bluuebunny/crossref_metadata_2025_split huggingface dataset:
Magnitude, disparity, and predictors of poor-quality antenatal care service: A systematic review and meta-analysis
Authors: Demissie Dereje Bayissa , Molla Gebeyaw , Tiruneh Tiyare Firew , Badacho Abebe Sorsa , Tadele Ashenif 
Published: May 2024

Background: Antenatal care is directed toward ensuring healthy pregnancy outcomes. Quality antenatal care increases the likelihood of receiving an effective intervention to maintain maternal, fetal, and neonatal well-being, while poor quality is linked to poor pregnancy outcomes. However, owing to the complex nature of quality, researchers have followed several approaches to systematically measure it. The evidence from these variable approaches appears inconsistence and poses challenges to programmers and policymakers. Hence, it is imperative to obtain a pooled estimate of the quality of antenatal care. Therefore, considering the scarcity of evidence on the quality of antenatal care, this study aimed to review, synthesize, and bring pooled estimates of accessible evidence. Objective: This study aimed to estimate the pooled magnitude and predictors of quality of antenatal care services and compare regional disparity. Method: We conducted a comprehensive systematic three-step approach search of published and unpublished sources from 2002 to 2022. The methodological quality of eligible studies was checked using Joanna Briggs Institute critical appraisal tool for cross-sectional studies. Meta-analysis was carried out using STATA version 16. Statistical heterogeneity was assessed using Cochran’s Q test. In the presence of moderate heterogeneity ( I2 more than 50%), sensitivity and subgroup analyses were conducted and presented in a forest plot. Effect size was reported using standardized mean difference and its 95% confidence interval. Funnel plots and Egger’s regression test were used to measure publication bias at the 5% significance level. A trim-and-fill analysis was conducted to adjust for publication bias. Pooled estimates were computed using random-effects models and weighted using the inverse variance method in the presence of high heterogeneity among studies. A 95% CI and 5% significance level were considered to declare significance variables. Results: The global pooled poor-quality antenatal care was 64.28% (95% CI: 59.58%−68.98%) ( I2 = 99.97%, p = 0.001). The identified pooled predictors of good-quality antenatal care service were: number of antenatal care visits (fourth and above antenatal care visit) (Adjusted odds ratio (AOR) = 2.6, 95% CI: 1.37–3.84), family wealth index (AOR = 2.72, 95% CI: 1.89–3.55), maternal education attainment (AOR = 3.03, 95% CI: 2.24–3.82), residence (urban dwellers) (AOR = 4.06, 95% CI: 0.95–7.17), and confidentiality antenatal care (AOR = 2.23, 95% CI: −0.36 to −4.82). Conclusions: The study found regional and country-level disparities in the quality of antenatal care services for pregnant women, where poor-quality antenatal care services were provided for more than two-thirds to three-fourths of antenatal care attendants. Therefore, policymakers and health planners should put a great deal of emphasis on addressing the quality of antenatal care services.
Liquidity and Credit Risk in Indonesia: The Role of FinTech Development
Authors: Yudaruddin Rizky , Nugroho Bramantyo Adi , Mardiany  , Fitrian Zhikry , Hapsari Pebiansyah , Fitrianto Yuli , Santi Eka Nor 
Published: May 2024

This study examines the relationship between liquidity, FinTech development, and credit risk in the Indonesian banking industry. Specifically, it investigates the impact of FinTech, particularly in peer-to-peer lending and payment systems, on credit risk in conjunction with liquidity. The analysis is conducted using panel data from 142 commercial banks in Indonesia over a 15-year period from 2004 to 2018. The results reveal that higher liquidity leads to a reduction in credit risk, whereas FinTech development is found to increase credit risk, particularly in small banks (BUKU 3 and BUKU 4) and private national banks. Notably, this study identifies that the impact of liquidity on credit risk is conditional on the level of FinTech development. Furthermore, the findings suggest that the effects of FinTech on credit risk are contingent on the bank’s characteristics and the economic environment. These results have significant policy implications for designing an inclusive financial framework in the digital era, especially in managing the risks associated with FinTech development. JEL Classification: G231, F31. R10.
Diesel Engine Exhaust Exposure in Relation to Lung Cancer in Long-Haul Truck Drivers: An Eight-Step Concept Analysis
Authors: Harris Cara , Vance David E. , Heaton Karen 
Published: May 2024

