bluuebunny/crossref_metadata_2025_split huggingface dataset:
Clients’ expectations and experiences with providers of menstrual regulation: a qualitative study in Bangladesh
Authors: Ramirez Ana Maria , Tabassum Tanzila , Filippa Sofia , Katz Anna , Chowdhury Rezwana , Bercu Chiara , Baum Sarah E. 
Published: May 2024

Abstract
Background
Menstrual Regulation (MR) has been legal in Bangladesh since 1979 in an effort to reduce maternal mortality from unsafe abortion care. However, access to high-quality and patient-centered MR care remains a challenge. This analysis aimed to explore what clients know before going into care and the experience itself across a variety of service delivery sites where MR care is available.

Methods
We conducted 26 qualitative semi-structured interviews with MR clients who were recruited from three different service delivery sites in Dhaka, Bangladesh from January to March 2019. Interviews explored client expectations and beliefs about MR care, the experience of the care they received, and their perception of the quality of that care. We conducted a thematic content analysis using a priori and emergent codes.

Results
Clients overall lacked knowledge about MR care and held fears about the damage to their bodies after receiving care. Despite their fears, roughly half the clients held positive expectations about the care they would receive. Call center clients felt the most prepared by their provider about what to expect during their MR care. During counseling sessions, providers at in-facility locations reinforced the perception of risk of future fertility as a result of MR and commonly questioned clients on their need for MR services. Some even attempted to dissuade nulliparous women from getting the care. Clients received this type of questioning throughout their time at the facilities, not just from their medical providers. The majority of clients perceived their care as good and rationalized these comments from their providers as coming from a caring place. However, a handful of clients did report bad care and negative feelings about their interactions with providers and other clinical staff.

Conclusion
Providers and clinical staff can play a key role in shaping the experience of clients accessing MR care. Training on accurate knowledge about the safety and effectiveness of MR, and the importance of client communication could help improve client knowledge and person-centered quality of MR care.
Exploring the consent process among pregnant and breastfeeding women taking part in a maternal vaccine clinical trial in Kampala, Uganda: a qualitative study
Authors: Ssali Agnes , Namugumya Rita , Nalubega Phiona , Kyohere Mary , Seeley Janet , Doare Kirsty Le 
Published: May 2024

Abstract
Background
The involvement of pregnant women in vaccine clinical trials presents unique challenges for the informed consent process. We explored the expectations and experiences of the pregnant women, spouses/partners, health workers and stakeholders of the consent process during a Group B Streptococcus maternal vaccine trial.

Methods
We interviewed 56 participants including pregnant women taking part in the trial, women not in the trial, health workers handling the trial procedures, spouses, and community stakeholders. We conducted 13 in-depth interviews and focus group discussions with 23 women in the trial, in-depth interviews with 5 spouses, and 5 women not in the trial, key informant interviews with 5 health workers and 5 other stakeholders were undertaken.

Results
Decision-making by a pregnant woman to join a trial was done in consultation with spouse, parents, siblings, or trusted health workers. Written study information was appreciated by all but they suggested the use of audio and visual presentation to enhance understanding. Women stressed the need to ensure that their male partners received study information before their pregnant partners joined a clinical trial. Confidentiality in research was emphasised differently by individual participants; while some emphasised it for self, others were keen to protect their family members from being exposed, for allowing them to be involved in research. However, others wanted their community participation to be acknowledged.

Conclusion
We found that pregnant women make decisions to join a clinical trial after consulting with close family. Our findings suggest the need for an information strategy which informs not only the pregnant woman, but also her family about the research she is invited to engage in.
Sensory nerve conduction stimulus threshold measurements of the infraorbital nerve and its applicability as a diagnostic tool in horses with trigeminal-mediated headshaking
Authors: Nessler Jasmin Nicole , Delarocque Julien , Kloock Tanja , Twele Lara , Neudeck Stephan , Meyerhoff Nina , Riese Franziska , Cavalleri Jessica-M. V. , Tipold Andrea , Feige Karsten , Niebuhr Tobias 
Published: May 2024

Abstract
Background
To determine whether sensory nerve conduction stimulus threshold measurements of the infraorbital nerve are able to differentiate horses with idiopathic trigeminal-mediated headshaking (i-TMHS) from healthy horses and from horses with secondary trigeminal-mediated headshaking (s-TMHS). In a prospective trial, headshaking horses were examined using a standardized diagnostic protocol, including advanced diagnostics such as computed tomography and 3-Tesla-magnetic resonance imaging (MRI), to differentiate s-TMHS from i-TMHS. Clinically healthy horses served as controls. Within this process, patients underwent general anesthesia, and the minimal sensory nerve conduction stimulus threshold (SNCT) of the infraorbital nerve was measured using a bipolar concentric needle electrode. Sensory nerve action potentials (SNAP) were assessed in 2.5–5 mA intervals. Minimal SNCT as well as additional measurements were calculated.

