bluuebunny/crossref_metadata_2025_split huggingface dataset:
Informal Credits in India’s Agriculture Sector: Debt Incidence, Size and Distribution across Major Farm-size Groups
Authors: Basumatary Rupon , Kalita Simi , Bharadwaj Himakshi 
Published: October 2024

Until recently, studies on agricultural finance in India mostly focus on farmers’ access to formal credits, thereby largely sidelining their informal borrowings. This study makes an effort to present an analysis of farmers’ informal debts and their distribution across the major farm-size groups in India. The study uses unit-level data from the 77th round ‘Situation Assessment Survey (SAS)’ of agricultural households conducted by the National Statistical Office (NSO), Ministry of Statistics and Programme Implementation (MOSPI), Government of India (GOI), during January–December, 2019. Data were collected for the reference period of July 2018–June 2019. We use descriptive statistics and multivariate regression procedures for analysis. Results show that about one-half of the borrowers continue to depend on informal credit sources—partially or fully. Informal sources also account for about one-third of the total debt of the agricultural households. Informal debt incidence (IDI) and informal debt share (IDS) are found to be higher among the smallholders. Our findings are imperative of policy measures to improve the current state of the antecedents of formal credit access to benefit the otherwise high default risk and credit-rationed smallholders. Future studies may focus on formal credit rationing, informal credit terms and repayment burden of the agricultural households in India.
Intrathecal immune reactivity against Measles-, Rubella-, and Varicella Zoster viruses is associated with cerebrospinal fluid inflammation in multiple sclerosis
Authors: Vlad Benjamin , Neidhart Stephan , Hilty Marc , Asplund Högelin Klara , Reichen Ina , Ziegler Mario , Khademi Mohsen , Lutterotti Andreas , Regeniter Axel , Martin Roland , Al Nimer Faiez , Jelcic Ilijas 
Published: October 2024

Background/Objectives: We aimed to determine in multiple sclerosis (MS) whether intrathecal immunoglobulin G (IgG) production against measles- (M), rubella- (R), and varicella zoster (Z) viruses, which is called MRZ reaction (MRZR) and considered the most specific soluble biomarker for MS, is associated with demographic and basic cerebrospinal fluid (CSF) parameters reflecting inflammation. Methods: We analyzed the presence of positive MRZR and associations with demographic and clinical routine CSF parameters in 513 patients with MS and 182 non-MS patients. Results: Comparing MS patients versus non-MS patients, positive MRZR (38.8% versus 2.2%; specificity 97.8%; positive likelihood ratio, PLR 17.7) had a better specificity and PLR for MS than CSF-specific OCB (89.5% versus 22.0%; specificity 78.0%; PLR 4.1). A positive MRZR in MS patients was associated with female sex ( p = 0.0001), pleocytosis ( p < 0.0001), higher frequency of presence of plasma cells in CSF ( p = 0.0248), normal CSF/serum albumin ratio ( p = 0.0005), and intrathecal production of total IgG or CSF-specific OCB (both p < 0.0001), but not with intrathecal production of total IgA or IgM. Conclusions: This study confirms the MRZR as a highly specific marker of MS and shows that MRZR-positive MS patients more frequently are female and show inflammatory changes of basic CSF parameters than MRZR-negative MS patients.
Long-term modifications of the peripheral immune repertoire after switching from sequestering disease-modifying treatments in multiple sclerosis
Authors: Vercellino Marco , Marasciulo Stella , Ricotti Emanuela , Rolando Anna , Bosa Chiara , Garelli Paola , Gallina Virginia , Vaula Giovanna , Calvo Andrea , Cavalla Paola 
Published: October 2024