Background: Long-haul truck drivers (LHTDs) face a number of occupational hazards. One such hazard is exposure to diesel engine exhaust (DEE). However, this concept has yet to be analyzed. To address this gap, a concept analysis was conducted to explore the effects of DEE in relation to lung cancer. Methods: Walker and Avant’s eight-step concept analysis method was utilized: concept selection, analysis purpose, concept uses, defining attributes, model case, borderline case, antecedents and consequences, and empirical referents. PubMed, Scopus, and CINAHL databases were searched for relevant literature. Findings: Diesel engine exhaust was identified as a mixture of gases and particulates that are considered carcinogenic. Defining attributes of DEE for truckers include respiratory effects such as decreased peak flow and increased airway resistance leading to symptoms such as a phlegm-producing cough, eye and throat irritation, exacerbation of asthma symptoms, and allergic responses. The identified level of DEE exposure associated with these attributes is 75 μg EC/m3 for 1 to 2 hours daily or a long-term exposure of 10 μg EC/m3. The conceptual definition of DEE in truckers was illustrated by the attributes, antecedents, consequences, model case, and empirical referents. Conclusion: Lung cancer was identified as a significant consequence of occupational DEE exposure for LHTDs. This analysis highlights the need for future research to develop interventions that will safeguard truckers from the adverse health effects of DEE exposure.
Association of Graft Maturity on MRI With Return to Sports at 9 Months After Primary Single-Bundle ACL Reconstruction With Autologous Hamstring Graft
Authors: Zhou Tianping , Xu Yihong , Zhang Aiai , Zhang Xuchao , Deng Kehan , Wu Haoran , Xu Weidong 
Published: May 2024

Background: The relationship between graft maturity on magnetic resonance imaging (MRI) and return to sports (RTS) after anterior cruciate ligament (ACL) reconstruction is unclear. Purpose: To compare signal-to-noise quotient (SNQ) values and ACL graft T2* (gradient echo) values between patients who did RTS and those who did not RTS (NRTS) after ACL reconstruction and to evaluate the predictive value of T2* mapping for RTS after ACL reconstruction. Study Design: Case-control study; Level of evidence, 3. Methods: At a minimum of 9 months after arthroscopic single-bundle ACL reconstruction with autologous hamstring tendon graft, 82 patients underwent RTS assessment as well as MRI evaluation. The patients were classified into RTS (n = 53) and NRTS (n = 29) groups based on the results of the assessment. The SNQ values in the proximal, middle, and distal regions of the graft and the T2* values of the graft were measured on MRI. The correlation between T2* values and RTS was assessed using Spearman correlation analysis. Receiver operating characteristic curves were constructed to compare the diagnostic performance, and the optimal T2* cutoff value for detecting RTS was determined based on the maximum Youden index. Results: At 9 months after ACL reconstruction, the proximal, middle, and mean SNQ values in the RTS group were significantly lower than those in the NRTS group (proximal: 17.15 ± 4.85 vs 19.55 ± 5.05, P = .038; middle: 13.45 ± 5.15 vs. 17.75 ± 5.75, P = .001; mean: 12.37 ± 2.74 vs 15.07 ± 3.32, P < .001). The T2* values were lower in the RTS group (14.92 ± 2.28 vs 17.69 ± 2.48; P < .001) and were correlated with RTS ( r = −0.41; P = .02). The area under the curve of T2* was 0.79 (95% CI, 0.75-0.83), and the optimal cutoff value for T2* was 16.65, with a sensitivity and specificity for predicting failure to RTS of 67.9% and 88.2%, respectively. Conclusion: Study findings indicated that the SNQs (mean, proximal, and middle) and the T2* values of the graft in the RTS group were significantly lower than those in NRTS group. A T2* value of 16.65 was calculated to predict patients who failed RTS tests with a sensitivity of 67.9% and specificity of 88.2%.
Prediction of anticancer drug sensitivity using an interpretable model guided by deep learning
Authors: Pang Weixiong , Chen Ming , Qin Yufang 
Published: May 2024

