bluuebunny/crossref_metadata_2025_split huggingface dataset:
Emergency contraceptive use of Metronidazole among University female students in Dodoma region of Tanzania: a descriptive cross-sectional study
Authors: Samson Nipael M. , Sumari Emmanuel Izack , Ndesendo Valence , Mbwasi Romuald 
Published: August 2023

Abstract
Background
Metronidazole is known for its therapeutic effect as antibacterial and anti-parasitic. However, its toxicity on the reproductive system remains unclear. Metronidazole use in rodents is associates with toxic effects on the reproductive system, including hormonal alterations, reduced number of fertile cells and reduced sites for implantation, size of the placental disc area, constituent elements of the labyrinth, and spongiotrophoblast layers. Its use at a therapeutic dose among humans has been associated with an increased risk of spontaneous abortion. The effects on the reproductive system in humans may result in misconceptions about contraceptive effects hence sexually active individuals like students who, for any reason, fail to access safe contraceptive services use any possible methods to protect them from conception. This study aims to investigate the unofficial (un-prescribed) use of Metronidazole as an emergency contraceptive and some of its associated factors.

Methods
This quantitative cross-sectional study involved 470 participants where stratified random sampling technique was used to obtain the sample from three educational institutions in the Dodoma Municipal, Dodoma region. Collected data were analyzed using SPSS version 25, descriptive statistical analysis was done to determine frequencies, percentages, and association, p < 0.05 was used to determine statistical significance. Further analysis using Multivariate binary logistic regression was done to determine the nature of the association between the study variables.

Results
The finding shows that 169(62.4%) use Metronidazole as an emergency contraceptive. Notably, 345(73.4%) stated that they had ever heard someone use Metronidazole for contraception, especially their peers. Furthermore, an increase in the year of study was significantly associated with reduced use of Metronidazole as an emergency contraceptive (B = [-0.45], p = [0.02]). Furthermore, an increase in age, studying in non-medical college/university, the experience of using contraceptive methods, and hearing someone ever used Metronidazole was found to be positively associated with its use as an emergency contraceptive, although not statistically significant.

Conclusion
Metronidazole was found to be used as an emergency contraceptive in high doses, different factors associated with its use, and reasons influencing its use. Further research may be done to explore the toxicological effect of high doses of Metronidazole as a contraception and compare the efficiency of Metronidazole over other emergency contraceptives.
Characterization of Somatotrope Cell Expansion in Response to GHRH in the Neonatal Mouse Pituitary
Authors: Gonigam Richard L , Weis Karen E , Ge Xiyu , Yao Boyuan , Zhang Qilin , Raetzman Lori T 
Published: August 2023

Abstract
In humans and mice, loss-of-function mutations in growth hormone–releasing hormone receptor (GHRHR) cause isolated GH deficiency. The mutant GHRHR mouse model, GhrhrLit/Lit (LIT), exhibits loss of serum GH, but also fewer somatotropes. However, how loss of GHRH signaling affects expansion of stem and progenitor cells giving rise to GH-producing cells is unknown. LIT mice and wild-type littermates were examined for differences in proliferation and gene expression of pituitary lineage markers by quantitative reverse transcription polymerase chain reaction and immunohistochemistry at postnatal day 5 (p5) and 5 weeks. At p5, the LIT mouse shows a global decrease in pituitary proliferation measured by proliferation marker Ki67 and phospho-histone H3. This proliferative defect is seen in a pituitary cell expressing POU1F1 with or without GH. SOX9-positive progenitors show no changes in proliferation in p5 LIT mice. Additionally, the other POU1F1 lineage cells are not decreased in number; rather, we observe an increase in lactotrope cell population as well as messenger RNA for Tshb and Prl. In the 5-week LIT pituitary, the proliferative deficit in POU1F1-expressing cells observed neonatally persists, while the number and proliferative proportion of SOX9 cells do not appear changed. Treatment of cultured pituitary explants with GHRH promotes proliferation of POU1F1-expressing cells, but not GH-positive cells, in a mitogen-activated protein kinase–dependent manner. These findings indicate that hypothalamic GHRH targets proliferation of a POU1F1-positive cell, targeted to the somatotrope lineage, to fine tune their numbers.
OS RETIRANTES DE PORTINARI Uma Estética da Miséria, da Fome e da Morte
Authors: Ferreira Gilmar Leite 
Published: August 2023

