bluuebunny/crossref_metadata_2025_split huggingface dataset:
Assessing contraceptive use as a continuum: outcomes of a qualitative assessment of the contraceptive journey
Authors: Simmons Rebecca G. , Baayd Jami , Waters Megan , Diener Zoë , Turok David K. , Sanders Jessica N. 
Published: February 2023

Abstract
Background
Contraceptive use is often a multi-decade experience for people who can become pregnant, yet few studies have assessed how this ongoing process impacts contraceptive decision-making in the context of the reproductive life course.

Methods
We conducted in-depth interviews assessing the contraceptive journeys of 33 reproductive-aged people who had previously received no-cost contraception through a contraceptive initiative in Utah. We coded these interviews using modified grounded theory.

Results
A person’s contraceptive journey occurred in four phases: identification of need, method initiation, method use, and method discontinuation. Within these phases, there were five main areas of decisional influence: physiological factors, values, experiences, circumstances, and relationships. Participant stories demonstrated the ongoing and complex process of navigating contraception across these ever-changing aspects. Individuals stressed the lack of any “right” method of contraception in decision-making and advised healthcare providers to approach contraceptive conversations and provision from positions of method neutrality and whole-person perspectives.

Conclusions
Contraception is a unique health intervention that requires ongoing decision-making without a particular “right” answer. As such, change over time is normal, more method options are needed, and contraceptive counseling should account for a person’s contraceptive journey.
Clear cell renal cell carcinoma with cystic component similar to multilocular cystic renal neoplasm of low malignant potential: a rare pattern of cyst-dependent progression from multilocular cystic renal neoplasm of low malignant potential
Authors: Yang Bo , Sun Lin , Cao Wen-feng , Qi Li-sha , Guo Yu-hong , Sun Yan 
Published: February 2023

Abstract
Background
For clear cell renal cell carcinoma (ccRCC) with cystic component similar to multilocular cystic renal neoplasm of low malignant potential (MCRN-LMP) and solid low-grade component simultaneously, we propose the designation “ccRCC with cystic component similar to MCRN-LMP” and to study the relationship between MCRN-LMP and it.

Methods
Twelve cases of MCRN-LMP and 33 cases of ccRCC with cystic component similar to MCRN-LMP were collected from 3,265 consecutive RCCs to compare them in clinicopathological features, immunohistochemical findings (PAX8, CA-IX, CK7, Vimentin, CD10, P504s, TFE3, 34βE12) and prognosis.

Results
There was no significant difference in age, sex ratio, tumor size, treatment, grade and stage between them (P > 0.05). All ccRCCs with cystic component similar to MCRN-LMP coexisted with MCRN-LMP and solid low-grade ccRCCs, and MCRN-LMP component ranged from 20 to 90% (median, 59%). The positive ratio of CK7 and 34βE12 in MCRN-LMPs and ccRCCs’ cystic parts was significantly higher than that in ccRCCs’ solid parts, but the positive ratio of CD10 in MCRN-LMPs and ccRCCs’ cystic parts was significantly lower than that in ccRCCs’ solid parts (P < 0.05). There was no significant difference of all immunohistochemistry profiles between MCRN-LMPs and ccRCCs’ cystic parts (P > 0.05). No patient developed recurrence or metastasis.

Conclusions
MCRN-LMP and ccRCC with cystic component similar to MCRN-LMP have similarity and homology in clinicopathological features, immunohistochemical findings and prognosis, and form a low-grade spectrum with indolent or low malignant potential behavior. The ccRCC with cystic component similar to MCRN-LMP may be a rare pattern of cyst-dependent progression from MCRN-LMP.
Development of a nomogram to predict surgical site infection after open reduction and internal fixation for closed pilon fracture: a prospective single-center study
Authors: Xie Lei , Liu Guofeng , Wang Xin , Luo Zixuan , Li Yansen , Wang Xiaomeng , Zhang Fengqi 
Published: February 2023

Abstract
Background
To explore the risk factors and develop a nomogram in order to predict surgical site infection (SSI) after open reduction and internal fixation (ORIF) for closed pilon fractures (CPF).