Abstract
Background
The prediction of drug sensitivity plays a crucial role in improving the therapeutic effect of drugs. However, testing the effectiveness of drugs is challenging due to the complex mechanism of drug reactions and the lack of interpretability in most machine learning and deep learning methods. Therefore, it is imperative to establish an interpretable model that receives various cell line and drug feature data to learn drug response mechanisms and achieve stable predictions between available datasets.

Results
This study proposes a new and interpretable deep learning model, DrugGene, which integrates gene expression, gene mutation, gene copy number variation of cancer cells, and chemical characteristics of anticancer drugs to predict their sensitivity. This model comprises two different branches of neural networks, where the first involves a hierarchical structure of biological subsystems that uses the biological processes of human cells to form a visual neural network (VNN) and an interpretable deep neural network for human cancer cells. DrugGene receives genotype input from the cell line and detects changes in the subsystem states. We also employ a traditional artificial neural network (ANN) to capture the chemical structural features of drugs. DrugGene generates final drug response predictions by combining VNN and ANN and integrating their outputs into a fully connected layer. The experimental results using drug sensitivity data extracted from the Cancer Drug Sensitivity Genome Database and the Cancer Treatment Response Portal v2 reveal that the proposed model is better than existing prediction methods. Therefore, our model achieves higher accuracy, learns the reaction mechanisms between anticancer drugs and cell lines from various features, and interprets the model’s predicted results.

Conclusions
Our method utilizes biological pathways to construct neural networks, which can use genotypes to monitor changes in the state of network subsystems, thereby interpreting the prediction results in the model and achieving satisfactory prediction accuracy. This will help explore new directions in cancer treatment. More available code resources can be downloaded for free from GitHub (https://github.com/pangweixiong/DrugGene).
Exploring the diversity and evolutionary strategies of prophages in Hyphomicrobiales, comparing animal-associated with non-animal-associated bacteria
Authors: Gonçalves-Oliveira Jonathan , Pattenden Tyler , Nachum-Biala Yaarit , de Sousa Keyla Carstens M. , Wahl Lindi , Harrus Shimon 
Published: May 2024

AbstractThe Hyphomicrobiales bacterial order (previously Rhizobiales) exhibits a wide range of lifestyle characteristics, including free-living, plant-association, nitrogen-fixing, and association with animals (Bartonella and Brucella). This study explores the diversity and evolutionary strategies of bacteriophages within the Hyphomicrobiales order, comparing animal-associated (AAB) with non-animal-associated bacteria (NAAB). We curated 560 high-quality complete genomes of 58 genera from this order and used the PHASTER server for prophage annotation and classification. For 19 genera with representative genomes, we curated 96 genomes and used the Defense-Finder server to summarize the type of anti-phage systems (APS) found in this order. We analyzed the genetic repertoire and length distributions of prophages, estimating evolutionary rates and comparing intact, questionable, and incomplete prophages in both groups. Analyses of best-fit parameters and bootstrap sensitivity were used to understand the evolutionary processes driving prophage gene content. A total of 1860 prophages distributed in Hyphomicrobiales were found, 695 in AAB and 1165 in the NAAB genera. The results revealed a similar number of prophages per genome in AAB and NAAB and a similar length distribution, suggesting shared mechanisms of genetic acquisition of prophage genes. Changes in the frequency of specific gene classes were observed between incomplete and intact prophages, indicating preferential loss or enrichment in both groups. The analysis of best-fit parameters and bootstrap sensitivity tests indicated a higher selection coefficient, induction rate, and turnover in NAAB genomes. We found 68 types of APS in Hyphomicrobiales; restriction modification (RM) and abortive infection (Abi) were the most frequent APS found for all Hyphomicrobiales, and within the AAB group. This classification of APS showed that NAAB genomes have a greater diversity of defense systems compared to AAB, which could be related to the higher rates of prophage induction and turnover in the latter group. Our study provides insights into the distributions of both prophages and APS in Hyphomicrobiales genomes, demonstrating that NAAB carry more defense systems against phages, while AAB show increased prophage stability and an increased number of incomplete prophages. These results suggest a greater role for domesticated prophages within animal-associated bacteria in Hyphomicrobiales.
Factors predicting self-care behavior of cardiovascular patients during the COVID-19 epidemic
Authors: Sharafkhani Naser , Gazhdomi Mostafa Yousefi Ghaleh , Norouzi Samaneh , Ghasemi Mahmoud , Salahshouri Arash 
Published: May 2024