Background: Scarce data are available on the long-term immunological effects of multiple sclerosis (MS) disease-modifying treatments (DMTs). Objectives: This study aimed to investigate the long-term modifications of the peripheral immune repertoire on interruption of a sequestering DMT (natalizumab, fingolimod) and switch to another high-efficacy DMT. Methods: Lymphocyte subpopulations were assessed, every 6 months up to 48 months, in patients switched from fingolimod or natalizumab to ocrelizumab, and in patients switched from fingolimod to natalizumab, compared to patients switched to ocrelizumab or natalizumab from a moderate-efficacy DMT and to naive patients. Results: We included 389 MS patients (200 ocrelizumab and 189 natalizumab). After adjusting for baseline variables, patients switched from fingolimod to ocrelizumab showed lower CD3 + and CD4 + lymphocytes up to 48 months after switch (with lower percentage of naive CD4 +), and increased odds of total, CD3+, CD4+ lymphopenia. Patients switched from natalizumab to ocrelizumab showed higher CD3 + lymphocytes up to 36 months after switch, and higher CD4+, CD8+ lymphocytes up to 24 months. The frequency of infections was not influenced by previous treatment. Conclusions: A long-term persistence of the residual effects of the exposure to sequestering DMTs (fingolimod and less natalizumab) on the peripheral immune repertoire was observed after switching to another high-efficacy DMT.
Voice pitch and gender in autism
Authors: Kissine Mikhail , Clin Elise 
Published: October 2024

Autistic adults are often perceived as having an atypical speech. The acoustic characteristics of these impressions prove surprisingly difficult to delineate, but one feature that does robustly emerge across different studies is higher pitch (F0 values) in autistic versus neurotypical individuals. However, there is no clear explanation why autistic individuals should have higher-pitched voices. We propose that the solution lies in the gender imbalance still prevalent in autism, which entails an overrepresentation of male participants in research on speech in autism. We analyse speech samples from a gender-balanced group of 40 autistic and 40 neurotypical adults, controlling for potential stress levels through electrodermal activity recordings. We find that autistic males tend to have higher pitch than neurotypical males, but that autistic females tend to have lower pitch than neurotypical females. The interpretation we put forth for our finding – that the autistic versus neurotypical group difference in pitch goes in opposite directions between males and females – is that autistic individuals tend to be less influenced by neurotypical gender stereotypes. Lay abstract It is has often been observed that autistic individuals have higher-pitched voices than non-autistic ones, but no clear explanation for this difference has been put forth. However, autistic males are still dramatically over-represented in published research, including the acoustic studies that report higher pitch in autistic participants. In this study, we collected speech samples from a group of autistic and neurotypical adults that, unlike in most studies, was perfectly balanced between groups and genders. In this gender-balanced sample, pitch was significantly higher in autistic versus neurotypical men, but lower in autistic versus neurotypical women. Overall, women tend to have higher-pitched voices than men, but the magnitude of this difference is culture dependent and may be significantly influenced by the internalisation of normative expectations towards one’s gender. We propose that higher pitch in autistic males and lower pitch in autistic females could be due, at least in part, to a lesser integration of sociolinguistic markers of gender. Our report shows that speech atypicality should not be operationalised in terms of systematic and unidirectional deviation from the neurotypical baseline.
Rural service coordination programming for women using substances and their families
Authors: Cottrell Lesley , Workman Charlotte , Danko Melina , Walker Ellis , Dmytrijuk Anthony , Harrison Susan , Lee Mikisha , McKinsey Ashleigh , Smith Mark C 
Published: October 2024

Background: Women experiencing substance use during their pregnancies or after the birth of a child report being fearful of losing their children based on care, stigmatized when seeking assistance, and barriers to care such as having to provide the same information to different providers, and having to repeat their lived experiences with substance use in detail. Particularly these service barriers can be confusing, complicated, and difficult to follow, which could lead to non-compliance or not seeking services. Objectives: We evaluated components of a service coordination program for women experiencing substance use, their children, and larger families who help with caregiving. We examined stakeholder interest in the program, feasibility providing services over time, and initial program effectiveness. Design: Participant enrollment and outcomes as well as service coordination activities provided over a 4-year period was gathered across three demonstration site locations (a birthing hospital, reunification program, and home visiting program). Methods: Program information was gathered from needs assessment data, health survey data from enrolled caregivers and infants, training evaluations, and budget recordings of direct aid. In this mixed method design, we examined potential differences between baseline and the last assessment for women and children enrolled in the program. We also utilized univariate analyses of variance to examine the main effects of maternal and infant characteristics on final maternal and infant outcomes. Results: Three sites enrolled 182 women and families for program services. Patient navigators provided direct aid, training, goal setting, and service coordination and planning. Families remained in the program, on average, 655 days and were satisfied with the services received. Respondents thought the program elements were easy to implement within the rural setting. The program effectively addressed basic needs, violence ( p < 0.001; η2 = 0.34 (0.05–0.53)), infant development ( p < 0.02; η2 = 0.51 (0.13–0.61)), and maternal depression ( p < 0.05; η2 = 0.9 (0.00–0.22)). Select outcomes did differ by site. Conclusion: A service coordination model utilizing a patient navigator role to coordinate client services coupled with an approach that serves the infant and caregiver needs was feasible and desirable by all stakeholders within a rural setting. Service coordination effectively impacted select caregiver and infant outcomes.
Pickleball and the Rising Incidence of Achilles Tendon Injuries in the Elderly
Authors: McCahon Joseph A. S. , Miller Mark , Riebesell Samantha , Pedowitz David I. , Parekh Selene G. , Daniel Joseph N. 
Published: October 2024

