bluuebunny/crossref_metadata_2025_split huggingface dataset:
Prevalence of discontinuation of contraceptives due to failure among women aged 14 to 49 years in Uganda: a nation wide cross-sectional survey
Authors: Kisuza Ruth Ketty , Kicaber Saviour , Abila Derrick Bary , Bongomin Felix , Garimoi Christopher Orach 
Published: February 2023

Abstract
Background
Sustained motivation is essential for effective use of contraceptive methods by women in low- and middle-income countries as many women are likely to abandon contraceptives, especially when they continually experience episodes of failure. We aimed to determine the prevalence of discontinuation of contraceptives due to failure and its associated factors among Ugandan women aged 14–49 years.

Methods
A cross sectional study was conducted using the UDHS 2016 data. Multi stage stratified sampling was used to select participants. All eligible women aged 15 to 49 years at the time of the survey were enrolled. Bivariable and Multivariable logistic regression analysis were used to determine the factors associated with contraceptive failure. All analysis were done using Stata version 13. Contraceptive failure (getting pregnant while on contraceptives) within five years preceding the survey was the dependent variable.

Results
A total of 9061 women were included in the study. The overall prevalence of contraceptive failure was 5.6% [n = 506, 95% CI: 5.1–6.1] and was higher (6.2%) among women aged 20–29 years or had completed secondary education (6.1%). Having informed choice on contraceptives [aOR = 0.59, 95% CI: 0.49 – 0.72] and older age [aOR = 0.46, 95% CI: 0.24–0.89] were associated with lower odds of contraceptive failure.

Conclusion
The burden of contraceptive failure among women of reproductive age in Uganda is substantial and significantly varied by women's age, level of education, exposure to the internet, mass media, and informed choice. These findings highlight the need for improved counseling services and contraceptive quality to help women and couples use methods correctly and consistently.
Cytotoxicity associated with acute and chronic administration of synthetic cannabinoids “Strox” in the brain, liver, heart, and testes of male albino rats: histological and immunohistochemical study
Authors: Abdelmoneim Wafaa M. , Bakr Marwa H. , Ghandour Nagwa M. , Mohammed Marwa Kh. , Fawzy Mohamed , Ramadan Abdelrahman G. , Abdellah Nora Z. 
Published: February 2023

Abstract
Background
Synthetic cannabinoids are one of the largest groups of new psychoactive substances that invaded Egypt’s drug abuse market over the past few years.

Aim
Randomized controlled trial study to demonstrate the effects of acute and chronic toxicity by synthetic cannabinoid (Strox) on the brain, liver, heart, and testes in adult male albino rats through histopathological examination by light microscope and immunohistochemistry.

Methods
Total number of fifty male albino rats were divided into five different groups, two control and three treated groups. Negative and positive control groups received distilled water and dimethyl sulfoxide, respectively, acute group received LD50 (lethal dose 50) once and observed for 14 days, chronic group received 1/10 LD50 for 3 months, and finally chronic withdrawal groups received 1/10 LD50 for 3 months and then left 2 weeks without the substance to observe the withdrawal manifestations.

Results
The current study revealed various histopathological changes in all organs with increased expression of cannabinoid receptor 1. The most important findings observed by light microscope examination were shrinkage and degenerative changes in Purkinje cells in brain sections, abnormalities in blood sinusoids and architecture in liver section, disruption in cardiac muscle fiber in heart sections, and finally testes showed irregularities in seminiferous tubules and germinal cells. Immunohistochemical staining for caspase-3 in the brain, liver, and heart showed weak-positive reaction in acute group and a strong reaction with chronic groups. Additionally, increase in collagen fiber was observed in sections of the liver and heart of chronic group.

Conclusions
Synthetic cannabinoid sample (Strox) toxicity caused adverse effects on the brain, liver, heart, and testes as shown by increasing cannabinoid receptor 1 and caspase-3 expression.
The impact of regional deprivation on stroke incidence, treatment, and mortality in Germany
Authors: Belau Matthias Hans , Becher Heiko , Riefflin Maya , Bartig Dirk , Schwettmann Lars , Schwarzbach Christopher Jan , Grau Armin 
Published: February 2023

Abstract
Background
Regional deprivation has been shown to be an influential factor in stroke incidence risk. However, there is a paucity of knowledge on regional differences in stroke incidence and mortality in Germany.