O presente artigo intitulado Os Retirantes de Portinari: uma estética da miséria, da fome e da morte é uma intepretação fundamentada na filosofia de Merleau-Ponty, na literatura e na educação, tendo como método a descrição fenomenológica. O objetivo é a experiência sensível como uma educação do olhar sobre a obra de arte. Nesse sentido, convido o leitor, por meio da linguagem sensível, para entrar através da escrita em alguns quadros de Portinari e perceber o êxodo, a miséria, a fome e a morte, revelando a estética assustadora dos corpos esquálidos dos sertanejos. Através de uma escrita poética e interdisciplinar, narro à jornada do desespero na extrema metafísica dos corpos expressivos dos sertanejos, nos quais, uma ontologia da vida revela-se na tragédia da fome, diante da ameaça da morte. Nessa perspectiva, o sofrimento e a morte são transubstanciados nas cores e nos desenhos dos quadros do Portinari. Como resultado, o compreendo as causas do êxodo, não é apenas por questões climáticas, mas a opressão do latifúndio e o descaso dos governos, nos séculos passados.
Low readmission and reattendance rate in day-case total knee arthroplasties
Authors: Fishley William G. , Paice Sarah , Iqbal Haaris , Mowat Stephen , Kalson Nicholas S. , Reed Mike , Partington Paul , Petheram Timothy G. 
Published: August 2023

AimsThe rate of day-case total knee arthroplasty (TKA) in the UK is currently approximately 0.5%. Reducing length of stay allows orthopaedic providers to improve efficiency, increase operative throughput, and tackle the rising demand for joint arthroplasty surgery and the COVID-19-related backlog. Here, we report safe delivery of day-case TKA in an NHS trust via inpatient wards with no additional resources.MethodsDay-case TKAs, defined as patients discharged on the same calendar day as surgery, were retrospectively reviewed with a minimum follow-up of six months. Analysis of hospital and primary care records was performed to determine readmission and reattendance rates. Telephone interviews were conducted to determine patient satisfaction.ResultsSince 2016, 301/7350 TKAs (4.1%) in 290 patients at our institution were discharged on the day of surgery. Mean follow-up was 31.4 months (6.2 to 70.0). In all, 28 patients (9.3%) attended the emergency department or other acute care settings within 90 days of surgery, most often with wound concerns or leg swelling; six patients (2.0%) were readmitted. No patients underwent a subsequent revision procedure, and there were no periprosthetic infections. Two patients (0.7%) underwent secondary patella resurfacing, and one patient underwent arthroscopic arthrolysis after previous manipulation under anaesthetic (MUA). Three patients (1.0%) underwent MUA alone. Primary care consultation records, available for 206 patients, showed 16 patients (7.8%) contacted their general practitioner within two weeks postoperatively; two (1.0%) were referred to secondary care. Overall, 115/121 patients (95%) telephoned stated they would have day-case TKA again.ConclusionDay-case TKA can be safely delivered in the NHS with no additional resources. We found low incidence of contact with primary and secondary care in the postoperative period, and high patient satisfaction.Cite this article: Bone Jt Open 2023;4(8):621–627.
Laboratory evaluation of eleven rapid diagnostic tests for serological diagnosis of Chagas disease in Colombia
Authors: Marchiol Andrea , Florez Sanchez Astrid Carolina , Caicedo Andrés , Segura Maryi , Bautista Jessica , Ayala Sotelo Martha Stella , Herazo Rafael , Forsyth Colin , Bohorquez Laura C. 
Published: August 2023

Background
Chagas disease is a public health challenge in Colombia, where only an estimated 1.2% of people at risk have accessed diagnosis, while less than 0.5% of affected people have obtained treatment. The development of simplified diagnostic algorithms would enable progress in access to diagnosis; however, the current diagnostic algorithm relies on at least two laboratory-based tests that require qualified personnel, processing equipment, and infrastructure, which are still generally lacking at the primary care level. Rapid diagnostic tests (RDTs) for Chagas disease could simplify diagnosis, but their performance in the epidemiological context of Colombia is not well known.

Methodology
A retrospective analytical observational study of RDTs was performed to estimate the operational characteristics of 11 commercially available RDTs designed for in vitro detection of anti-T. cruzi IgG antibodies. The study was performed under controlled laboratory conditions using human serum samples.