Results
In 60 horses, SNAP could be recorded, of which 43 horses had i-TMHS, six had suspected s-TMHS, three horses had non-facial headshaking, and eight healthy horses served as controls. Controls had a minimal SNCT ≥ 15 mA, whereas 14/43 horses with i-TMHS and 2/6 horses with s-TMHS showed a minimal SNCT ≤ 10 mA. Minimal SNCT ≤ 10 mA showed 100% specificity to distinguish TMHS from controls, but the sensitivity was only 41%.

Conclusion
A minimal SNCT of the infraorbital nerve ≤ 10 mA was able to differentiate healthy horses from horses with TMHS. Nevertheless, a higher minimal SNCT did not exclude i-TMHS or s-TMHS and minimal SNCT does not distinguish s-TMHS from i-TMHS.
Quadrilateral plate classification program of acetabular fractures based on three-column classification: a three-dimensional fracture mapping study
Authors: Wang Ruihan , Jiang Songtao , Wang Wei , Yang Yingqiu , Zhang Lei , Wang Guoyou 
Published: May 2024

Abstract
Background
A new classification system for acetabular fractures has been proposed in recent years, which is called the 3-column classification. However, this system does not provide information regarding quadrilateral plate fractures. To address this issue, we utilized three-dimensional (3D) fracture line mapping and heat map to analyze the link between the 3-column classification and quadrilateral plate fractures.

Methods
We collected CT scan data from 177 patients who had been diagnosed with acetabular fractures. Additionally, we utilized a CT scan of a healthy adult to generate a standard acetabular model. We utilized the collected CT data of the fracture to create a 3D model and subsequently reduced it. We then matched each acetabular fracture model with the standard acetabular model and mapped all of the fracture lines to the standard model. 3D fracture lines and heat maps were created by overlapping all fracture lines. Fracture characteristics were then summarized using these maps.

Results
This study analyzed a total of 221 acetabular fractures. The most frequently observed fracture type, based on the three-column classification, was A1.2, which corresponds to fractures of the anterior column. In contrast, the least common type of fracture was A4, which represents fractures of the central wall. It was noted that quadrilateral plate fractures were frequently observed in fractures classified as type B and C according to the three-column classification.

Conclusions
Among the three-column classification, the QLP fractures are commonly observed in type B and C. It is important to carefully identify these fractures during the diagnostic process. Therefore, based on the three-column classification, we have amalgamated quadrilateral plate fractures and formulated a classification program for acetabular fractures.
Genetic variability of Aedes aegypti (Diptera: Culicidae) in El Salvador and Honduras: presence of a widespread haplotype and implications for mosquito control
Authors: Joyce A. L. , Moreno Miguel , Palomo Leonel , O’Connor Raul , Escobar Denis 
Published: May 2024

Abstract
Background
This study examined population genetics of Aedes aegypti in El Salvador and Honduras, two adjacent countries in Central America. Aedes aegypti is associated with yellow fever, dengue, chikungunya, and Zika. Each year, thousands of cases of dengue are typically reported in El Salvador and Honduras.

Methods
In El Salvador, collections were obtained from five Departments. In Honduras, samples were obtained from six municipalities in four Departments. Mitochondrial DNA cytochrome oxidase I (COI) was sequenced, and consensus sequences were combined with available sequences from El Salvador to determine haplotype number, haplotype diversity, nucleotide diversity, and Tajima’s D. A haplotype network was produced to examine the relationship between genotypes.

Results
In El Salvador, there were 17 haplotypes, while in Honduras there were 4 haplotypes. In both El Salvador and Honduras, Haplotype 1 is most abundant and widespread. In El Salvador, haplotype H2 was also widespread in 10 of 11 sampled municipalities, but it was not present in Honduras. The capital of El Salvador (San Salvador) and the eastern region of ES had the highest haplotype diversity of regions sampled.

Conclusions
Haplotype 1 and H2 each belong to different phylogenetic lineages of Ae. aegypti. The most geographically widespread haplotype (H1) may have been present the longest and could be a remnant from previous eradication programs. These data may contribute to future control programs for Ae. aegypti in the two countries.

Graphical Abstract
A comprehensive analysis of food insecurity in the drought–prone rural areas of Tigray
Authors: Gebre Tewelde , Abraha Zenebe , Zenebe Amanuel , Zeweld Woldegebrial 
Published: May 2024

Abstract
Background
The number of globally food-insecure people is increasing since 2017. Sub-Saharan Africa has the highest proportion of severely food-insecure people in the world. Tigray region of Ethiopia is one of the food-insecure regions, which, over the past many decades has been affected by recurrent food insecurities. In the drought–prone rural areas of Tigray, many people are living under the condition of chronic hunger. Proper food security studies are vital for proper intervention mechanisms. Yet, previous food security studies have rarely addressed the four pillars of food security: availability, access, utilization, and stability. In this study, all components are duly considered to assess the food insecurity status in the drought–prone rural areas of Tigray, Ethiopia. Of the 34 rural districts in Tigray, 363 households from three drought–prone rural districts were studied.

