bluuebunny/crossref_metadata_2025_split huggingface dataset:
High disparity in repellent gland anatomy across major lineages of stick and leaf insects (Insecta: Phasmatodea)
Authors: Niekampf Marco , Meyer Paul , Quade Felix S. C. , Schmidt Alexander R. , Salditt Tim , Bradler Sven 
Published: January 2024

Abstract
Background
Phasmatodea are well known for their ability to disguise themselves by mimicking twigs, leaves, or bark, and are therefore commonly referred to as stick and leaf insects. In addition to this and other defensive strategies, many phasmatodean species use paired prothoracic repellent glands to release defensive chemicals when disturbed by predators or parasites. These glands are considered as an autapomorphic trait of the Phasmatodea. However, detailed knowledge of the gland anatomy and chemical compounds is scarce and only a few species were studied until now. We investigated the repellent glands for a global sampling of stick and leaf insects that represents all major phasmatodean lineages morphologically via µCT scans and analyzed the anatomical traits in a phylogenetic context.

Results
All twelve investigated species possess prothoracic repellent glands that we classify into four distinct gland types. 1: lobe-like glands, 2: sac-like glands without ejaculatory duct, 3: sac-like glands with ejaculatory duct and 4: tube-like glands. Lobe-like glands are exclusively present in Timema, sac-like glands without ejaculatory duct are only found in Orthomeria, whereas the other two types are distributed across all other taxa (= Neophasmatodea). The relative size differences of these glands vary significantly between species, with some glands not exceeding in length the anterior quarter of the prothorax, and other glands extending to the end of the metathorax.

Conclusions
We could not detect any strong correlation between aposematic or cryptic coloration of the examined phasmatodeans and gland type or size. We hypothesize that a comparatively small gland was present in the last common ancestor of Phasmatodea and Euphasmatodea, and that the gland volume increased independently in subordinate lineages of the Occidophasmata and Oriophasmata. Alternatively, the stem species of Neophasmatodea already developed large glands that were reduced in size several times independently. In any case, our results indicate a convergent evolution of the gland types, which was probably closely linked to properties of the chemical components and different predator selection pressures. Our study is the first showing the great anatomical variability of repellent glands in stick and leaf insects.
Regulatory scoping exercise for the future adoption of autonomous inland ships in Europe
Authors: Orzechowski Sophie C. 
Published: January 2024

AbstractShipping is a heavily regulated sector, and autonomous ships will by no means be able to escape the public regulator’s agenda. Furthermore, regulatory adaptation is necessary because current laws oppose the introduction of this new technology. In contrast to maritime shipping, in which considerable regulatory work on autonomous ships has already been achieved, the process of adapting inland shipping regulations for autonomous vessels is rather slow, thereby considerably hindering the further development of the sector. An important reason for this is the multi-levelled regulatory institutional structure in European inland shipping, which consequently has less unified rules than its maritime counterpart. In addition, previous research on regulatory obstacles is highly fragmented and restricted in scope. This study presents a systematic regulatory analysis of relevant inland shipping regulations by following the approach adopted by the International Maritime Organisation with respect to maritime shipping regulations, with the objective of identifying potential obstacles in relevant regulatory instruments and common themes across them. It also discusses the existing possibilities under current European Union law for the exceptional operation of autonomous inland ships and describes the latest policy directions taken by the European legislator to foster innovation development within the sector.
Women in low- and middle-income countries receive antenatal care at health institutions, yet not delivered there: a multilevel analysis of 2016–2021 DHS data
Authors: Merid Mehari Woldemariam , Chilot Dagmawi , Yigzaw Zeamanuel Anteneh , Melesse Alemakef Wagnew , Ferede Menberesibhat Getie , Aragaw Fantu Mamo , Bitew Desalegn Anmut 
Published: January 2024

Abstract
Background
The institutional delivery dropout (IDD) is a major problem that disproportionately affects low- and middle-income countries (LMICs). It is associated with increased risks of adverse birth outcomes among pregnant women. Hence, this study assessed the pooled estimate and determinants of IDD after antenatal care (ANC) visit among women in LMICs.

Method
The Demographic and Health Survey (DHS) data from 29 LMICs were used for this study. Data analysis was performed with STATA version 14. The forest plot was used to estimate the pooled prevalence of IDD. Multilevel binary logistic regression was fitted to identify determinants of IDD. The statistical significance level between the outcome and independent variables was determined through the adjusted odds ratio (AOR) with 95% CI and p-value less than 0.05.