Methods
A prospective cohort study with one-year follow-up was carried out in a provincial trauma center. From January 2019 to January 2021, 417 adult patients with CPFs receiving ORIF were enrolled. A Whitney U test or t test, Pearson chi-square test, and multiple logistic regression analyses were gradually used for screening the adjusted factors of SSI. A nomogram model was built to predict the risk of SSI, and the concordance index (C-index), the receiver operating characteristic (ROC) curve, calibration curve and decision curve analysis (DCA) were used for evaluating the prediction performance and consistency of the nomogram model. The bootstrap method was employed to test the validity of the nomogram.

Results
The incidence of SSI after ORIF for CPFs was 7.2% (30/417): 4.1% (17/417) of superficial SSIs and 3.1% (13/417) of deep SSIs. The most common pathogenic bacteria were Staphylococcus aureus (36.6%, 11/30). The multivariate analysis showed tourniquet use, longer preoperative stay, lower preoperative albumin (ALB), higher preoperative body mass index (BMI) and hypersensitive C-reactive protein (Hs-CRP) were independent risk factors of SSI. Additionally, the C-index and bootstrap value of the nomogram model were 0.838 and 0.820, respectively. Finally, the calibration curve indicated that the actual diagnosed SSI had good consistency with the predicted probability, and the DCA showed that the nomogram had clinical value.

Conclusions
Tourniquet use, longer preoperative stay, lower preoperative ALB, higher preoperative BMI and Hs-CRP were five independent risk factors of SSI after closed pilon fractures treated by ORIF. These five predictors are shown on the nomogram, with which we may be able to further prevent the CPS patients from SSI.
Trial registration NO 2018-026-1, October /24/2018, prospectively registered. The study was registered in October 24, 2018. The study protocol was designed based on the Declaration of Helsinki and admitted by the Institutional Review Board. The ethics committee approved the study on factors related to fracture healing in orthopedic surgery. Data analyzed in the present study were acquired from the patients who underwent open reduction and internal fixation from January 2019 to January 2021.
Treatment of rigid post-traumatic thoracolumbar kyphosis by a novel technique of spinal joints release
Authors: Wang Qing , Tang Chao , Wang GaoJu , Li GuangZhou , Zhong DeJun , Wang Song , Ma Fei 
Published: February 2023

Abstract
Objective
The purpose of this study was to evaluate the feasibility of a novel technique named spinal joints release (SJR) and observe its efficacy in treating rigid post-traumatic thoracolumbar kyphosis (RPTK).

Methods
RPTK patients who were treated by SJR with facet resection, limited laminotomy, clearance of the intervertebral space, and release of the anterior longitudinal ligament through the intervertebral foramen and disc of injury segment from August 2015 to August 2021 were reviewed. Intervertebral space release, internal fixation segment, operation time, and intraoperative blood loss were recorded. The intraoperative, postoperative, and final follow-up complications were observed. An improvement in the VAS score and ODI index was observed. Spinal cord functional recovery was evaluated by American Spinal Injury Association Impairment Scale (AIS). Improvement of local kyphosis (Cobb angle) was evaluated by radiography.

Results
Forty-three patients were successfully treated by the SJR surgical technique. Open-wedge anterior intervertebral disc space was performed in 31 cases, and repeated release and dissection of the anterior longitudinal ligament and callus were performed in 12 cases. There was no lateral annulus fibrosis release in 11 cases, the anterior half release of lateral annulus fibrosis in 27 cases, and complete release in five cases. There were five cases of screw placement failure in one or two side pedicles of the injured vertebrae due to excessive resection of the facets and improper pre-bending of the rod. Sagittal displacement occurred in four cases at the released segment due to the complete release of bilateral lateral annulus fibrosus. Autologous granular bone + Cage was implanted in 32 cases, and autologous granular bone was implanted in 11 cases. There were no serious complications. The average operation time was 224 ± 31 min, and intraoperative blood loss was 450 ± 225 mL. All the patients were followed up with an average of 26 ± 8.5 months. The VAS scores and ODI index improved significantly at the final follow-up. All of the 17 patients with incomplete spinal cord injury achieved more than one grade of neurological recovery at the final follow-up. An 87% correction rate of kyphosis was achieved and maintained, with the Cobb angle decreasing from 27.7° preoperatively to 5.4° at the final follow-up.