Background With its rising popularity of pickleball, particularly in the aging population, comes concern for potential injuries that previously rarely affected this patient cohort. The purpose of this study was to investigate the trends of pickleball-related Achilles tendon injuries. Methods A retrospective case series was performed to determine the trends associated with pickleball-related Achilles tendon injuries over the last 10 years. A database search of all Achilles tendon ruptures (ICD-10 S86.0) presenting to a large, multistate, subspecialty referral orthopaedic clinic between January 2013 and June 2023 were identified and included in the study. Pickleball-related injuries were identified via query and confirmed with manual chart review. The incidence of pickleball-related injuries, as well as patient demographics and rate of surgery was determined and compared with the total population during that time period. Results A total of 2684 patients who suffered an Achilles tendon injury between January 2013 and June 2023 were identified, with 43 patients meeting the inclusion criteria for pickleball-related Achilles tendon ruptures. The number and overall incidence of pickleball-related Achilles tendon injuries has been increasing since 2016, excluding 2020 where there was a large decrease likely due to the COVID-19 epidemic. Pickleball was associated with older age at time of injury (64.5 vs 48.6, P < .001) as well as a lower BMI (26.6 vs 29.4, P < .001). In addition, patients who sustained a pickleball-related Achilles tendon injury were more likely to undergo surgery (67.4% vs 45.4%, P = .008). Conclusion The rising popularity of pickleball and its associated injuries poses a significant risk to the aging population, with Achilles tendon injuries occurring in older individuals and resulting in a higher likelihood of undergoing surgery. Level of Evidence: IV; retrospective case-series
Are Mopani Worms a Mechanism for Mopane Tree (Colophospermum mopane) Conservation? An Evaluation of the Villages Around Giyani, Limpopo Province, South Africa
Authors: Sinthumule Ndidzulafhi Innocent 
Published: October 2024

Background and Background Aims Colophospermum mopane provides many benefits including mopani worms, firewood, timber for construction, and medicine. Despite C. mopane playing a significant role in the lives and livelihoods of communities within their range, they are destroyed because of unsustainable harvesting practices coupled with lack of management practices. Assessment of people’s attitudes has become significant in studies dealing with the conservation of biodiversity. This study aims to assess the attitudes of local communities in and surrounding Giyani in Limpopo Province in South Africa towards the mopane tree and to determine if their attitudes relate to obedience to traditional rules and regulations. Methods Interview-administered questionnaires were used to systematically select 161 households in Muyexe village and 82 households in Nsavulani village. The questionnaire evaluated the biographical data of respondents, knowledge of mopane woodlands, importance of mopane trees and mopani worms, and their attitudes towards mopane tree conservation. Results The overwhelming majority of respondents in both villages had positive attitudes towards mopane trees for ethical reasons. Respondents were also positive that mopane trees should be protected for future generations. The positive attitude of most respondents relates to obedience to rules and regulations that do not allow cutting of wet C. mopane. Respondents only cut dead or dry mopane woodlands for fuelwood. Cutting or harvesting was done on a subsistence and sustainable basis. Conclusion The communities have shown that they are guardians of C. mopane. The study concluded that mopani worms serve a mechanism for C. mopane conservation in Muyexe and Nsavulani villages in South Africa. Implications for conservation The positive attitudes of local communities, and obedience to the customary rules and regulations is a positive sign not only for ethical reasons, but also for long-term mopane woodlands conservation. This approach encourages the long sustainability of mopane woodlands in the study area.
Physical Therapy for Knee Pain Relief Induces Changes in Gut Microbiome Composition: A Secondary Analysis of Data From a Randomized Controlled Trial
Authors: Kouraki Afroditi , Vijay Amrita , Gohir Sameer , Millar Bonnie , Kelly Anthony , Valdes Ana M 
Published: October 2024