Methods
We assessed data from the Diagnosis Related Groups statistics (2016–2019) and the German Federal Registry of Physicians (2019). Negative binomial regression analysis was used to examine the association between the German Index of Multiple Deprivation 2015 covering 401 districts and district-free cities in Germany and stroke incidence, treatment, and mortality.

Results
The adjusted rate ratios of stroke incidence and mortality with the highest deprivation level compared with the least deprived area were 1.161 (95% CI [1.143, 1.179]) and 1.193 (95% CI [1.148, 1.239]), respectively. Moreover, this study revealed that physician density was higher in district-free cities compared to districts.

Conclusions
Our results indicate that regional deprivation is associated with incident and mortality cases of stroke, necessitating a more targeted approach to stroke prevention in deprived regions.
Subsidizing the Costs of Loyalty: Lima, Montevideo, and the Making of the Loyalist Río de la Plata, 1810–1814
Authors: Caso Bello Álvaro 
Published: February 2023

AbstractThis article rereads the history of loyalist Montevideo through the prism of intraimperial fiscal cooperation and redistribution. On the eve of Buenos Aires’ 1810 revolution, Montevideo received close to one million pesos in external fiscal subsidies; such supplements to its meager tax base help account for its loyalism. As Spain proved unable to directly assist loyal Montevideanos, regency appointees and local corporations turned to loyalist authorities and locals in Lima, Peru. Through original archival research in Peru, Spain, and Uruguay, this article gives the first detailed account of the multiple seaborne missions sent from Montevideo to Lima, which by 1814 secured more than a half-million pesos in monetary assistance. These funds not only sustained military and naval campaigns but also assured big and small imperial stakeholders that the system of fiscal transfers that benefited them had not been brought to a complete halt.
Envisioning African Intersex
Authors: Swarr Amanda Lock 
Published: February 2023

Since the 1600s, travelers, scientists, and doctors have claimed that “hermaphroditism” and intersex are disproportionately common among black South Africans. In Envisioning African Intersex Amanda Lock Swarr debunks this claim by interrogating contemporary intersex medicine and demonstrating its indivisibility from colonial ideologies and scientific racism. Tracing the history of racialized research that underpins medical and scientific premises of gendered bodies, Swarr analyzes decolonial actions by intersex South Africans from the 1990s to the present, centering the work of organizers such as Sally Gross, the first openly intersex activist in Africa and a global pioneer of intersex legislation. Swarr also explores African social media activism that advocates for intersex justice and challenges the mistreatment of South African Olympian Caster Semenya. Throughout, Swarr shows how activists displace doctors’ impositions to fashion self-representation. By unseating colonial visions of gender, intersex South Africans are actively disrupting medical violence, decolonizing gender binaries, and inciting policy changes.
All author royalties from Envisioning African Intersex will be donated to Intersex South Africa.
Long-Term Seizure Freedom, Resolution of Epilepsy and Perceived Life Changes in Drug Resistant Temporal Lobe Epilepsy With Hippocampal Sclerosis: Comparison of Surgical Versus Medical Management
Authors: Jayalakshmi Sita , Vasireddy Sindhu , Sireesha Jala , Vooturi Sudhindra , Patil Anuja , Sirisha Sai , Vadapalli Rammohan , Chandrasekhar Y. B. V. K. , Panigrahi Manas 
Published: February 2023