Result
The pooled prevalence of IDD after ANC booking among reproductive age women in LMICs was 22.25% (95%CI: 18.25, 26.25). Additionally, the prevalence of IDD was highest (29.83%) among women from the South and Central Europe and the Caribbean countries and lowest (13.72%) in Central/Western Asia and the Oceania.
In the multilevel analysis; no education (AOR = 2.92; 95% CI: 2.72, 3.13), poorest wealth index (AOR = 3.46; 95% CI: 3.28, 3.66), inadequate ANC visits (AOR = 1.73; 95% CI: 1.39, 1.77), no media exposure (AOR = 1.27; 95% CI: 1.23, 1.30), rural (AOR = 1.50; 95% CI: 1.43, 1.54), distance a big problem (AOR = 1.28; 95% CI: 1.25, 1.31), and women located in the South/Eastern Europe and Caribbean region 6.67 (AOR = 6.67; 95% CI: 6.20, 7.20), women lived in low-income countries 7.05 (AOR = 7.05; 95% CI: 6.57, 7.56), and women from lower middle-income countries 5.34 (AOR = 5.57; 95% CI: 4.93, 5.78), had increased odds of IDD after ANC among women in LMICs. However, women who had ever born one child (AOR = 0.29; 95% CI: 0.28, 0.31), and women from Central and Western Asia and the Oceania (AOR = 0.78; 95%CI: 0.74, 0.82) had decreased odds of IDD.

Conclusion
The IDD was high among women in LMICs and significantly increased among women with no education, from poorest household, had inadequate ANC visit, no media exposure, rural, distance a big problem. Hence, interventions to reduce IDD should focus on addressing the gaps related to maternal education, access to media, and number of ANC visits among women in LMICs.
Integrated health reporting within the UN architecture: learning from maternal, newborn and child health
Authors: Akselrod Svetlana , Collins Téa , Berlina Daria , Collins Amy , Allen Luke 
Published: January 2024

AbstractDespite a proliferation of the United Nations General Assembly high-level meetings on a range of health issues and developmental challenges, global funding continues to flow disproportionately to HIV and maternal, newborn and child health (MNCH). Using the experience of MNCH, this short article argues that successful human rights framing and the development of robust and regular reporting mechanisms in the international development architecture has contributed to these areas receiving attention. Taking non-communicable diseases (NCDs) as an example of a relatively neglected health area, we propose mechanisms that would improve integrated reporting of health issues in a way that aligns with the move toward cross-cutting themes and matching political and financial commitments with impact. As new frameworks are being developed to support multi-agency approaches to achieving SDG 3—including reporting and accountability—there are opportunities to ensure MNCH and NCDs jointly seek data collection measures that can support specific targets and indicators that link NCDs with early childhood development.
The use of patient reported outcome measures in oncology clinical practice across Australia and New Zealand
Authors: Maharaj Ashika D. , Roberts Natasha , Jefford Michael , Ng Jerome , Rutherford Claudia , Koczwara Bogda 
Published: January 2024

Abstract
Background
While there is increasing evidence on the benefits of PROMs in cancer care, the extent of routine collection and use of PROMs in clinical cancer practice across Australia and New Zealand (ANZ) is unknown. This study examined the prevalence and characteristics of PROMs use in routine clinical cancer care in ANZ.

Methods
An online survey was designed and disseminated via professional societies and organisations using a snowball sampling approach to clinical and health administration professionals managing cancer care in ANZ. A poster advertising the study was also circulated on professional social media networks via LinkedIn and Twitter inviting health professionals from ANZ to participate if they were using or intending to use PROMs in clinical cancer practice. Responders opted into the survey via the survey link.

Results
From 132 survey views, 91(response rate, 69%) respondents from 56 clinical practices across ANZ agreed to participate in the survey, and of these 55 (n = 55/91, 60%) respondents reported collecting PROMs within their clinical practice. The majority of the respondents were from the State of New South Wales in Australia (n = 21/55, 38%), hospital (n = 35/55, 64%), and a public setting (n = 46/55, 83%). PROMs were collected in all cancer types (n = 21/36, 58%), in all stages of the disease (n = 31/36, 86%), in an adult population (n = 33/36, 92%), applied in English (n = 33/36, 92%), and used to facilitate communication with other reasons (27/36, 75%). A geospatial map analysis provided insights into the variation in PROMs uptake between the two countries and in certain jurisdictions within Australia. This study also highlights the limited resources for PROMs implementation, and a lack of systematic priority driven approach.