Conclusion
Posterior SJR surgery for patients with RPTK has the advantages of less trauma and less blood loss, and kyphosis correction is satisfactory.
The bronchiolitis epidemic in 2021–2022 during the SARS-CoV-2 pandemic: experience of a third level centre in Northern Italy
Authors: Faraguna Martha Caterina , Lepri Irene , Clavenna Antonio , Bonati Maurizio , Vimercati Chiara , Sala Debora , Cattoni Alessandro , Melzi Maria Luisa , Biondi Andrea 
Published: February 2023

Abstract
Background
The aim of this study is to compare the 2021–2022 bronchiolitis season to the four previous years (2017–2018, 2018–2019, 2019–2020, 2020–2021) to see if there was an anticipation of the peak, an overall increase of cases, and an increased need of intensive care.

Methods
A retrospective single-centre study in the San Gerardo Hospital Fondazione MBBM, Monza, Italy was performed. Emergency Departments (ED) visits of patients aged < 18 years and ≤ 12 months were analyzed: the incidence of bronchiolitis on total assessments, the urgency level at triage and the hospitalization rate were compared. Data of children admitted to the Pediatric Department due to bronchiolitis were analyzed in terms of need of intensive care, respiratory support (type and duration), length of hospital stay, main etiological agent, patient characteristics.

Results
During 2020–2021 (first pandemic period) an important reduction in the ED attendance for bronchiolitis was observed, while in 2021–2022 there was an increase in incidence of bronchiolitis (13% of visits in infants < 1 year) and in the rate of urgent accesses (p = 0.0002), but hospitalization rates did not differ compared to previous years. Furthermore, an anticipated peak in November 2021 was observed. In the 2021–2022 cohort of admitted children to the Pediatric Department, a statistically significative increased need of intensive care unit was detected (Odds Ratio 3.1, 95% CI 1.4–6.8 after adjustment for severity and clinical characteristics). Instead, respiratory support (type and duration) and length of hospital stay did not differ. RSV was the main etiological agent and RSV-bronchiolitis determined a more severe infection (type and duration of breathing support, intensive care need and length of hospital stay).

Conclusions
During Sars-CoV-2 lockdowns (2020–2021), there was a dramatic decrease of bronchiolitis and others respiratory infections. In the following season, 2021–2022, an overall increase of cases with an anticipated peak was observed and data analysis confirmed that patients in 2021–2022 required more intensive care than children in the four previous seasons.
Improved wild horse optimization with levy flight algorithm for effective task scheduling in cloud computing
Authors: Saravanan G. , Neelakandan S. , Ezhumalai P. , Maurya Sudhanshu 
Published: February 2023