BACKGROUND:Outcome of temporal lobe epilepsy associated with hippocampal sclerosis (TLE-HS) has rarely been evaluated exclusively.OBJECTIVE:To compare long-term seizure freedom, resolution of epilepsy, and perceived life changes in patients with drug-resistant TLE-HS who underwent surgery vs those who opted for best medical management.METHODS:In this retrospective longitudinal study, 346 patients with TLE-HS who underwent surgery were compared with 325 who received best medical management. Predictors for long-term remission, resolution of epilepsy, and seizure recurrence were analyzed.RESULTS:The duration of follow-up ranged from 3-18 (mean 12.61) years. The average age of study population was 28.54 ± 12.27 years with 321 (47.8%) women. Age at onset of epilepsy (11.84 ± 8.48 vs 16.29 ± 11.88;P≤ .001) was lower, and duration of epilepsy (15.65 ± 9.33 vs 12.97 ± 11.44;P< .001) was higher in the surgery group. Seizure freedom at 3 (81.8 vs 19.0%;P< .001), 5 (73% vs 16.1%;P< .001), and 10 years (78.3% vs 18.5;P< .001) and resolution of epilepsy (30.5% vs 0.6%;P< .001) was higher in the surgery group. The overall perceived life changes score was higher in the surgery group (80.96 ± 25.47 vs 66.24 ± 28.13;P< .001). At long-term follow-up (≥10 years), the presence of an aura was the strongest predictor for resolution of epilepsy (β: 2.29 [95% CI; 1.06-4.93];P= .035), whereas acute postoperative seizures (APOS) (β: 6.06 [95% CI 1.57-23.42];P< .001) and an abnormal postoperative EEG (β: 0.222 [95% CI 0.100-0.491];P< .001) were predictors of persistent seizures. Seizure freedom both at 3 and 5 years predicted seizure freedom at 10 years.CONCLUSION:Surgery for drug-resistant TLE-HS was associated with higher rate of long-term seizure-freedom, resolution of epilepsy, and reduction of anti-seizure medications with improvement in perceived life changes compared with best medical management. The presence of an aura was predictor for resolution of epilepsy while APOS and an abnormal postoperative EEG were predictors of persistent seizures.
Long-Term Durability of Stand-Alone Lateral Lumbar Interbody Fusion
Authors: Agarwal Nitin , White Michael D. , Roy Souvik , Ozpinar Alp , Alan Nima , Lavadi Raj Swaroop , Okonkwo David O. , Hamilton D. Kojo , Kanter Adam S. 
Published: February 2023

BACKGROUND:
The long-term durability of stand-alone lateral lumbar interbody fusion (LLIF) remains unknown.

OBJECTIVE:
To evaluate whether early patient-reported outcome measures after stand-alone LLIF are sustained on long-term follow-up.

METHODS:
One hundred and twenty-six patients who underwent stand-alone LLIF between 2009 and 2017 were included in this study. Patient-reported outcome measures included the Oswestry Disability Index (ODI), EuroQOL-5D (EQ-5D), and visual analog score (VAS) scores. Durable outcomes were defined as scores showing a significant improvement between preoperative and 6-week scores without demonstrating any significant decline at future time points. A repeated measures analysis was conducted using generalized estimating equations (model) to assess the outcome across different postoperative time points, including 6 weeks, 1 year, 2 years, and 5 years.

RESULTS:
ODI scores showed durable improvement at 5-year follow-up, with scores improving from 46.9 to 38.5 (P = .001). Improvements in EQ-5D showed similar durability up to 5 years, improving from 0.48 to 0.65 (P = .03). VAS scores also demonstrated significant improvements postoperatively that were durable at 2-year follow-up, improving from 7.0 to 4.6 (P < .0001).

CONCLUSION:
Patients undergoing stand-alone LLIF were found to have significant improvements in ODI and EQ-5D at 6-week follow-up that remained durable up to 5 years postoperatively. VAS scores were found to be significantly improved at 6 weeks and up to 2 years postoperatively but failed to reach significance at 5 years. These findings demonstrate that patients undergoing stand-alone LLIF show significant improvement in overall disability after surgery that remains durable at long-term follow-up.
Orientation of Osteotomized Vertebrae in 2-Level Pedicle Subtraction Osteotomy Plays a Crucial Role in the Remodeling of Harmonious Sagittal Curve for Severe Thoracolumbar Kyphotic Deformity Caused by Ankylosing Spondylitis
Authors: Li Yao , Qian Bang-ping , Qiu Yong , Yu Yang , Wang Bin 
Published: February 2023

BACKGROUND:
Few studies reported the remodeling of harmonious sagittal curve after 2-level pedicle subtraction osteotomy (PSO) for severe thoracolumbar kyphosis in ankylosing spondylitis (AS).

OBJECTIVE:
To investigate how the orientation of osteotomized vertebrae (OV) affects the remodeling of harmonious sagittal curve in patients with AS undergoing 2-level PSO.

