bluuebunny/crossref_metadata_2025_split huggingface dataset:
Prevalence and under-reporting of sexual abuse in Ruwa: A human rights-based approach
Authors: Chibango Conrad , Chibango Sheila T. 
Published: December 2022

The under-reporting of sexual abuse reduces the chances of winning the battle against sexual abuse of women and children in Zimbabwe. It leaves girl children powerless and vulnerable, despite the country’s determination to put an end to injustice and gender discrimination in line with the Sustainable Development Goals (SDGs), in particular, SDG 5, which focuses on gender and equality, and SDG 16, which is concerned with justice and peace. The aim of this study was to explore the barriers to reporting sexual abuse in Ruwa. Informed by the human rights-based approach, the study adopted a quantitative research design. Survey data were solicited from 51 randomly selected female respondents. Results revealed that 69% of the respondents were abused, yet only 2% of the total respondents reported the abuse to authorities, while 67% did not report incidences of abuse. About 98% of respondents believed that most sexual abuse cases in Ruwa went unreported. Results also showed that barriers to reporting sexual abuses comprised cultural and economic factors, most of which were characterised by shame, embarrassment, and fear, as well as the desire to protect male breadwinners. The results are consistent with existing literature generalisations on sexual abuse, particularly in terms of the prevalence of sexual abuse and under-reporting. It is also argued that culture is the determinant factor for most of the barriers to reporting sexual abuse, as well as the effects of reporting.Based on the results and in view of promoting and protecting human rights associated with sexuality, the study recommends that local authorities and social institutions implement awareness programmes and campaigns on reporting sexual abuse in the community.Contribution: This study is the first of its kind in Ruwa. Its significance is embedded in how it reflects on the role played by culture, religion and societal views on matters of sexual abuse.
The profile of Black South African men diagnosed with prostate cancer in the Free State, South Africa
Authors: Benedict Matthew O.A. , Steinberg Wilhelm J. , Claassen Frederik M. , Mofolo Nathaniel 
Published: December 2022

Background: Prostate cancer (PCa) ranks high in terms of morbidity and mortality, especially in Africa. Prostate-specific antigen (PSA) screening remains a practical method of screening for and thereby detecting PCa early, especially among African men who are more negatively affected. Modifiable risk factors for PCa are mostly behavioural and lifestyle. Understanding community-specific determinants is important when developing health promotion interventions.Objective: This study aimed to determine the profile of African men with PCa in the Free State, South Africa.Method: A cross-sectional descriptive study was conducted using case record information and self-administered questionnaires among 341 African men with PCa attending the oncology and urology clinics of a tertiary hospital.Result: Participants’ median age at diagnosis was 66 years. Only 76 (22.3%) participants had ever heard of PCa prior to being diagnosed with the disease, 36 (47.4%) of whom had ever had screening performed. The majority (n = 298, 87.4%) were symptomatic; 50% sought medical help within six months. At diagnosis, 133 (39.0%) men presented with stage T3 or T4 disease, 75 (22.0%) with metastatic disease and 84 (24.6%) with Gleason score ≥ 8. Factors associated with advanced and high-grade disease included smoking, decreased sunlight exposure and physical activity, relatively increased ingestion of dairy products and red meat. Factors associated with early stage and low-grade disease included relatively increased ingestion of fruits, vegetables and fish.Conclusion: Advanced and high-grade PCa disease is not uncommon among men ≥ 60 years in this study setting. Certain modifiable risk factors associated with advanced disease were established in this study. The majority had lower urinary tract symptoms (LUTS) prior to PCa diagnosis, but they were of poor health-seeking behaviour. Although there seems not to be a systematic delay in the definitive diagnosis and initiation of treatment for PCa, there is a need to improve on health education and awareness in the study setting.
Etiology of Femoral Head Avascular Necrosis in Patients
Authors: Teimouri Mehdi , Motififard Mehdi , Hatami Saeed 
Published: December 2022

Background:
Avascular necrosis (AVN), known as osteonecrosis, aseptic necrosis, or ischemic bone necrosis, results in the destruction of bone cells. In the present study, we aimed to report the most common causes of AVN in in patients referred to Isfahan educational and medical centers.

Materials and Methods:
This study is a cross-sectional study that was performed on all patients with AVN in medical educational centers in Isfahan during 2019 and 2020. We included all patients diagnosed with AVN. Patients' information including age, sex, cause of femoral head necrosis, medical history, and drug usage were collected. Finally, reliable data from 99 patients were recorded.

