřábek Hynek 
Published: December 2021

During the 1960s Paul F. Lazarsfeld, co-founder of the renowned Columbia school, worked to promote a useful new research methodology. This paper analyses these activities. In a series of papers, Lazarsfeld demonstrated that the roots of empirical research, the useful methodology he developed, lie in the work of early European scholars. Building on his belief that quantification does not need numbers, he showed that Hermann Conring, with his “classificatory statistics,” had predated Frédéric Le Play and his “ family budgets” and Adolphe Quételet and his “probability statistics” by almost two centuries. In another paper he highlighted the importance of Max Weber’s empirical studies on agrarian and industrial workers within the frame of his life work. His seminars at Columbia University with Robert K. Merton and at the Sorbonne with Raymond Boudon opened up transatlantic cooperation on empirical research between New York and Paris for decades to come.