AbstractCloud Computing, the efficiency of task scheduling is proportional to the effectiveness of users. The improved scheduling efficiency algorithm (also known as the improved Wild Horse Optimization, or IWHO) is proposed to address the problems of lengthy scheduling time, high-cost consumption, and high virtual machine load in cloud computing task scheduling. First, a cloud computing task scheduling and distribution model is built, with time, cost, and virtual machines as the primary factors. Second, a feasible plan for each whale individual corresponding to cloud computing task scheduling is to find the best whale individual, which is the best feasible plan; to better find the optimal individual, we use the inertial weight strategy for the Improved whale optimization algorithm to improve the local search ability and effectively prevent the algorithm from reaching premature convergence. To deliver services and access to shared resources, Cloud Computing (CC) employs a cloud service provider (CSP). In a CC context, task scheduling has a significant impact on resource utilization and overall system performance. It is a Nondeterministic Polynomial (NP)-hard problem that is solved using metaheuristic optimization techniques to improve the effectiveness of job scheduling in a CC environment. This incentive is used in this study to provide the Improved Wild Horse Optimization with Levy Flight Algorithm for Task Scheduling in cloud computing (IWHOLF-TSC) approach, which is an improved wild horse optimization with levy flight algorithm for cloud task scheduling. Task scheduling can be addressed in the cloud computing environment by utilizing some form of symmetry, which can achieve better resource optimization, such as load balancing and energy efficiency. The proposed IWHOLF-TSC technique constructs a multi-objective fitness function by reducing Makespan and maximizing resource utilization in the CC platform. The IWHOLF-TSC technique proposed combines the wild horse optimization (WHO) algorithm and the Levy flight theory (LF). The WHO algorithm is inspired by the social behaviours of wild horses. The IWHOLF-TSC approach's performance can be validated, and the results evaluated using a variety of methods. The simulation results revealed that the IWHOLF-TSC technique outperformed others in a variety of situations.
A shift in focus: Mothers’ descriptions of sharing a child with a co-parent with unhealthy alcohol use after participating in a support program
Authors: Siljeholm Ola , Ekström Veronica 
Published: February 2023

Abstract
Background
Unhealthy alcohol use (UAU) affects not only the drinking individual, but also significant others (SOs), such as partners and children. Most of the harm to others caused by alcohol can be attributed to common, moderate drinking patterns, but existing studies have mainly included SOs of individuals with severe UAU. There is a need for increased knowledge regarding SOs of individuals in an earlier stage of UAU and efficacious support programs for this group. The aims of this study were to investigate reasons for seeking support as described by SOs sharing a child with a co-parent with UAU and to investigate how SOs perceived effects of a web-based self-delivered support program.

Methods
A qualitative design conducting semi-structured interviews with 13 female SOs sharing a child with a co-parent with UAU. The SOs were recruited from a randomized controlled trial of the web-based program and had completed at least two of four modules in the program. Transcribed interviews were analyzed using conventional qualitative content analysis.

Results
Regarding reasons for seeking support, we created four categories and two subcategories. Main reasons were wanting validation/emotional support and coping strategies for handling the co-parent, and negative perceptions of available support options for SOs. Regarding perceived effects of the program, we created three categories and three subcategories. Main effects were an improved relationship to their children, increased own positive activities, and less adaptation to the co-parent, though SOs also mentioned what was perceived as missing in the program. We argue that the interviewees represent a population of SOs living with co-parents with slightly less severe UAU than previous studies and therefore provide new insights for future interventions.

Conclusions
The web-based approach with potential anonymity was important for facilitating support-seeking. Support for the SOs themselves and coping strategies for co-parent alcohol consumption were more common reasons for seeking help than worry about the children. For many SOs, the program was a first step in seeking further support. Spending more dedicated time with their children and being validated as living under stressful conditions were described by the SOs as particularly helpful.
Trial registration The trial was pre-registered at isrctn.com, reference number ISRCTN38702517, November 28, 2017
Experiment to distinguish two fumaroles consistently emanating infrasound at Kirishima Iwo-Yama
Authors: Yamakawa Kazuya , Ichihara Mie , Muramatsu Dan , Matsushima Takeshi , Takahashi Hidetoshi , Wada Ruka , Shimoyama Isao 
Published: February 2023

AbstractIn the infrasonic observation of a fumarolic field, distinguishing multiple fumarolic sources is challenging. The array technique effectively estimates the source locations and identifies the target signal from other signals and noise. We conducted an experiment at Kirishima Iwo-Yama, Japan, where two active fumarolic areas were separated by ~ 450 m. A three-element array with an aperture of ~ 20 m was installed between the two fumarolic areas. In addition, a single microphone was installed near one of the fumaroles. The array combined with the waveform correlation analysis estimated the most prominent source but failed to estimate the other weak source. A joint analysis of the array and the single microphone effectively resolved the two sources. It was also confirmed that newly developed power-saving MEMS microphones were useful for observing the fumaroles. This paper presents the instrumentation and analytical method that would be beneficial for monitoring volcanoes that have multiple hydrothermally active vents.
Graphical Abstract
Performance characteristic of a PV module as influenced by dust accumulation: theory versus experiment
Authors: Kamal Reham , Abdel-Salam Mazen , Nayel Mohamed 
Published: February 2023