Abstract
Background
The COVID-19 virus has had wide-ranging effects on all healthcare systems and a direct impact on all areas of human life in all countries around the world. Therefore, it is necessary to take preventive actions to reduce the prevalence and severity of the complications associated with this disease. The purpose of this study was to explain the dimensions of adopting general self-care behaviors (mask-wearing, social distancing, hand hygiene, and home quarantine) for preventing COVID-19 based on the theory of planned behavior (TPB) in cardiovascular patients.

Methods
This was a descriptive-analytical study conducted with the participation of 420 patients referring to health and treatment centers of Ahvaz, southwest of Iran, in 2022. Sampling was done using a non-random (convenience) method. The data collection tool was a questionnaire containing items addressing demographic characteristics, questions related to the TPB, and questions dealing with the adoption of everyday self-care behaviors against contracting COVID-19. Data were analyzed using descriptive and inferential statistical methods (prevalence, mean, standard deviation, Pearson’s correlation coefficient, and linear regression) in SPSS version 25.

Results
The results of this study showed that the rate of adoption of self-care behaviors against COVID-19 among cardiovascular patients was moderate. The results also showed that among the constructs of the TPB, Perceived behavioral control, Subjective norms, and Perceived behavioral intention were the most important predictors of adopting self-care behaviors among cardiovascular patients with a change variance of 46%.

Conclusions
The results of the present study have implications for health and treatment policy makers as well as planners of educational and behavioral interventions aimed at promoting the adoption of self-care behaviors against COVID-19. In this respect, managing and institutionalizing desirable behaviors among cardiovascular patients could be beneficial from economic, social, and health-related aspects.
Randomized comparison of the effects of tailored text messaging versus pillbox organizers on medication adherence of heart failure patients
Authors: FarzanehRad Ameneh , Allahbakhshian Atefeh , Gholizadeh Leila , Khalili Azizeh Farshbaf , hasankhani Hadi 
Published: May 2024

Abstract
Background
Heart failure (HF) is a major public health issue worldwide, affecting approximately 64.3 million people in 2017. Non-adherence to medication is a common and serious issue in the management of HF. However, new reminder systems utilizing mobile technology, such as text messaging, have shown promise in improving medication adherence. The purpose of this study was to compare the impact of tailored text messaging (TTM) and pillbox organizers on medication adherence in individuals with HF.

Methods
A randomized controlled trial was conducted, involving 189 eligible patients with HF who were randomly assigned to either the TTM, pillbox organizer, or control group. Medication adherence was evaluated using pill counting and the Medication Adherence Rating Scale (MARS) over a period of three months and compared across the groups. The data were analyzed using Kruskal-Wallis, Analysis of Variance (ANOVA), and Repeated Measures ANOVA tests.

Results
The results indicate that both the TTM and pillbox organizers groups had significantly higher medication adherence compared to the control group, as measured by pill counting (MD = 0.05, 95%CI = 0.03–0.06; p < 0.001 for TTM group, MD = 0.04, 95%CI = 0.03–0.06; p < 0.001 for pillbox organizers group) and the MARS (MD = 1.32, 95%CI = 0.93 to 1.72; p < 0.001 for TTM group, MD = 1.33, 95%CI = 0.95 to 1.72; p < 0.001 for pillbox organizers group). However, there was no statistically significant difference in medication adherence between the two intervention groups using either measurement method. The TTM group exhibited a lower hospitalization rate than the other groups in the first follow up (p = 0.016).

