bluuebunny/crossref_metadata_2025_split huggingface dataset:
Awareness of obstetric fistula and its associated factors among reproductive-age women in Ethiopia: a multilevel analysis of Ethiopian Demographic and Health Survey data: a cross-sectional study
Authors: Aleminew Wallelign , Mulat Bezawit , Shitu Kegnie 
Published: December 2021

ObjectiveThis study aimed to determine the magnitude and associated factors of obstetric fistula (OF) awareness among reproductive-age women in Ethiopia.MethodsThis community-based cross-sectional study was conducted among 15 683 reproductive-aged women in Ethiopia. Following the presentation of a case vignette, women’s OF awareness was measured by asking if they had ever heard of OF. A multilevel multivariable logistic regression analysis was employed. A 95% CI and p<0.05 were used to declare statistical significance.ResultThe magnitude of women’s awareness of OF was 38% (95% CI 0.37 to 0.39). Individual level variables including being in the age group of 20–25 (adjusted OR, AOR 1.17; 95% CI 1.02 to 1.35), 26–30 (AOR 1.50; 95% CI 1.27 to 1.76) and >30 (AOR 1.76; 95% CI 1.50 to 2.07), being Muslim (AOR 0.83; 95% CI 0.73 to 0.94), having primary (AOR 1.70; 95% CI 1.53 to 1.89), secondary (AOR 3.43; 95% CI 2.95 to 3.99) and tertiary education (AOR 5.88; 95% CI 4.66 to 7.42), history of pregnancy termination (AOR 1.31; 95% CI 1.13 to 1.51), media exposure (AOR 1.33; 95% CI 1.2 to 1.49), internet use (AOR 2.25; 95% CI 1.84 to 2.75), medium (AOR 1.17; 95% CI 1.02 to 1.34) and rich house hold wealth (AOR 1.50; 95% CI 1.31 to 1.72) and community level factors including high community media exposure (AOR 1.30; 95% CI 1.05 to 1.61), high community antenatal care rate (AOR 1.66; 95% CI 1.37 to 2.02) and low health facility distance problem (AOR 1.49; 95% CI 1.23 to 1.81) were significantly associated with women’s awareness of OF.Conclusions and recommendationsThe magnitude of women’s awareness of OF was very low in Ethiopia. Awareness of OF was influenced by sociodemographic, economic, obstetric and community-related factors. Thus, tailored public health education is required at the national level to enhance women’s awareness of OF.
Preferences for healthcare services among hypertension patients in China: a discrete choice experiment
Authors: Yu Xiaolan , Bao Haini , Shi Jianwei , Yuan Xiaoyu , Qian Liangliang , Feng Zhe , Geng Jinsong 
Published: December 2021

ObjectivesOur study aimed to support evidence-informed policy-making on patient-centred care by investigating preferences for healthcare services among hypertension patients.DesignWe identified six attributes of healthcare services for a discrete choice experiment (DCE), and applied Bayesian-efficient design with blocking techniques to generate choice sets. After conducting the DCE, we used a mixed logit regression model to investigate patients’ preferences for each attribute and analysed the heterogeneities in preferences. Estimates of willingness to pay were derived from regression coefficients.SettingThe DCE was conducted in Jiangsu province and Shanghai municipality in China.ParticipantsPatients aged 18 years or older with a history of hypertension for at least 2 years and who took medications regularly were recruited.ResultsPatients highly valued healthcare services that produced good treatment effects (β=4.502, p<0.001), followed by travel time to healthcare facilities within 1 hour (β=1.285, p<0.001), and the effective physician–patient communication (β=0.771, p<0.001). Continuity of care and minimal waiting time were also positive predictors (p<0.001). However, the out-of-pocket cost was a negative predictor of patients’ choice (β=−0.168, p<0.001). Older adults, patients with good health-related quality of life, had comorbidities, and who were likely to visit secondary and tertiary hospitals cared more about favourable effects (p<0.05). Patients were willing to pay ¥2489 (95% CI ¥2013 to ¥2965) as long as the clinical benefits gained were substantial.ConclusionsOur findings highlight the importance of effective, convenient, efficient, coordinated and patient-centred care for chronic diseases like hypertension. Policy-makers and healthcare providers are suggested to work on aligning the service provision with patients’ preferences.
Estimating the economic impacts of percutaneous coronary intervention in Australia: a registry-based cost burden study
Authors: Lee Peter , Brennan Angela L , Stub Dion , Dinh Diem T , Lefkovits Jeffrey , Reid Christopher M , Zomer Ella , Liew Danny 
Published: December 2021