Conclusion
PROM use across Australia and New Zealand seems variable and occurring predominantly in larger metropolitan centres with limited standardisation of approach and implementation. A greater focus on equitable adoption of PROMs in diverse cancer care settings is urgently needed.
Foraminal and far lateral lumbar disc herniation: outcome of unilateral full facetectomy with instrumented fusion
Authors: Elnaggar Ahmed Gabry , Habib Hosam Abdel-Azim 
Published: January 2024

Abstract
Background
Far lateral lumbar disc herniation is a clinical condition characterized by nerve root compression out of the spinal canal, in its extraforaminal/extracanalicular course at the inferior or lateral aspect of the facet joint.

Objective
To analyze the effect of unilateral full facetectomy with instrumented fusion in management of foraminal and far lateral lumbar disc herniation.

Methods
This retrospective trial carried out on 34 cases (24 males, 10 females) aged from 27 to 68, with mean value of 49 years who were entered to the Neurosurgery Department, Menoufia University Hospital from January 2018 and January 2022. All patients suffered from foraminal and/or far lateral lumbar disc herniation and were treated with unilateral full facetectomy with instrumented fusion.

Results
The herniation level was at L2-3, L3-4, L4-5, and L5-S1 in 2, 10, 18, and 4 patients, respectively. Overall, the mean preoperative VAS score decreased from 8.6 to 2.3 in the short-term. When the long-term functional outcome following surgery was analyzed according to the MacNab Criteria, the recovery was excellent, good, fair, and poor in 26, 8, 0, and 0, respectively.

Conclusions
Full facetectomy ± laminectomy technique provides direct visualization of the complete course of the nerve root extending far laterally to avoid missed disc fragments and protect the nerve root from inadvertent trauma. Pedicle fixation for stabilization following full facetectomy has been indicated to avoid postoperative pain syndromes due to `micro-instability'.
Evaluation of the effect of ozonated water in treatment of denture stomatitis associated with removable prosthetics
Authors: Mostafa Basma , Elboraey Asmaa Nabil , El-Masry Hossam M. , Dehis Wessam M. 
Published: January 2024

Abstract
Background
Ozone therapy is highly demarcated in the dental field owing to its efficient antimicrobial action in its gaseous and aqueous forms. One of the most common difficulties accompanied by utilizing dentures is denture stomatitis (DS) which is principally triggered by Candida albicans (C. albicans).

Objectives
Assessing and comparing the impact of ozonated water versus chlorhexidine mouthwash on healing of intra-oral inflammations associated with complete dentures.

Subjects and methods
Fifty middle-aged male completely edentulous patients wearing complete dentures were screened for the possibility of having any accompanied DS and/or C. albicans. Patients were randomly distributed into two groups. Group I patients were treated with chlorhexidine mouthwash and oral hygiene measures (OHM); while, Group II patients received ozonated water as a mouthwash and OHM. Evaluation of inflammation, pain grade, and oral Candidiasis count took place for all patients in all visits; from the initial day of treatment and after 7, 14, and 30 days.

Results
The inflammation’s area and severity together with pain grade showed a significant decrease with time when using both chlorhexidine mouthwash and ozonated water. Comparing the use of chlorhexidine mouthwash and ozonated water together showed insignificant differences. Regarding the Candida forming units (CFU) there was a significant decrease in the colonies number over time, but with insignificant difference between the two groups.