Principal findings
Eleven RDTs were assessed, ten using 585 serum samples and one using 551 serum samples. Employing the current national diagnostic algorithm as a reference standard for serological diagnosis of chronic infection, the sensitivity of the assessed RDTs ranged from 75.5% to 99.0% (95% CI 70.5–100), while specificity ranged from 70.9% to 100% (95% CI 65.3–100). Most tests (7/11, 63.6%) had sensitivity above 90%, and almost all (10/11, 90.9%) had specificity above 90%. Five RDTs had both sensitivity and specificity above 90%.

Conclusions/Significance
The evaluation of these 11 commercially available RDTs under controlled laboratory conditions is a first step in the assessment of the diagnostic performance of RDTs in Colombia. As a next step, field studies will be conducted on available RDTs with sensitivity and specificity greater than 90% in this study, to evaluate performance in real world conditions, with the final goal to allow simplified diagnostic algorithms.
Scabies prevalence after ivermectin-based mass drug administration for lymphatic filariasis, Samoa 2018–2019
Authors: Willis Gabriela A. , Kearns Therese , Mayfield Helen J. , Sheridan Sarah , Thomsen Robert , Naseri Take , David Michael C. , Engelman Daniel , Steer Andrew C. , Graves Patricia M. , Lau Colleen L. 
Published: August 2023

Background
Scabies is a common skin infestation caused by the Sarcoptes scabei mite. Ivermectin, one of three drugs used in mass drug administration (MDA) for lymphatic filariasis, is also effective for treating scabies. Ivermectin-based MDA was first conducted in Samoa in August 2018, with ivermectin being offered to those aged ≥5 years. Here, we report scabies prevalence in Samoa after MDA.

Methods
We conducted household surveys 1.5–3.5 months (Survey 1) and 6–8 months (Survey 2) after the 2018 MDA in 35 primary sampling units. We conducted clinical examination for scabies-like rash and used International Alliance for the Control of Scabies classification criteria. We estimated scabies prevalence by age, gender and region. Multivariable logistic regression was used to assess factors associated with prevalence.

Results
We surveyed 2868 people (499 households) and 2796 people (544 households) aged 0–75 years in Surveys 1 and 2, respectively. Scabies prevalence increased from 2.4% (95% CI 2.1–2.7%) to 4.4% (95% CI 4.0–4.9%) between surveys. Scabies was associated with younger age (0–4 years: aOR 3.5 [2.9–4.2]; 5–15 years: aOR 1.6 [1.4–1.8] compared to ≥16 years), female gender (aOR 1.2 [95% CI 1.1–1.4]; region (aOR range from 1.4 [1.1–1.7] to 2.5 [2.1–3.1] between regions), large households (aOR 2.6 [2.0–3.4] households ≥13), and not taking MDA in 2018 (aOR 1.3 [95% CI 1.1–1.6]).

Conclusions
We found moderate prevalence of scabies in two population-representative surveys conducted within 8 months of the 2018 MDA for lymphatic filariasis. Prevalence appeared to increase between the surveys, and ongoing surveillance is recommended, particularly in young children.
Novel on-site follow-up and enhancement program (FEP) improves knowledge, clinical skills and enabling environment of skilled birth attendants in Nepal
Authors: Thapa R. , Nikolli K. , McMahon D. , Blakemore S. , Tamang S. , Bhatta S. , Gautam P. , Shrestha R. , Rajbhandari R. 
Published: August 2023

Introduction
Although great strides have been made in maternal and newborn health in Nepal, the maternal mortality ratio (MMR) is still high at 186 per 100,000 births. Many maternal deaths are preventable if there is access to a skilled birth attendant (SBA). The Ministry of Health and Population of Nepal launched the in-service SBA training program in 2007 and has trained over 10,000 SBAs to date. Evidence shows that one episode of training is not enough to retain skills. Therefore, the Nick Simons Institute (NSI) in collaboration with National Health Training Center (NHTC) devised a Follow-Up and Enhancement Program (FEP) in 2011 where the knowledge, clinical skills, and working environment of SBA graduates were assessed directly at their worksites. FEP allows on-site coaching and feedback so that graduates may continue to improve upon any gaps in their knowledge, skills, and working environment. This study aims to assess the effectiveness of FEP.

Methods
We used a mixed-methods research design. A total of 73 SBAs who had a pre-FEP assessment in 2016 were followed up for a post-FEP assessment in 2017. We also collected data from 3 additional districts (115 SBAs) that had not previously had FEP, to compare SBAs in FEP versus non-FEP districts. Qualitative data was collected from 16 health facilities on the perceptions, motivation, and satisfaction of stakeholders.