Conclusions
Both the TTM and pillbox organizers were shown to be effective in enhancing medication adherence among patients with HF. Therefore, healthcare providers should take into account the patient’s condition and preferences when selecting one of these methods to promote medication adherence. Future research should aim to address the limitations of this study, such as controlling for confounding variables, considering long-term effects, and comparing the effectiveness of different interventions.
Clinical analysis of 314 patients with high-grade squamous intraepithelial lesion who underwent total hysterectomy directly: a multi-center, retrospective cohort study
Authors: Lei Lingyu , Zhang Lin , Zheng Yahong , Ma Wei , Liu Fang , Li Dongmei , Chen Keming , Zeng Yong 
Published: May 2024

Abstract
Objective
To identify the risk factors of cervical high-grade squamous intraepithelial lesion(HSIL) complicated with occult cervical cancer and standardize the management of initial treatment for HSIL.

Method
The clinical data of patients who underwent total hysterectomy directly due to HSIL in the obstetrics and gynecology department of two tertiary hospitals and three secondary hospitals from 2018 to 2023 were collected. Their general characteristics, pathological parameters and survival status were analyzed. Logistic regression model was used to analyze the correlation between clinical parameters and postoperative pathological upgrading.

Result
1. Among the 314 patients with HSIL who underwent total hysterectomy directly, 73.2% were from primary hospitals. 2. 25 patients (7.9%) were pathologically upgraded to cervical cancer, all of which were early invasive cancer. 3. Up to now, there was no recurrence or death in the 25 patients with early-stage invasive cancer, and the median follow-up period was 21 months(range 2–59 months). 4. Glandular involvement(OR 3.968; 95%CI 1.244–12.662) and lesion range ≥ 3 quadrants (OR 6.527; 95% CI 1.78–23.931), HPV 16/18 infection (OR 5.382; 95%CI 1.947–14.872), TCT ≥ ASC-H (OR 4.719; 95%CI 1.892–11.766) were independent risk factors that affected the upgrading of postoperative pathology. 5. The area under the curve (AUC) calculated by the Logistic regression model was 0.840, indicating that the predictive value was good.

Conclusion
There is a risk of occult cervical cancer in patients with HSIL. Glandular involvement, Lesion range ≥ 3 quadrants, HPV 16/18 infection and TCT ≥ ASC-H are independent risk factors for HSIL combined with occult cervical cancer. The prognosis of biopsy-proved HSIL patients who underwent extrafascial hysterectomy and unexpected early invasive cancer was later identified on specimen may be good.
Associations of long-term fluctuation in blood pressure and ocular perfusion pressure with visual field progression in normal-tension glaucoma
Authors: Lee Na Young , Shin Da Young , Park Chan Kee 
Published: May 2024

Abstract
Backgroud
The aim of this study was to investigate the associations between fluctuation in blood pressure (BP), ocular perfusion pressure (OPP) and visual field (VF) progression in normal-tension glaucoma (NTG).

Methods
This prospective, longitudinal study included 44 patients with NTG. Only newly diagnosed NTG patients who had not been treated with a glaucoma medication were included. Patients were examined every year for 7 years. Intraocular pressure (IOP), heart rate (HR), systolic BP (SBP), diastolic BP (DBP), ocular perfusion pressure (OPP), and diastolic ocular perfusion pressure (DOPP) were measured at the same time. Ophthalmic examinations, including perimetry, were performed also. Initial VF were compared with follow-up data after 7 years.

Results
After 7 years of follow-up, 9 of the 44 patients showed VF progression. The standard deviation (SD) of SBP and OPP were significantly associated with VF progression (P = 0.007, < 0.001, respectively). Multiple regression analysis showed that VF progression was significantly associated with SD of OPP (odds ratio, OR = 2.012, 95% CI = 1.016–3.985; P = 0.045).

Conclusions
Fluctuation in OPP was associated with VF progression in patients with NTG.