Background: Aerobic exercise alters gut microbiome composition, yet the impact of gentle physiotherapy on gut microbiome and its relation to muscle strengthening and physical function remains unexplored. Hypothesis: Physiotherapy exercises modulate gut microbiome composition and changes in gut microbes are linked to improvements in muscle strength or function. Study Design: Secondary data analysis of samples from a randomized controlled trial. Level of Evidence: Level 2b. Methods: Data from a 6-week randomized controlled trial of physiotherapy for knee pain were analyzed. Gut microbiota profiling utilized 16S sequencing. We compared intervention and control (usual care) groups using microbial diversity metrics. Amplicon sequence variants (ASVs) that changed after the program were identified with ALDEX2, and correlations between these ASVs and measures of physical function, muscle strength, and interleukin-6 (IL-6) were explored. Results: No diversity changes were observed between standard care (n = 43) and physiotherapy (n = 34). Physiotherapy led to significant increases in Alistipes, Bacteroides, Clostridium sensu stricto 1, and Faecalibacterium ASVs. Of these, Clostridium sensu stricto 1 and Faecalibacterium were associated with postintervention muscle strength. Increase in Faecalibacterium was correlated with a decrease in IL-6 in the physiotherapy group. Conclusion: Physiotherapy had modest effects on gut microbiome composition affecting 4 taxa. Increases in muscle strength were correlated with increases in 2 taxa including Faecalibacterium. Faecalibacterium was also linked to reduced inflammation. Improved walking speed was linked to an increase in Alistipes with no differences found for strength or squatting ability. Clinical Relevance: Improved gut microbiome composition is linked to better overall health outcomes, including enhanced immune function, reduced inflammation, and improved metabolic health. This is particularly relevant for patients with osteoarthritis, who are known to have a high prevalence of cardiometabolic comorbidities. Integrating physiotherapy protocols that positively influence the gut microbiome can thus enhance overall patient outcomes.
Does More Invasive Surgery Result in Higher Patient Satisfaction? A Long-Term Follow-Up of 136 Zygomaticomaxillary Complex Fractures
Authors: Rahbin Samin , Sunnergren Ola , McBride Ellen , Darabi Hatef , Alinasab Babak 
Published: October 2024

Study Design Retrospective with follow-up. Objective To evaluate the long-term satisfaction of surgically treated patients with zygomaticomaxillary complex (ZMC) fractures in relation to the use of internal fixation, number of fixation points, and orbital floor (OF) reconstruction. Secondary objectives were to describe the use of antibiotics and post-operative infections. Methods Patients with unilateral ZMC fractures between 2007-2018 and treatment with either open reduction and internal fixation (ORIF) or closed reduction (CR) were identified from medical records and invited to follow-ups between 2018-2020. Patients were examined, photographed, and completed a questionnaire. A review panel of 3 experienced surgeons evaluated photographs and computed tomography (CT) scans pre- and post-surgery. Results The study sample consisted of 136 patients (108 ORIF, 28 CR) with a median follow-up time of 76 months. Patient satisfaction of surgical outcome was high (97.8%), with no significant differences in relation to the use of internal fixation, number of fixation points, or OF reconstruction. Dissatisfaction was primarily related to hypoesthesia. On post-operative CT scans, malar asymmetry was more often predicted in patients with 1-point fixations. On questionnaires and photographs, malar asymmetry was more common in patients with 3-point fixations. Prophylactic antibiotics had no effect on the rate of post-operative infections. Conclusions Patient satisfaction was not influenced by internal fixation, number of fixation points, or OF reconstruction. Selected ZMC fractures can be treated with less invasive approaches. Caution should be observed when predicting long-term malar asymmetry on post-operative CT scans. The findings of this study highlight the importance of a rational and ethical use of surgery.
Exploring the community pharmacist’s knowledge, attitude, and practices regarding adverse drug reactions and its reporting in the United Arab Emirates: a survey-based cross-sectional study
Authors: Shareef Javedh , Sridhar Sathvik Belagodu , Bhupathyraaj Mullaicharam , Shariff Atiqulla , Thomas Sabin 
Published: October 2024