Results
Household Food Insecurity Access Scale and Food Insecurity Experience Scale were adapted to measure the food availability, access to food, and stability components of food security; and, Household Dietary Diversity Score (HDDS), Food Consumption Score (FCS), mid-upper arm circumference, and Bitot’s spot were used to analyze the food utilization aspect. Findings show that 68% of the studied community frequently ate less food than they felt they needed and 82.1% of the households have experienced hunger because of lack of food. The study rural districts were unconnected to road networks; hence, 87.9% of the elderly and 20.4% of the women and girls had no access to food markets. Regarding the food utilization, 81.5% of the studied households had poor FCS; and the average HDDS and FCS for the study areas were 2.47 and 18.9, respectively. The prevalence of Global acute malnutrition, severe acute malnutrition (SAM), and moderate acute malnutrition (MAM) for 6–59 months of age children in the study areas were 50.3, 4.2, and 46.1%, respectively. More notably, the prevalence of SAM for children from the food-insecure households was 21.2%. The prevalence of MAM for pregnant and lactating women (PLW) in the study areas was 59.5. Further, the prevalence of Bitot’s spot among 6–59 months of age children was 1.9%. On the other hand, all the rural households had anxiety about their future food demands.

Conclusion
The rural households living in the studied areas were critically food-insecure. All the measurements implied that the food insecurity situation in the study areas was unacceptably worrisome and life-threatening. This calls for an instant action to avert the occurrence of famine and starvation in the drought–prone rural areas of Tigray region. Thus, interventions should primarily target the vulnerable rural people and need to be planned based on attaining food availability first rather than concurrently addressing all components of food security. Further, due emphasis should be given to diversifying livelihood strategies of the vulnerable villagers.
Do you have AI dependency? The roles of academic self-efficacy, academic stress, and performance expectations on problematic AI usage behavior
Authors: Zhang Shunan , Zhao Xiangying , Zhou Tong , Kim Jang Hyun 
Published: May 2024

AbstractAlthough previous studies have highlighted the problematic artificial intelligence (AI) usage behaviors in educational contexts, such as overreliance on AI, no study has explored the antecedents and potential consequences that contribute to this problem. Therefore, this study investigates the causes and consequences of AI dependency using ChatGPT as an example. Using the Interaction of the Person-Affect-Cognition-Execution (I-PACE) model, this study explores the internal associations between academic self-efficacy, academic stress, performance expectations, and AI dependency. It also identifies the negative consequences of AI dependency. Analysis of data from 300 university students revealed that the relationship between academic self-efficacy and AI dependency was mediated by academic stress and performance expectations. The top five negative effects of AI dependency include increased laziness, the spread of misinformation, a lower level of creativity, and reduced critical and independent thinking. The findings provide explanations and solutions to mitigate the negative effects of AI dependency.
Comparison of vascular risk profile and clinical outcomes among patients with central (branch) retinal artery occlusion versus amaurosis fugax
Authors: Diel Norma J. , Gerner Stefan T. , Doeppner Thorsten R. , Juenemann Martin , Maxhuni Toska , Frühwald Tobias , Worm Andre , Alhaj Omar Omar , Lytvynchuk Lyubomyr , Struffert Tobias , Bauer Pascal , Huttner Hagen B. 
Published: May 2024

Abstract
Background
Retinal artery occlusions lead to sudden, painless vision loss, affecting millions globally. Despite their significance, treatment strategies remain unestablished, contrasting with acute ischemic stroke (AIS), where IVT has proven efficacy. Similar to AIS, retinal artery occlusions demand urgent evaluation and treatment, reflecting the principle "time is retina". Even for patients with transient monocular vision loss, also known as amaurosis fugax (AF), pertinent guidelines meanwhile recommend immediate emergency assessment in a specialized facility. However, data on the clinical benefit and comparability with persistent occlusions are missing. This study aimed to compare the results of a comprehensive stroke-workup among patients with persistent retinal artery occlusions (RAO), including both central retinal (CRAO) and branch retinal artery occlusion (BRAO) and those with AF.

Methods
Conducted at the University Hospital Giessen, Germany, this exploratory cross-sectional study enrolled patients with transient or permanent unilateral vision loss of non-arteritic origin. The primary outcome were differences between the two groups RAO and AF with regard to cardiovascular risk profiles and comorbidities, vascular and pharmacological interventions and clinical neurological and ophthalmological outcomes. Secondary outcome was a sub-group analysis of patients receiving IVT.