Results:
We collected data of 99 patients in this study. The most prevalent cause of ANV was corticosteroids use (32.3%), and it was more prevalent among women (51.4%); the second prevalent cause of AVN in our study sample was trauma (28.28%), and it was more prevalent among men (32.8%).

Conclusion:
The most common cause of AVN was corticosteroids, which was consistent with previous studies. Other main causes of AVN were traumatic or idiopathic issues.
Co-Expression of Chaperones for Improvement of Soluble Expression and Purification of An Anti-HER2 scFv in Escherichia Coli
Authors: Estabragh Amir Mirzapour , Sadeghi Hamid Mir Mohammad , Akbari Vajihe 
Published: December 2022

Background:
Single-chain fragment variable (scFv) is one of the most commonly used antibody fragments. They offer some advantages over full-length antibodies, including better penetration to target tissues. However, their functional production has been a challenge for manufacturers due to the potential misfolding and formation of inclusion bodies. Here we evaluated the soluble expression and purification of molecular chaperone co-expression.

Materials and Methods:

E. coli BL21(DE3) cells were co-transformed with the mixture of plasmids pKJE7 and pET22b-scFv by the electroporation method. First, L-arabinose was added to induce the expression of molecular chaperones, and then IPTG was used as an inducer to start the expression of anti-HER2 scFv. The effect of cultivation temperature and IPTG concentration on soluble expression of the protein with or without chaperones was evaluated. The soluble expressed protein was subjected to native purification using the Ni-NTA affinity column.

Results:
SDS-PAGE analysis confirmed the successful co-expression of anti-HER2-scFv and DnaK/DnaJ/GrpE chaperones. Co-expression with chaperones and low-temperature cultivation synergistically improved the soluble expression of anti-HER2 scFv. Co-expression with chaperone also exhibited an approximately four-fold increase in the final yield of purified soluble protein.

Conclusion:
The combination of co-expression with chaperones and low temperature presented in this work may be useful for the improvement of commercial production of other scFvs in E. coli as functionally bioactive and soluble form.
Risk Factors for In-Hospital Mortality among Patients with Coronavirus-19 in Isfahan City, Iran
Authors: Riahi Roya , Ghasemi Marziye , Shatouri Zahra Montazeri , Gharipour Mojgan , Maghami Mahboobeh , Melali Hamid , Sami Ramin , Tabatabaei Aminreza , Hosseini Sayed Mohsen 
Published: December 2022

Background:
The aim of the study is to explore the risk factors of mortality for hospitalized patients in three designated hospitals in Isfahan province.

Materials and Methods:
This retrospective cohort study was conducted on all positive coronavirus disease (COVID)-19 patients admitted to Khorshid, Isabn Maryam, and Amin hospitals in Isfahan province. The demographic, clinical, laboratory, and outcome data of patients who were died or discharged from February 24, 2020, to April 18, 2020, were extracted from patient's medical records.

Results:
Overall 1044 COVID-19 patients were included in this analysis. Based on the findings of this study, older age (≥65 years) (adjusted hazard ratio [aHR]: 2.06; 95% confidence interval [CI]: 1.13–3.76), chronic obstructive pulmonary disease (COPD) history (aHR: 2.52; 95% CI: 1.09–5.83), white blood cell (WBC) counts more than 10 × 10^3/L (aHR: 3.05; 95% CI: 1.42–6.55), Hb level <13 gr/L (aHR: 2.82; 95% CI: 1.34–5.93), bilateral pulmonary infiltrates (aHR: 2.02; 95% CI: 1.12–3.64) at admission, development of acute respiratory distress syndrome (ARDS) (aHR: 1.87; 95% CI: 1.01–3.47), and intensive care unit (ICU) admission (aHR: 2.09; 95% CI: 1.04–4.18) during hospitalization were risk factors for in-hospital mortality in patients with COVID-19.

Conclusions:
Multiple factors were found related to the severity and death among COVID-19 patients. We were found that older age (≥65 years) with COPD history, high level of WBC, low level of Hb (<13 g/L), bilateral pulmonary infiltrates at admission, development of ARDS, and ICU admission during hospitalization were identified as risk factors of death among COVID-19 patients. More related studies are needed in the future.
Effects of Methadone on the Toll-like Receptor 4 Expression in Human Non-Small Cell Lung Carcinoma A549 Cell Line Using In-silico and In vitro Techniques
Authors: Vaseghi Golnaz , Rashidi Nastaran , Zare Nasrin , Ghasemi Fahimeh , Pourhadi Marjan , Rafiee Laleh , Javanmard Shaghayegh Haghjooy 
Published: December 2022

Background:
In this study, the effects of methadone and naloxone on the expression of toll-like receptor 4 (TLR4) gene have been evaluated in human non-small cell lung carcinoma A549 cell line migration using in-silico and in vitro techniques.