METHODS:
Twenty-six patients treated with 2-level PSO were reviewed. Plumb lines of thoracic apex and lumbar apex, the superior/inferior endplate angle of OV, and OV tilt were measured. Patients with AS were grouped based on the postoperative lumbar lordotic apex (LLA, L3 or L4 vs L5 or others).

RESULTS:
The level of thoracic kyphotic apex was positively correlated with that of superior OV postoperatively. Larger sacral slope, L1-L3 lordotic angle, and plumb lines of lumbar apex could be obtained in patients with LLA at L3 or L4, accompanied with larger superior endplate angle of OV and OV tilt of inferior OV (P < .05). Besides, larger lumbar lordotic angle (LL) was observed in these patients (marginally significant, P = .057). For patients with relocated LLA at L5 or others, lower pelvic incidence was observed, accompanied with significant loss of correction (P < .05) and worse Visual Analog Scale scores (marginally significant, P = .054) during follow-up.

CONCLUSION:
Ventrally leaning inferior OV combined with dorsally leaning superior OV contributed to the most harmonious sagittal curve defined as thoracic kyphotic apex at T8 or above and LLA at L3 or L4. Sagittal curve with LLA at L5 could be acceptable in patients with more severe kyphosis, especially those with low pelvic incidence.
The Impact of Weather and Mode of Transport on Outcomes of Patients With Acute Ischemic Stroke Undergoing Mechanical Thrombectomy
Authors: Sioutas Georgios S. , Amllay Abdelaziz , Chen Ching-Jen , El Naamani Kareem , Abbas Rawad , Jain Paarth , Garg Ananya , Stine Emily A. , Tjoumakaris Stavropoula I. , Herial Nabeel A. , Gooch M. Reid , Zarzour Hekmat , Schmidt Richard F. , Rosenwasser Robert H. , Jabbour Pascal 
Published: February 2023

BACKGROUND:
Efficient transfer to mechanical thrombectomy (MT)–capable centers is essential for patients with stroke. Weather may influence stroke risk, transportation, and outcomes.

OBJECTIVE:
To investigate how weather affects stroke patient transfer and outcomes after MT.

METHODS:
We retrospectively collected data for patients with stroke transferred from spoke to our hub hospital to undergo MT between 2017 and 2021. We examined associations between weather, transportation, and patient outcomes.

RESULTS:
We included 543 patients with a mean age of 71.7 years. The median National Institutes of Health Stroke Score increased from 14 to 15 after transportation. The median modified Rankin Scale was 4 at discharge and 90 days, and 3 at the final follow-up (mean 91.7 days). Higher daily temperatures were associated with good outcome, whereas daily drizzle was associated with poor outcome. More patients were transferred by air when visibility was better, and by ground during heavier precipitation, higher humidity, rain, mist, and daily drizzle, fog, and thunder. Patient outcomes were not associated with transportation mode. Among the independent predictors of good outcome, none was a weather variable. Lower hourly relative humidity (P = .003) and longer road distance (P < .001) were independent predictors of using air transportation, among others.

CONCLUSION:
During transportation, higher temperature was associated with good outcome, whereas daily drizzle was associated with poor outcome after MT. Although weather was associated with transportation mode, no differences in outcomes were found between transportation modes. Further studies are needed to modify transfer protocols, especially during cold and rainy days, and potentially improve outcomes.
A Guide to Indoor Rock Climbing Injuries
Authors: Leung Jonathan 
Published: February 2023

Abstract
Rock climbing is an increasingly popular indoor sport with a sizable risk of overuse injuries. Yet, many medical practitioners have little familiarity with evaluating and treating climbing injuries because of the terminology, biomechanical demands, mechanisms of injury, and return to sport counseling needed, unique to the sport. This review seeks to educate practitioners on these aspects. Upper extremity injuries occur more frequently than lower extremity injuries, with finger injuries being most prevalent. Pulley injuries, consisting of rupture of the A2 or A4 annular pulleys are the most common type of injury. Other finger injuries include tenosynovitis of the flexor tendons, as well as lumbrical muscle tears. Elbow injuries occur frequently, with medial epicondylopathy being most common. Brachialis injuries are seldom seen outside of climbing. Lower-extremity injuries are typically more acute in nature, including ankle injuries from falls and knee injuries from strenuous climbing moves.
Risk factors of COVID-19 clinical worsening: A retrospective cohort study in COVID-19 referral hospital in west Java, Indonesia
Authors: Soeroto Arto Yuwono , Yudisman Ade , Asriputri Nabila Nauli , Suryadinata Hendarsyah 
Published: February 2023