Results
Out of 166 patients assessed, 76 with RAO and 40 with AF met the inclusion criteria. Both groups exhibited comparable age, gender distribution, and cardiovascular risk profiles. Notably, RAO patients did not show significantly more severe vascular comorbidities than AF patients. However, AF patients received vascular interventions more frequently. Pharmacological intervention rates were similar across groups. RAO patients had slightly worse neurological outcomes, and IVT did not yield favorable ophthalmological outcomes within any observed patients.

Conclusion
The study found similar vascular burden and risk factors in patients with RAO and AF, with implications for clinical workflows. IVT for RAO may only be effective in very early treatment windows. This emphasizes the need for public awareness and collaborative protocols between ophthalmologists and neurologists to improve outcomes.
The Thai GoodWalk Index and the Thai Walkability Index: their application to urban regeneration exemplified by a historic riverside neighbourhood in Bangkok, Thailand
Authors: Serisakul Niramon , Guntamueanglee Adisak , Ovatvoravarunyou Thanaporn , Dechakaneewong Munchuchada , Navaraj Preechaya 
Published: May 2024

AbstractThe urban heritage regeneration strategy through walkability is widely accepted. However, in the context of a developing country, the tools to measure walkability, which are crucial for urban planning and development, still need to be improved. This article investigates ways to revitalise a run-down historic riverside area in Bangkok. It develops two indices, the Thai GoodWalk Index (TGWI) and the Thai Walkability Index (TWI). A hybrid of both indices is based on geospatial techniques and technology to optimise problem analysis processes, create problem-solving options, enhance spatial site selection decision capabilities, and assist urban planners in carrying out spatial scenario planning processes. It demonstrates how the GoodWalk Index has been employed to plan and prioritise urban development projects. This is exemplified by the Master Plan for the Regeneration of Kadeejeen-Klongsan, a historic riverside neighbourhood in Bangkok with limitations in density, functional mix of spaces, and access networks, especially in riverfront areas. The TGWI and TWI can be applied to the regeneration of other historic districts throughout Thailand.
Reimagining care: effectiveness of modifying an adolescent eating disorder intensive service
Authors: Hayes Ellen , Tweedy Nicola , Chapman Victoria 
Published: May 2024

Aims and method
The COVID-19 pandemic prompted a surge in adolescent eating disorders and rapid changes in the delivery of intensive community treatments. This study investigates the modification from a group-based day programme to an intensive family treatment approach. A retrospective chart review was performed on data from 190 patients who accessed the intensive service for anorexia nervosa in the past 6 years. Outcomes from the traditional model were compared with the new intensive family model, namely length of admission, percentage median body mass index difference and transfers to in-patient services.

Results
There was a significant reduction in the length of intensive treatment (from 143.19 to 97.20 days). The number of transfers to specialist eating disorder in-patient services also significantly reduced, and is decreasing year on year.

Clinical implications
The findings hold particular relevance as intensive services for adolescent eating disorders continue to be established within health services, with no clear unified approach to treatment.
Shared Decision Making in Oncology and Its Implementation in Cervical Cancer Management in the Philippines: A Narrative Review
Authors: Bacorro Warren , Short Michala , Baldivia Kathleen , Mariano Jocelyn , Bautista Aida , Amparo Genalin , Tagayuna Irene , Jainar Carl Jay , Antonio Linda , Dancel Evelyn , Ortin Teresa Sy , Gonzalez Gil , Canlas Rodel 
Published: May 2024

PURPOSE Shared decision making (SDM) is an approach where clinicians and patients make decisions together using the best available evidence. Although much studied, recognized to be ethically imperative, and recommended in international health policies, it remains poorly implemented. In the Philippines, there are limited studies on patient decision making preferences and SDM. Practical guidance on the implementation of SDM or use of patient decision aids (PtDAs) is often not detailed in existing national clinical practice guidelines in oncology. METHODS We performed a systematic search of Philippine literature on SDM in oncology and an iterative review of international literature on the philosophy and methods of SDM, the utility and effectiveness of PtDAs, and the facilitators and barriers to implementation or usage. We contextualized our review to the cervical cancer management and health service delivery in the Philippines. RESULTS Local literature is limited to five scientific publications and two registered studies. International literature encompasses patient decisional preferences, the role of PtDAs and the standards for their development and evaluation, their effectiveness, and barriers and facilitators to their use in cancer-related decision making. We discussed the implications on the management of cervical cancer in the Philippines, challenges in health service delivery and standards, and SDM research. CONCLUSION Local SDM research is limited. Our preliminary experience in a multicenter clinical trial in Manila on PtDA use in the framework of SDM in cervical cancer suggest good patient and clinician acceptability. Challenges to implementation such as unfavorable financial situations, urgency of clinical decisions, low patient or caregiver educational attainment, and poor integration of multidisciplinary and SDM in organizational workflows will be important when implementing SDM in different settings.