ObjectivesIn this study, we sought to evaluate the costs of percutaneous coronary intervention (PCI) across a variety of indications in Victoria, Australia, using a direct per-person approach, as well as to identify key cost drivers.DesignA cost-burden study of PCI in Victoria was conducted from the Australian healthcare system perspective.SettingA linked dataset of patients admitted to public hospitals for PCI in Victoria was drawn from the Victorian Cardiac Outcomes Registry (VCOR) and the Victorian Admitted Episodes Dataset. Generalised linear regression modelling was used to evaluate key cost drivers. From 2014 to 2017, 20 345 consecutive PCIs undertaken in Victorian public hospitals were captured in VCOR.Primary outcome measuresDirect healthcare costs attributed to PCI, estimated using a casemix funding method.ResultsKey cost drivers identified in the cost model included procedural complexity, patient length of stay and vascular access site. Although the total procedural cost increased from $A55 569 740 in 2014 to $A72 179 656 in 2017, mean procedural costs remained stable over time ($A12 521 in 2014 to $A12 185 in 2017) after adjustment for confounding factors. Mean procedural costs were also stable across patient indications for PCI ($A9872 for unstable angina to $A15 930 for ST-elevation myocardial infarction) after adjustment for confounding factors.ConclusionsThe overall cost burden attributed to PCIs in Victoria is rising over time. However, despite increasing procedural complexity, mean procedural costs remained stable over time which may be, in part, attributed to changes in clinical practice.
Retrospective case–control study to evaluate hypocalcaemia as a distinguishing feature of COVID-19 compared with other infective pneumonias and its association with disease severity
Authors: Mehta Meera , Ghani Hakim , Chua Felix , Draper Adrian , Calmonson Sam , Prabhakar Meghna , Shah Rijul , Navarra Alessio , Vaghela Tejal , Barlow Andrew , Vancheeswaran Rama 
Published: December 2021

ObjectivesTo investigate whether calcium derangement was a specific feature of COVID-19 that distinguishes it from other infective pneumonias, and its association with disease severity.DesignA retrospective observational case–control study looking at serum calcium on adult patients with COVID-19, and community-acquired pneumonia (CAP) or viral pneumonia (VP).SettingA district general hospital on the outskirts of London, UK.Participants506 patients with COVID-19, 95 patients with CAP and 152 patients with VP.Outcome measuresBaseline characteristics including hypocalcaemia in patients with COVID-19, CAP and VP were detailed. For patients with COVID-19, the impact of an abnormally low calcium level on the maximum level of hospital care, as a surrogate of COVID-19 severity, was evaluated. The primary outcome of maximal level of care was based on the WHO Clinical Progression Scale for COVID-19.ResultsHypocalcaemia was a specific and common clinical finding in patients with COVID-19 that distinguished it from other respiratory infections. Calcium levels were significantly lower in those with severe disease. Ordinal regression of risk estimates for categorised care levels showed that baseline hypocalcaemia was incrementally associated with OR of 2.33 (95% CI 1.5 to 3.61) for higher level of care, superior to other variables that have previously been shown to predict worse COVID-19 outcome. Serial calcium levels showed improvement by days 7–9 of admission, only in survivors of COVID-19.ConclusionHypocalcaemia is specific to COVID-19 and may help distinguish it from other infective pneumonias. Hypocalcaemia may independently predict severe disease and warrants detailed prognostic investigation. The fact that decreased serum calcium is observed at the time of clinical presentation in COVID-19, but not other infective pneumonias, suggests that its early derangement is pathophysiological and may influence the deleterious evolution of this disease.Trial registration number20/HRA/2344.
Exploring healthcare providers’ perceptions of mental health amid COVID-19 pandemic in obstetrics and gynaecology department of a tertiary care public sector hospital of Karachi, Pakistan: an exploratory qualitative study protocol
Authors: Yasmin Haleema , Sadia Afreen , Qamar Areesha , Shahil Feroz Anam 
Published: December 2021