Materials and Methods:
Lung cancer A549 cell cultures were stimulated for 24 h with methadone (5, 10, and 20 μM) and naloxone (20 and 40 μM) concentrations. The level of TLR4 expression was determined by the quantitative real-time polymerase chain reaction. Migration of the A549 cells was investigated after a 4-h incubation period with methadone using the Boyden Chamber assay.

Results:
Migration rate of the A549 cells treated with 5 (P < 0.05) and 20 (P < 0.01) μM methadone was, respectively, increased and decreased with 20 μM naloxone (P < 0.05). Furthermore, the TLR4 expression was enhanced with 5 (P < 0.05) and 20 (P < 0.01) μM methadone and decreased with 20 (P < 0.05) and 40 μM naloxone (P < 0.01). In addition, in silico docking analysis revealed docking of methadone to MD-2 and TLR4.

Conclusion:
According to the present DATA, methadone affects the TLR4 expression. It may however cause adverse consequences by increasing the TLR4 expression. Therefore, the useful analgesic properties of methadone should be separated from the unwanted TLR4-mediated side effects.
Preparedness of primary & secondary care health facilities for the management of non-communicable diseases in tribal population across 12 districts in India
Authors: Kaur Prabhdeep , Borah P.K. , Gaigaware Pooja , Mohapatra P.K. , Das Nabajit K.R. , Uike Pankaj V. , Tobgay Karma Jigme , Tushi Aonungdok , Zorinsangi  , Mazumdar Gautam , Marak Bibha , Pizi Dirang , Chakma Tapas , Sugunan A.P. , Vijayachari P. , Bhardwaj Rakesh R. , Arambam Probin C. , Kutum Tridip , Sharma Anand , Pal Piyalee , Shanmugapriya P.C. , Manivel Prathab , Kaliyamoorthy Neelakandan , Chakma Joy , Mathur Prashant , Dhaliwal R.S. , Mahanta J. , Mehendale Sanjay M. 
Published: December 2022

Background and objectives:
Non-communicable diseases (NCDs) are highly prevalent in the tribal populations; however, there are limited data regarding health system preparedness to tackle NCDs among these populations. We estimated the availability of human resources, equipment, drugs, services and knowledge of doctors for NCD management in the selected tribal districts in India.

Methods:
A cross-sectional survey was conducted in 12 districts (one from each State) with at least 50 per cent tribal population in Andaman and Nicobar Islands, Himachal Pradesh, Madhya Pradesh, Odisha and eight northeastern States. Primary health centres (PHCs), community health centres (CHCs) and district/sub-district hospitals (DHs) were surveyed and data on screening and treatment services, human resources, equipment, drugs and information systems indicators were collected and analysed. The data were presented as proportions.

Results:
In the present study 177 facilities were surveyed, including 156 PHCs/CHCs and 21 DHs. DHs and the majority (82-96%) of the PHCs/CHCs provided outpatient treatment for diabetes and hypertension. Overall, 97 per cent of PHCs/CHCs had doctors, and 78 per cent had staff nurses. The availability of digital blood pressure monitors ranged from 35 to 43 per cent, and drugs were either not available or inadequate. Among 213 doctors, three-fourths knew the correct criteria for hypertension diagnosis, and a few correctly reported diabetes diagnosis criteria.

Interpretation & conclusions:
The results of this study suggest that the health system of the studied tribal districts was not adequately prepared to manage NCDs. The key challenges included inadequately trained workforce and a lack of equipment and drugs. It is suggested that capacity building and, procurement and distribution of equipment, drugs and information systems to track NCD patients should be the key focus areas of national programmes.
Relevance of Sonological Evaluation in Medial Knee Injuries and Its Comparison with Magnetic Resonance Imaging Findings – A Prospective Study
Authors: Mohanan Gayathri , Chandan Kumar , Unnikrishnan J. , Job Suma 
Published: December 2022

Background:
Ultrasonography offers several unique strengths over magnetic resonance imaging (MRI) that makes it a promising technique for the evaluation of certain disorders of the knee. Ultrasonography has higher spatial resolution than MRI, which may be helpful in evaluating the superficial structures and popliteal fossa of the knee in detail. Visualizing the medial collateral ligament (MCL) under ultrasound is relatively easy due to its superficial location, spanning from the medial femoral condyle to the medial tibial metaphysis. Meanwhile, MRI is expensive, not advisable to all due to its claustrophobia and ferromagnetic property. Ultrasound, on the other hand, is an inexpensive, widely available, and non-invasive technique which also allows dynamic imaging. Our objective is to assess the validity of ultrasound in the diagnosis of medial knee injuries in comparison with MRI findings.