Results
Of the total 188 SBAs that were sampled, a one-time FEP increased knowledge scores by 9%, clinical skills scores by 29%, and enabling environment scores by 7%. The number of deliveries conducted improved with a one-time FEP, although this increase was not statistically significant. We found a trickle-down effect of working in a facility that has had prior FEP, with SBAs that have never had FEP improving their clinical skills. FEP was found to be a highly accepted program and is beneficial to SBAs, trainers, and the Hospital Management Committee (HFOMC). However, a one-time FEP is not sufficient in retaining clinical skills and knowledge.

Conclusion
FEP is a highly effective program by both quantitative and qualitative evaluation. Our study suggests that FEP should be frequent and continuous to retain the knowledge and clinical skills of SBAs, motivate them through on-site coaching, and improve their working environment through direct feedback to the Ministry of Health and Population.
Development of a Core Outcome Set for the research and assessment of inoperable malignant bowel obstruction
Authors: Bravington Alison , Obita George , Baddeley Elin , Johnson Miriam J. , Murtagh Fliss E. M. , Currow David C. , Boland Elaine G. , Nelson Annmarie , Seddon Kathy , Oliver Alfred , Noble Simon I. R. , Boland Jason W. 
Published: August 2023

Background
Malignant bowel obstruction is experienced by 15% of people with advanced cancer, preventing them from eating and drinking and causing pain, nausea and vomiting. Surgery is not always appropriate. Management options include tube or stent drainage of intestinal contents and symptom control using medication. Published literature describing palliative interventions uses a broad range of outcome measures, few of which are patient-relevant. This hinders evidence synthesis, and fails to consider the perspectives of people undergoing treatment.

Aims
To develop a Core Outcome Set for the assessment of inoperable malignant bowel obstruction with clinician, patient and caregiver involvement, using COMET methodology (Core Outcome Measures in Effectiveness Trials).

Methods
A systematic review of clinical trials and observational studies, a rapid review of the qualitative literature and in-depth patient and clinician interviews were conducted to identify a comprehensive list of outcomes. Outcomes were compared and consolidated by the study Steering Group and Patient and Public Involvement contributors, and presented to an international clinical Expert Panel for review. Outcomes from the finalised list were rated for importance in a three-round international Delphi process: results of two survey rounds were circulated to respondents, and two separate consensus meetings were conducted with clinicians and with patients and caregivers via virtual conferencing, using live polling to reach agreement on a Core Outcome Set.

Results
130 unique outcomes were identified. Following the independent Expert Panel review, 82 outcomes were taken into round 1 of the Delphi survey; 24 outcomes reached criteria for critical importance across all stakeholder groups and none reached criteria for dropping. All outcomes rated critically important were taken forward for re-rating in round 2 and all other outcomes dropped. In round 2, all outcomes were voted critically important by at least one stakeholder group. Round 2 outcomes were presented again at online consensus meetings, categorised as high ranking (n = 9), middle ranking (n = 7) or low ranking (n = 8). Stakeholders reached agreement on 16 core outcomes across four key domains: Symptom control, Life impact, Treatment outcomes, and Communication and patient preferences.

Conclusion
Use of this Core Outcome Set can help to address current challenges in making sense of the evidence around treatment for inoperable malignant bowel obstruction to date, and underpin a more robust future approach. Clearer communication and an honest understanding between all stakeholders will help to provide a basis for responsible decision-making in this distressing situation in clinical practice.
Flipping the script? Native-speaker linguists and colonial orthographies in nineteenth-century Senegal
Authors: Calhoun Doyle 
Published: August 2023

Abstract
Throughout the nineteenth century, Senegal was the site of some of the most extensive French experiments with alphabetic print literacy in African languages, especially Wolof. Before the advent of the International Phonetic Alphabet (IPA), authors such as Jean Dard, Jacques-François Roger, Aloïs Kobès, David Boilat, Louis Faidherbe, and Louis Descemet experimented with Latin-scripted orthographies for representing the sounds of Wolof. This article focuses on the contributions of Boilat and Descemet, both members of prominent multilingual métis families in Saint-Louis and native speakers of Wolof. Even as they expressed deference to their predecessors, Boilat and Decemet asserted their intuitions as native speakers, challenging dominant colonial “scripts” by authoring their own texts and proposing their own orthographies. I read their nineteenth-century analyses of Wolof as important, if understudied, contributions to the history of phonetics by situating their works within the politics of colonial alphabet schemes.
Weighted sparsity regularization for source identification for elliptic PDEs
Authors: Elvetun Ole Løseth , Nielsen Bjørn Fredrik 
Published: August 2023