IntroductionIn the wake of the unprecedented public health challenge of the COVID-19 pandemic, it is highly significant to recognise the mental health impact of this mounting threat on healthcare providers (HCPs) working in the obstetrics and gynaecology department. Experience from epidemics and emerging literature around COVID-19 show that the unparalleled amount of stress that HCPs are dealing with is linked with the increased burden of mental health conditions. We aim to conduct an exploratory qualitative descriptive study to assess HCPs’ perceptions of mental health amid the COVID-19 pandemic in the obstetrics and gynaecology department of a public sector tertiary care hospital of Karachi, Pakistan.Methods and analysisThis study will use a qualitative descriptive approach where approximately 20–25 HCPs from the obstetrics and gynaecology department will be recruited using a purposive sampling approach. Data will be collected through semistructured interviews and it will be analysed thematically using NVivo V.12 Plus software.Ethics and disseminationEthical approval for this study has been obtained from the Institutional Review Board Committee of Jinnah Postgraduate Medical Center hospital. The study results will be disseminated to the scientific community and the HCPs participating in the study. The findings will help us to explore the doctor’s perceptions of mental health during the current pandemic of COVID-19 and its impact on their daily lives and mental well-being.
Technology-based counselling in dementia (TeCoDem): study protocol of a mixed-methods systematic review with qualitative comparative analysis and meta-analysis
Authors: Hirt Julian , Langer Gero , Wilde Fabian , Bauernschmidt Dorothee , Meyer Gabriele , Bieber Anja 
Published: December 2021

IntroductionInformation technology can enhance timely and individual support for people with dementia and informal carers. There is some evidence that people with dementia and informal carers would benefit from technology-based counselling. However, it remains unclear which features of those interventions relate to beneficial outcomes and which aspects are necessary for a successful implementation. Therefore, the primary objectives are: (1) to identify conditions of successful implementation of technology-based counselling interventions in dementia and (2) to investigate the effectiveness of those interventions.Methods and analysisWe will conduct a mixed-methods systematic review. The first primary objective requires evidence from various study designs addressing aspects on effective and non-effective implementation of technology-based counselling. This could be telephone-based, web-based or mobile-based interventions for people with dementia and informal carers. For the second primary objective, randomised controlled trials (RCTs) dealing with any outcomes will be included. Year of publication and language will not be restricted. We will search CINAHL, Cochrane Library, MEDLINE, PsycINFO and Web of Science up to April 2021. Additionally, we will perform web searching and citation tracking. To achieve the first primary objective, a Qualitative Comparative Analysis (QCA) will be conducted. The QCA enables us to identify necessary or sufficient components for a successful implementation. To reach the second primary objective, a meta-analysis will be performed with respect to potential clinical and statistical heterogeneity of RCTs. The revised Risk of Bias tool 2.0 will be used to check the risk of bias in RCTs. For all other study designs, the Mixed Method Appraisal Tool will be used.Ethics and disseminationEthics approval is not required for this review. We will disseminate our findings through scientific and non-scientific journal articles and conference presentations as well as formats directed to the public and decision-makers in healthcare.PROSPERO registration numberCRD42021245473.
Study on Risk Factors for Death from Cardiomyopathy and Effectiveness of Health Information Management
Authors: Wang Lei , Zhang Shuping , Wang Yan , Xuan Jin , Han Yanli , Ke Jianlin 
Published: December 2021

Objective. To explore risk factors for death from cardiomyopathy and the effectiveness of health information management (HIM). Methods. A total of 80 patients with cardiomyopathy admitted in ICU of our hospital (January 2016–January 2020) were selected as study subjects, and the clinical data of the patients were retrospectively analyzed. The patients were divided into the survival group (n = 72) and the death group (n = 14) according to the treatment outcome. Then, according to the management mode, the survival group was further equally divided into the conventional group and the HIM group to investigate the influence of risk factors on prognosis of patients with cardiomyopathy and the effectiveness of HIM. Results. No significant difference was found in baseline body mass, myocardial enzymes, troponin, infection factors, history of heart disease, and gender between the survival group and the death group (

P

> 0.05). Compared with the survival group, the patients of the death group were older (

P

< 0.05), LVEF of the death group was obviously lower (

P

< 0.05), and the scores of APACHE II and SOFA of the death group were obviously higher (

P

< 0.05). Further logistic regression analysis of the univariate factors influencing the risk of death from cardiomyopathy led to the conclusion that LVEF was an independent risk factor for death in patients with cardiomyopathy. LVEF below 24.69% examined by echocardiography had a high predictive value, with a sensitivity of 98.6% and a specificity of 78.6%. No obvious difference was found in general data between the conventional group and the HIM group (

P

> 0.05). Compared with the conventional group, the disease remission rate, complication rate, awareness rate of health knowledge, ICU length of stay, and scores of self-management efficacy of the HIM group were obviously better (

P

< 0.05). No significant difference was found in 5-year mean survival rate between the conventional group and the HIM group (