Background: Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2) is marked as one of the highly pathogenic viruses, resulting in millions of deaths worldwide. Management of COVID-19 in limited resources requires appropriate decisions. Clinical considerations along with simple laboratory parameters that can predict the worsening are needed to determine which patients should be treated more intensively. Methods: This is a retrospective cohort study based on the Research Electronic Data Capture (REDCap) registry of COVID-19 patients in Hasan Sadikin General Hospital from April to December 2020. Patients were divided into worsening and non-worsening groups within a 14-day follow-up. Factors affecting these conditions were analyzed. Results: A total of 537 patients were included in this study, of which 72 patients suffered deterioration. Multivariate analysis showed the significant factors affecting the worsening of COVID-19 patients were age > 60 years (aOR 4.207, 95% CI 2.13-8.32), heart disease (aOR 2.802, 95% CI 1.12-6.99), diabetes mellitus (aOR 3.107, 95% CI 1.43-6.74), respiratory rate > 23x/minute (aOR 3.71, 95% CI 1.87-7.38), and NLR > 3.8 (aOR 2.51, 95% CI 1.21-5.21). Conclusions: Older age, chronic heart disease, diabetes mellitus, tachypnea, and higher neutrophil-to-lymphocyte ratio (NLR) are risk factors for the clinical worsening of COVID-19 and can be useful to predict the worsening outcome and poor prognosis.
Determination of pharmacological activity of bioactives in Allium sativum using computational analysis
Authors: Ouma Stephen , Kagia Richard , Kamakia Faith 
Published: February 2023

Introduction: Use of natural products for management of diseases has increased widely due to the belief that natural products are less toxic than conventional medicines. Natural products have been utilised for management of chronic diseases such as diabetes and cancers. Respiratory infections have also been managed using natural products. Allium sativum is one of the natural products that has been utilised in the management of SARS-CoV infections, diabetes and cancer. Methods: This study was aimed at screening bioactive agents in Allium sativum using computational analysis. The targets of the bioactive agents were predicted using SwissTargetPrediction tools. Molecular docking followed, where the docking energies of the bioactive agents to the targets were generated. The bioactive agents were analysed for pharmacokinetics properties using SwissADME as well as toxicity profiles using the ProTox II webserver. The docking scores, toxicities and pharmacokinetics profiles of the bioactive agents in Allium sativum were compared with those of reference compounds. Results: All the bioactives showed lower docking scores than the reference compounds. The bioactives, however, showed some activity on specific receptors such as carbonic anhydrases, cyclooxygenase and ghrelin. All the bioactives showed high gastrointestinal tract absorption and none violated Lipinski’s rule of five. Diallyl trisulphide was predicted to be most lethal, with an LD50 of 100mg/kg, while Alliin was the safest, with 8000mg/kg. Conclusions: In conclusion, bioactives showed lower docking scores than the reference compounds, therefore overall pharmacological activity could be attributed to synergy between the bioactives for a particular receptor.
Synergies Between Operations Research and Quantum Information Science
Authors: Parekh Ojas 
Published: February 2023

This article highlights synergies between quantum information science (QIS) and operations research for QIS-curious operations researchers (and vice versa), and the author challenges the community to discover more. History: This “Challenge” paper was invited by the Editor in Chief and based on the topics raised by the author at his plenary address at the 2022 INFORMS Computing Society Conference in Tampa, Florida. Funding: This material is based on work supported by the U.S. Department of Energy, Office of Science, Office of Advanced Scientific Computing Research, Accelerated Research in Quantum Computing, Fundamental Algorithmic Research for Quantum Computing. This article has been authored by an employee of National Technology & Engineering Solutions of Sandia, LLC, under Contract DE-NA0003525 with the U.S. Department of Energy (DOE).