AbstractThis paper is aimed at assessing by theory and experiment the current–voltage and power-voltage characteristics of a PV module as influenced by dust accumulation. A method is proposed in a computer code to follow-up an incident solar radiation through the module layers considering the reflection and transmission of radiation at the interfaces between the layers to evaluate how the incident radiation is attenuated before reaching the module. Also, absorption of radiation in the dust layer and the glass cover is considered. The evaluation of the reflectance and transmittance calls for analysis of the accumulated dust to identify its constituents using X-ray fluorescence apparatus. The refractive and absorption indices are assessed for dust constituents as well as the corresponding effective values for the sample as a whole. The current–voltage characteristic of the dusty module is calculated using Simulink with consideration of module parameters after being corrected according to the incident radiation received by the solar cell and the ambient temperature where the module is installed. The calculated current–voltage and power-voltage characteristics of the dusty module agreed reasonably with the measured ones for a 175-W module as the incident radiation decreased to 68% due to dust accumulation with a subsequent decrease of the maximum output power of dusty module by 31% when compared with the clean one. The percentage decrease of short-circuit current recorded 31% due to dust deposition against 2% for the increase of open-circuit voltage at ambient temperature of 44 °C and incident solar radiation of 1027 W/m2. This conforms to previous findings in the literature.
Two-dimensional echocardiographic and strain values of the proximal thoracic aorta in a normal sub-Saharan African population
Authors: Meel Ruchika , Blair Kelly 
Published: February 2023

Abstract
Background
There is limited data regarding reference ranges for aortic dimensions in African populations. This study aims to establish normal reference ranges for echocardiographic dimensions and circumferential strain (CS) of the proximal thoracic aorta in a healthy sub-Saharan African population.

Methods
This was a secondary analysis of data from a prospective cross-sectional study of 88 participants conducted at Chris Hani Baragwanath Hospital (2017–2019). Aortic measurements were obtained as per the 2015 American Society of Echocardiography guidelines using a Philips iE33 system. Circumferential Strain was measured using Philips QLAB version 11.0 software offline semi-automated analysis of speckle-based strain 2-D speckle-tracking software (Amsterdam, The Netherlands).

Results
Mean age was 37.22 ± 10.79 years (41% male). The mean diameter at the aortic annulus, sinuses, sino-tubular junction (STJ) and ascending aorta (AAO) were 19.11 ± 2.38 mm, 27.40 ± 6.11 mm, 25.32 ± 3.52 mm and 25.36 ± 3.38 mm, respectively. Males had larger absolute and indexed aortic diameters at all levels when compared to females. The mean aorta CS was 11.97 ± 5.05%. There was no significant difference in CS based on gender (12.19 ± 5.04% vs 11.51 ± 5.02%, P = 0.267). On multivariate linear regression analysis, male sex was the most significant predictor of increased diameter at the level of the aortic annulus (r = 0.17, P = 0.014), body surface area was the most significant predictor at the sinuses (r = 0.17, P = 0.014) and AAO (r = 0.30, P < 0.001), while age was the most significant predictor at the STJ (r = 0.27, P = 0.004). There was a negative correlation between age and aortic CS (r = − 0.12, P < 0.001). The most important predictor of aorta CS was age, on multivariate analysis (r = − 0.19, P = 0.024).

Conclusions
This study provides normal reference ranges for dimensions of the proximal aorta and circumferential strain (CS) in a sub-Saharan African population according to age, sex, and body habitus. It serves as a platform for future larger studies and allows for risk stratification of cardiovascular disease in an African population.