P

> 0.05). Conclusion. Older age, lower LVEF, and higher scores of APACHE II and SOFA are all risk factors for death from cardiomyopathy. Lower LVEF is an independent risk factor, and LVEF below 24.69% is an important indicator of increased risk of death. Moreover, HIM can effectively improve short-term treatment efficacy but has little effect on the long-term survival rate.
Comprehensive Genomic Profiling of Neuroendocrine Carcinomas of the Gastrointestinal System
Authors: Yachida Shinichi , Totoki Yasushi , Noë Michaël , Nakatani Yoichiro , Horie Masafumi , Kawasaki Kenta , Nakamura Hiromi , Saito-Adachi Mihoko , Suzuki Masami , Takai Erina , Hama Natsuko , Higuchi Ryota , Hirono Seiko , Shiba Satoshi , Kato Mamoru , Furukawa Eisaku , Arai Yasuhito , Rokutan Hirofumi , Hashimoto Taiki , Mitsunaga Shuichi , Kanda Mitsuro , Tanaka Hidenori , Takata So , Shimomura Ayaka , Oshima Minoru , Hackeng Wenzel M. , Okumura Tomoyuki , Okano Keiichi , Yamamoto Masakazu , Yamaue Hiroki , Morizane Chigusa , Arihiro Koji , Furukawa Toru , Sato Toshiro , Kiyono Tohru , Brosens Lodewijk A.A. , Wood Laura D. , Hruban Ralph H. , Shibata Tatsuhiro 
Published: December 2021

AbstractThe neuroendocrine carcinoma of the gastrointestinal system (GIS-NEC) is a rare but highly malignant neoplasm. We analyzed 115 cases using whole-genome/exome sequencing, transcriptome sequencing, DNA methylation assays, and/or ATAC-seq and found GIS-NECs to be genetically distinct from neuroendocrine tumors (GIS-NET) in the same location. Clear genomic differences were also evident between pancreatic NECs (Panc-NEC) and nonpancreatic GIS-NECs (Nonpanc-NEC). Panc-NECs could be classified into two subgroups (i.e., “ductal-type” and “acinar-type”) based on genomic features. Alterations in TP53 and RB1 proved common in GIS-NECs, and most Nonpanc-NECs with intact RB1 demonstrated mutually exclusive amplification of CCNE1 or MYC. Alterations of the Notch gene family were characteristic of Nonpanc-NECs. Transcription factors for neuroendocrine differentiation, especially the SOX2 gene, appeared overexpressed in most GIS-NECs due to hypermethylation of the promoter region. This first comprehensive study of genomic alterations in GIS-NECs uncovered several key biological processes underlying genesis of this very lethal form of cancer.Significance:GIS-NECs are genetically distinct from GIS-NETs. GIS-NECs arising in different organs show similar histopathologic features and share some genomic features, but considerable differences exist between Panc-NECs and Nonpanc-NECs. In addition, Panc-NECs could be classified into two subgroups (i.e., “ductal-type” and “acinar-type”) based on genomic and epigenomic features.This article is highlighted in the In This Issue feature, p. 587
In-Hospital Outcomes of Urgent, Early, or Late Revascularization for Symptomatic Carotid Artery Stenosis
Authors: Cui Christina L. , Dakour-Aridi Hanaa , Lu Jinny J. , Yei Kevin S. , Schermerhorn Marc L. , Malas Mahmoud B. 
Published: December 2021

Background and Purpose:
Advancements in carotid revascularization have produced promising outcomes in patients with symptomatic carotid artery stenosis. However, the optimal timing of revascularization procedures after symptomatic presentation remains unclear. The purpose of this study is to compare in-hospital outcomes of transcarotid artery revascularization (TCAR), transfemoral carotid stenting (TFCAS), or carotid endarterectomy (CEA) performed within different time intervals after most recent symptoms.

Methods:
This is a retrospective cohort study of United States patients in the vascular quality initiative. All carotid revascularizations performed for symptomatic carotid artery stenosis between September 2016 and November 2019 were included. Procedures were categorized as urgent (0–2 days after most recent symptom), early (3–14 days), or late (15–180 days). The primary outcome of interest was in-hospital stroke and death. Secondary outcomes include in-hospital stroke, death, and transient ischemic attacks. Multivariable logistic regression was used to compare outcomes.