Conclusions
Ozonated water showed favorable results in reducing the area and severity of inflammation and pain grade. Ozonated water has an antifungal effect and can be used as an alternative mouth rinse in treating denture stomatitis.
Predictors associated with symptoms of depression & anxiety during the COVID-19 among MENA immigrants in Houston, Texas
Authors: Zamil Jenna , Fatima Bilqees , Yazdanfard Sahar , Atrooz Fatin , Abughosh Susan , Salim Samina 
Published: January 2024

AbstractVery limited knowledge is available regarding the mental health of the immigrant population in the USA. We aim to assess the factors affecting the mental health of immigrants living in Houston from war-inflicted and stable countries of Middle Eastern and North African (MENA) origin during the pandemic. This cross-sectional study was conducted among the MENA immigrants using a validated survey of sociodemographic, general health, and COVID-19 questions. Multivariable logistic regression models assessed sociodemographic and clinical predictors of depression and anxiety. The outcome of interest was categorized as “moderate or severe” versus “minimal or mild” for depression and anxiety. Total of 94 participants completed the study, with the sample rate of "moderate or severe" symptoms of anxiety and depression being 29.78% and 64.89%, respectively. Multivariable regression analysis for depression showed that immigrants from war-inflicted countries of origin were less likely to report “moderate or severe” depression compared to immigrants from stable countries (OR = 0.082, 95% CI 0.012–0.551). Individuals with excellent overall health (OR = 0.074, 95% CI = 0.013–0.414) had a significantly lower likelihood of “moderate or severe” depression than those who reported fair/poor health. Non-smokers (OR = 0.068, 95% CI = 0.012–0.377) were less likely to report “moderate or severe” depression in comparison to those who engage in smoking behavior. Participants who responded to the question that they tried hard to avoid thoughts of COVID-19 were less likely to have symptoms of “moderate or severe” depression compared to participants who responded, “No” (OR = 0.110, 95% CI = 0.017–0.712). Those who have” excellent/good knowledge” (OR = 0.0146, 95% CI = 0.022–0.946) about the prevention of COVID-19 spread were less likely to have “moderate or severe” depression compared to those who had “average/poor/terrible”. Multivariable regression analysis revealed smoking as a significant predictor of anxiety, with non-smokers demonstrating a lower likelihood of experiencing "moderate or severe" anxiety than smokers (OR = 0.21, 95% CI = 0.06–0.84). MENA immigrant communities in the USA have diverse immigration experiences, cultural backgrounds, and instability issues in their home countries, possibly elevating the risk of depression and anxiety during the COVID-19 crisis. Predictors identified should be considered by policymakers when developing targeted interventions to ensure the mental and social well-being of immigrant communities in the USA.
Morphological and molecular assessment of Livoneca redmanii Leach, 1818, and Anilocra alloceraea Koelbel, 1878 (Isopoda: Cymothoidae) from Egyptian waters
Authors: Zayed Osama El-Sayed , Hellal Ahmed Metwally , Zeina Amr Farag , Tayel Safaa Ismail , El‑Tabakh Mohamed A. M. 
Published: January 2024

Abstract
Background
Two cymothoid isopod species, Livoneca redmanii Leach, 1818 and Anilocra alloceraea Koelbel, 1878, have been discovered throughout the research period. These species have been morphologically compared to other closely related species. Their species sequences have been determined using mitochondrial cytochrome c oxidase subunit I (COI) gene fragments and compared to previously identified Livoneca and Anilocra species. The present study aims to provide a detailed morphological description along with parasitological indices of the L. redmanii species in the Mediterranean, which has previously been described in Egypt by several researchers using various misidentifications.

Results
According to the study findings, Livoneca redmanii was accidentally introduced into Qarun Lake with fish fry from the Mediterranean Sea. The morphological and parasitological descriptions of Anilocra alloceraea and L. redmanii are discussed. Additionally, A. alloceraea species is considered the first to be documented on the Egyptian marine coast.

Conclusions
Livoneca redmanii species can rapidly adapt to favorable conditions and be found among the most prevalent species in Egyptian marine environments. Our study supports the description of L. redmanii males, as well as some additional morphological features of both cymothoid species females. The discovery of these species in Egyptian waters has extended their geographic distribution. Additionally, this study marks a significant advancement in our knowledge of the dynamics of some parasitic isopod distribution among their preferred species as well as a critical step toward identifying the species that indeed inhabit Egyptian waters.
Patients with longstanding psoriatic arthritis can achieve DAPSA remission or low disease activity and it correlates to better functional outcomes: results from a Latin-American real-life cohort
Authors: Cruz Larissa Vargas , Farani Júlia Boechat , Costa Júlia Rabello , de Andrade Águas João Victor , Ruschel Bruna , de Almeida Menegat Franciele , Gasparin Andrese Aline , Brenol Claiton Viegas , Kohem Charles Lubianca , Bessa Adrieli , Forestiero Francisco , Thies Felipe , Palominos Penélope Esther 
Published: January 2024

Abstract
Background
Patients with psoriatic arthritis (PsA) experience reduced physical function and impaired quality of life. Better patient-reported functional outcomes are found when lower disease activity is achieved.