Background: Adverse drug reactions (ADRs) contribute significant clinical and economic burden to the country’s healthcare system globally. Prompt reporting of ADRs by the community pharmacist is essential to the active pharmacovigilance program. Objectives: This study assesses private community pharmacists’ knowledge, attitude, and practice (KAP) about ADRs and reporting. Design: A cross-sectional, qualitative study was performed using a pre-validated self-administered questionnaire. Methods: This self-administered questionnaire was conducted at community pharmacies between March and July 2022. The data collected were analyzed using the Mann–Whitney and Kruskal–Wallis tests to examine the differences in overall KAP scores with a subgroup of sociodemographic characteristics of the study participants. Logistic regression analysis was used to analyze the predictors of practice. Results: In total, 156 fully completed questionnaires were collected by the community pharmacists. A positive association between the designation, qualification, and work experience with the total scores of the respondents was observed ( p < 0.05). Among the predictors of ADR reporting practice, a significant association was observed with knowledge score (⩾6, p = 0.0219), designation (pharmacists, p = 0.0102), qualification (masters, p = 0.0002), and work experience (⩾11 years, p = 0.0184). Most community pharmacists had good knowledge and attitude but poor practice toward reporting ADRs. Uncertainty of how and where to report, lack of training, lack of reporting forms, and insufficient clinical knowledge were the practice-based barriers in the ADR reporting process. Conclusion: Though the study found sufficient understanding and favorable views on ADR reporting, participants reported poor practices and barriers to reporting ADR. Therefore, structured continuing professional development programs for community pharmacists are needed to overcome the barriers and enhance the practice of ADR reporting.
A mixed-methods study of VA video connect utilization among veterans with diabetes experiencing housing instability during the pandemic
Authors: Kinney Rebecca L , Copeland Laurel A , Tsai Jack , Abbott Alice A , Wallace Kate , Walker Lorrie A , Weber Jillian , Katsos Shara , McInnes Donald K 
Published: October 2024

Introduction Prior to the coronavirus disease-2019 (COVID-19) pandemic the U.S. Department of Veterans Affairs (VA) had the largest telehealth program in the United States. The pandemic motivated providers within the VA to expand telehealth in effort to reduce disrupted care while mitigating risks. The pandemic provides a rare opportunity to examine how to better engage veterans experiencing housing instability (HI) in telehealth diabetes care. Methods Mixed methods design to examine VA video connect (VVC) diabetes care utilization among veterans experiencing HI from March 1, 2019, to March 1, 2022, combining multivariable regression analyses of VA administrative data with semi-structured interviews. Study aims included: (a) examine changes in diabetes care delivery mode over the peri-pandemic timeframe; (b) identify sociodemographic and clinical characteristics associated with VVC care among veterans with HI; and (c) understand the facilitators and barriers of VVC utilization. Results Totally, 5904 veterans were eligible for study analysis. Veterans who are female (OR: 1.63; 95% CI: 1.3, 2.0; p < 0.0001), self-identify as Hispanic (OR: 1.44; 95% CI: 1.1, 1.9; p = 0.02), are married (OR: 1.39; 95% CI: 1.2, 1.6; p < 0.0001), and are in VA priority group 1 (OR: 1.21; 95% CI 1.1, 1.4; p = 0.004) were more likely to use VVC the pandemic. Veterans of older age (OR: 0.97; 95% CI: 0.97, 0.98; p < .0001) and rural dwelling (OR: 0.85; 95% CI: 0.7, 1.2; p = 0.04), were less likely to use VVC. Thirteen VA providers and 15 veterans were interviewed. Veterans reported that decisions about using VVC were driven by limitations in in-person care availability, safety, and convenience. Discussion Telehealth played an important role in providing veterans with HI access to diabetes care during the pandemic. Future interventions should seek to increase education and technology in effort to increase VVC uptake into routine diabetes care to ensure veterans’ optimal and equitable access.