Results:

A total of 18 643 revascularizations were included: 2006 (10.8%) urgent, 7423 (39.8%) early, and 9214 (49.42%) late. Patients with TFCAS had the highest rates of stroke/death at all timing cohorts (urgent: 4.0% CEA, 6.9% TFCAS, 6.5% TCAR,
P
=0.018; early: 2.5% CEA, 3.8% TFCAS, 2.9% TCAR,
P
=0.054; late: 1.6% CEA, 2.8% TFCAS, 2.3% TCAR,
P
=0.003). TFCAS also had increased odds of in-hospital stroke/death compared with CEA in all 3 groups (urgent adjusted odds ratio [aOR], 1.7 [95% CI, 1.0–2.9]
P
=0.03; early aOR, 1.6 [95% CI, 1.1–2.4]
P
=0.01; and late aOR, 1.9 [95% CI, 1.2–3.0]
P
=0.01). TCAR and CEA had comparable odds of in-hospital stroke/death in all 3 groups (urgent aOR, 1.9 [95% CI, 0.9–4],
P
=0.10), (early aOR, 1.1 [95% CI, 0.7–1.7],
P
=0.66), (late aOR, 1.5 [95% CI, 0.9–2.3],
P
=0.08).

Conclusions:
CEA remains the safest method of revascularization within the urgent period. Among revascularization performed outside of the 48 hours, TCAR and CEA have comparable outcomes.
Further Reforming a Reformed Theology of Law
Authors: VanDrunen David 
Published: December 2021

Abstract
Early Reformed theology of law was very similar to Thomas Aquinas’s, although it also dissented from aspects of his work. This early Reformed thinking about law came to influential expression in the Marrow of Modern Divinity. The Marrow’s theology of law focused on concerns of Reformed soteriology while continuing to resemble much of Thomas’s scheme. This revised Reformed approach was generally helpful, yet did not give enough attention to the movement of redemptive history. Therefore, this article proposes a theology of law that incorporates earlier Reformed developments but also seeks to reform them further by taking redemptive-historical considerations into fuller account.
Barth on Divine Simplicity and the Attributes of God: A Theological Agenda for Christian/Muslim Dialogue
Authors: Pickard Stephen 
Published: December 2021

Abstract
This article examines the theological concepts of divine simplicity and the attributes of God. The purpose of this inquiry is to explore the significance of these themes for Christian/Muslim dialogue. In this sense the article is an overture to a public theology undertaken through aspects of the doctrine of God foundational for Christians and Muslims. An introduction identifies the somewhat marginal significance of theological dialogue in Christian-Muslim encounter. In doing so it considers what contribution Karl Barth might have to make to Christian-Muslim reflections on the doctrine of God. The main focus of the article examines Barth’s treatment of divine simplicity and the attributes of God. In this respect the article highlights the importance of Barth’s ethical transposition of the doctrine of divine simplicity and its implications for inter-religious engagements in the world. The article argues for a public theology which takes more seriously the relationship between theory and practice in inter-religious dialogue.
Hybrid Organization in the Church: Hybrid Church as a Strategy for Public Engagement
Authors: Wilson Richard 
Published: December 2021

Abstract
Hybrid churches adopt some local business practices and identities in order to create a place and role in secular public space for a public engagement.1 They use hospitality and embassy to challenge the basis of public engagement, discourse, objectives and goals. Hybrid organization alongside hospitality and embassy enables the creation of alternative public spaces in which engagement and discourse may take place according to an alternative communicative base to conventional public discourse, intentionally to critique secular conventions of public presence and discourse.
Repurposing Romantic Drama in Late-Nineteenth-Century Egypt: Najīb al-Ḥaddād’s Arabizations of Victor Hugo
Authors: Ziter Edward 
Published: December 2021

Abstract
At the end of the nineteenth century, Najīb al-Ḥaddād adapted two dramas by Victor Hugo for The Egyptian Patriotic Troupe. Al-Ḥaddād rewrote Hugo’s Hernani as Ḥamdān, transferring the story from the Spanish court of 1519 to Andalucía under ‘Abd al-Raḥmān II. Les Burgraves became Tha’rāt al-‘arab (Revenge of the Arabs), and transformed from a play about Barbarossa and the Holy Roman Empire into a play about a pre-Islamic Lakhmid king’s struggle to restore unified Arab rule in the Arabian peninsula. I argue that Al-Ḥaddād’s adaptations anachronistically placed modern ideas in the Arab past—characterizing shūrā as the election of leaders, using sha‘b to mean a sovereign people, and calling for Arab cultural unity and revival. Al-Ḥaddād’s adaptations transformed the nationalism of Hugo’s drama into calls for Arab solidarity. In producing these plays, The Egyptian Patriotic Troupe embodied an Arab past overlaid with modern communal identities.