Objectives
To evaluate the variation of physical function by HAQ-DI over time in PsA patients treated with standard therapy in a real-life setting: to verify predictors of achieving a minimum clinically important difference (MCID) in function by HAQ-DI (ΔHAQ-DI ≤ − 0.35) and to measure the impact of achieving REM/LDA on long-term function by HAQ-DI.

Methods
This is a longitudinal analysis of a real-life retrospective cohort. Data from PsA patients with at least 4 years of follow-up in the PsA clinic from 2011 to 2019 were extracted from electronic medical records. The variations of physical function by HAQ-DI and disease activity by DAPSA over time were calculated. A multivariate hierarchical regression model was applied to verify predictors of MCID in HAQ-DI. A comparison of HAQ-DI variation between patients with DAPSA REM, LDA, moderate and high disease activity was made using the generalized estimating equation model (GEE), adjusted by Bonferroni test. The Spearman correlation method was applied to verify the correlation of ΔDAPSA and ΔHAQ-DI over time. Statistical analysis was performed in SPSS program version 21.0.

Results
Seventy-three patients were included in the analysis. Physical function measured by HAQ-DI was determined by PsA disease activity measured by DAPSA (p < 0.000). A moderate and statistically significant correlation between ΔDAPSA and ΔHAQ-DI was observed (rs = 0.60; p < 0.001). Only patients in DAPSA REM demonstrated a constant decline in HAQ-DI scores during the follow-up. White ethnicity and older age at baseline were predictors for not achieving MCID in HAQ-DI [RR 0.33 (0.16–0.6795% CI p = 0.002) and RR 0.96 (0.93–0.9895% CI p < 0.000), respectively, while higher scores of HAQ-DI at baseline were predictors of achieving MCID [RR 1.71 (1.12–2.6095%CI p = 0.013)].

Conclusions
In PsA, patients who maintained DAPSA REM/LDA over time had better long-term functional outcomes. Higher HAQ-DI scores at baseline, non-white ethnicity and younger age were predictors for achieving a clinical meaningful improvement of HAQ-DI.
The randomized clinical trial trustworthiness crisis
Authors: Butt Furqan A. , Fawzy Mohammad , Al Wattar Bassel H. , Bueno-Cavanillas Aurora , Khan Khalid S. , Khalaf Yacoub 
Published: January 2024

Abstract
Background
The rising number of retracted randomised clinical trials (RCTs) is a concern over their trustworthiness. In today's digital landscape electronic observational data is easily accessible for research purposes. This emerging perspective, in tandem with the growing scrutiny of RCT credibility, may steer some researchers towards favouring non-randomized studies. It is crucial to emphasize the ongoing need for robust RCTs, shedding light on the areas within trial design that require enhancements and addressing existing gaps in trial execution.

Main body
Evidence-based medicine pivots on the nexus between empirical medical research and the theoretical and applied facets of clinical care. Healthcare systems regularly amass patient data, creating a vast reservoir of information. This facilitates large-scale observational studies, which may appear as potential substitutes for RCTs. These large-scale studies inherently possess biases that place them a notch below randomized evidence. Honest errors, data manipulation, lapses in professionalism, and methodological shortcomings tarnish the integrity of RCTs, compromising trust in trials. Research institutions, funding agencies, journal editors and other stakeholders have the responsibility to establish robust frameworks to prevent both deliberate and inadvertent mishandling of RCT design, conduct and analysis. Systematic reviews that collate robust RCTs are invaluable. They amalgamate superior evidence instrumental in improving patient outcomes via informed health policy decisions. For systematic reviews to continue to retain trust, validated integrity assessment tools must be developed and routinely applied. This way it will be possible to prevent false or untrustworthy research from becoming part of the recommendations based on the evidence.

Conclusion
High-quality RCTs and their systematic reviews play a crucial role in acquiring valid and reliable evidence that is instrumental in improving patient outcomes. They provide vital information on healthcare effectiveness, and their trustworthiness is key to evidence-based medicine.