Abstract
This investigation is motivated by PDE-constrained optimization problems arising in connection with electrocardiograms (ECGs) and electroencephalography (EEG).
Standard sparsity regularization does not necessarily produce adequate results for these applications because only boundary data/observations are available for the identification of the unknown source, which may be interior.
We therefore study a weighted

ℓ
1

\ell^{1}

-regularization technique for solving inverse problems when the forward operator has a significant null space.
In particular, we prove that a sparse source, regardless of whether it is interior or located at the boundary, can be exactly recovered with this weighting procedure as the regularization parameter 𝛼 tends to zero.
Our analysis is supported by numerical experiments for cases with one and several local sources.
The theory is developed in terms of Euclidean spaces, and our results can therefore be applied to many problems.
Innovációs ökoszisztémák betelepülési intenzitásának vizsgálata
Authors: Tóth Csilla , Háry András 
Published: August 2023

A TANULMÁNY CÉLJA
Az innovációs ökoszisztémákat a kapcsolódó kutatások rendszerint az innovációs környezet leírásának egyik módjaként tekintik. A kifejezés mára nemcsak egyes technológiai cégek programjaihoz és ágazatokhoz kötődő térségfejlesztési kezdeményezésekhez köthető, hanem földrajzilag koncentrált ökoszisztémák jellemzésére is szolgál. Az innovációs ökoszisztémákkal kapcsolatos korai kutatások vezettek el a tudományos és innovációs parkok fogalmi megalapozásához. Ezek olyan innovációs környezetet teremtenek, amely keret ad a különböző szereplők tudásalapú, innovációorientált fejlődéséhez, különös tekintettel a közöttük kialakuló együttműködésekre. A kapcsolódó kutatások és irodalmi definíciók alapján megállapítható, hogy az innovációs ökoszisztéma nem egy abszolút fogalom, annak a gyakorlatban többféle megjelenési formája létezik. A jelen kutatás a tudományos és innovációs parkok oldaláról vizsgálja az innovációs ökoszisztémák egyes sajátosságait. A kutatás célja megvizsgálni, hogy milyen összefüggés van a különböző típusú innovációs ökoszisztémák és a parkba betelepülők száma és az ökoszisztéma kora között.
ALKALMAZOTT MÓDSZERTAN
Elsőként a kapcsolódó kutatások fogalmi megközelítéseinek áttekintése alapján meghatározásra kerültek az alapvető innovációs ökoszisztéma típusok. Ezt követően a vizsgálat feldolgozta 92 európai tudományos és innovációs park jellemző adatait és a releváns információkat, amelyek alapján a parkok besorolásra kerültek a meghatározott ökoszisztéma típusokba. A vizsgálat során az egyes típusokhoz kapcsolódóan vizsgálta a kutatás a parkok kora és a betelepültek száma közötti összefüggést, és ennek alapján értelmezte a parkok típusai közötti eltéréseket.
LEGFONTOSABB EREDMÉNYEK
A kutatás eredményei az egyes innovációs ökoszisztéma típusokhoz kapcsolódóan rámutattak az eltérő betelepülési intenzitásra, mint egyik fontos jellemzőre. Ennek kutatási jelentősége, hogy ad egy támpontot a park jellegű innovációs ökoszisztémák megkülönböztetésére, és az eltérő jegyek alapján a különböző parki fejlődési pályák jobb megértésére, mint a szakirodalomban kevésbé kutatott terület.
GYAKORLATI JAVASLATOK
A kutatás eredményei nyomán, a vizsgálat eredményei alapján kijelölhetők azok a további kutatási irányok, amelyek mentén az ökoszisztémák típusai, a betelepülési intenzitáshoz kapcsolódó faktorok vagy egyéb ökoszisztéma jellemzők tovább vizsgálhatók. A kutatás gyakorlati szerepe, hogy indikációt ad a parki menedzsment számára a mérvadó betelepülési rátára, illetve egy támpontot park fejlesztési stratégiájának kialakításához.

Köszönetnyilvánítás: „Jelen kutatás Az Innovációs és Technológiai Minisztérium KDP-2021 kódszámú Kooperatív Doktori Program Doktori Hallgatói Ösztöndíj Programjának a Nemzeti Kutatási, Fejlesztési és Innovációs Alapból finanszírozott szakmai támogatásával készült.”