Materials and Methods:
Patients attending the Department of Orthopaedics are referred to the Department of Radiodiagnosis of Government (TD) Medical College, Alappuzha, who were clinically suspected to have medial knee injury, during the study. This study was a prospective study. Prospective patients with clinically suspected medial knee injuries scheduled for MRI of the knee were evaluated by ultrasound examination before the MRI. Sonographic findings were then compared to MRI results.

Results and Discussion:
Sixty patients were enrolled in the study. 73.3% of the study population were male and most of them belonged in their 2nd and 3rd decades. Most of the injuries were left-sided (60%) and majority (65%) presented for radiological evaluation within 1 week–1 month of history of injury. The accuracy of ultrasound in the diagnosis of MCL and medial meniscus injuries were 86.7% and 85%, respectively. Ultrasonography demonstrated 89.6% sensitivity and 75% specificity for MCL injuries and 85.3% sensitivity and 84.6% specificity for medial meniscus tears. The most frequent knee finding in this study was joint effusion which was seen in 50 (83.3%) of patients.

Conclusion:
Ultrasonography gives high accuracy and specificity in the detection of MCL and medial meniscal injuries. Ultrasound may have a role as the initial rapid imaging modality in patients with suspected MCL or medial meniscus injuries, and it may serve as an effective low-cost screening tool for patients with medial meniscal or MCL injuries and avoid performing the high-cost MRI.
Effect of Surgical Approach on Functional Outcome and Component Positioning in Total Hip Arthroplasty
Authors: Kashayi-Chowdojirao Sreekanth , Khazi Syed Asif Hussain , Boddeda Sandeep , Patnala Chandrasekhar 
Published: December 2022

Context:
Total hip arthroplasty (THA) is commonly performed through a posterior or a direct lateral (Hardinge) approach, and each one has merits and demerits.

Aims:
The purpose of this study was to examine the difference between the lateral and posterior approaches with respect to functional outcome, component positioning, intraoperative blood loss, and patient satisfaction.

Settings and Design:
This is a prospective comparative study of short- to mid-term outcome of cementless THA using two approaches.

Subjects and Methods:
Seventy hips satisfying our inclusion criteria were selected, of which 21 hips operated by lateral approach in supine position were included in lateral approach group (LAG), and 49 hips operated by posterior approach in lateral position were included in posterior approach group (PAG). Functional assessment was performed 1 day before surgery, 1 year after surgery, and at the latest follow-up using Harris Hip score (HHS). Component positioning of acetabular cup and femoral stem was assessed in plain radiographs at the latest follow-up. Generic satisfaction questionnaire was used to measure satisfaction after THA at the latest follow-up. Radiographic measurements (cup inclination, cup version, and femoral stem tip position) were performed postoperatively using low-centered pelvic anteroposterior and cross-table lateral hip radiographs.

Results:
At an average of 3 years and 6 months of follow-up, the mean HHSs were 88.05 and 90.32, respectively, in LAG and PAG; the difference was not significant (P = 0.178). The average inclination of the cup in LAG was 37.9° and in PAG was 45.02° with a significant difference (P = 0.00027), both of which are in the normal range. The cups were significantly (P ≤ 0.0001) more anteverted in the PAG (average angle of 27.69° vs. 16.14°). The mean blood loss was significantly more in PAG (510 ml vs. 436.67 ml; P = 0.04). Majority of femoral stems in lateral approach had their tips directed posterior. Nineteen out of 21 LAG patients and 45 out of 49 PAG were very satisfied/satisfied with their outcomes after THA.

Statistical Analysis Used:
Data were collected using prestructured data forms and analyzed with unpaired Student's t-test with 95% confidence interval.

Conclusions:
There was no significant difference in functional outcome and patient satisfaction at short- to mid-term follow-up between both approaches. The cup anteversion was significantly more in PAG. For better conclusions, other factors (i.e. immediate postoperative pain, and long-term survival), combined anteversion and spinopelvic parameters, have to be included in the study with a larger sample size.
Antibiotic-Impregnated Cement-Coated Intramedullary Nail in Primary Fixation of Compound Fractures of Tibial Shaft – A Comparative Study with External Fixator in Terms of Infection Control
Authors: Verma Rahul , Sharma Saurabh , Solanki Chetan , Prasad Ankit , Rao Mundalapati Gopala , Tandon Suneet 
Published: December 2022

Introduction:
Compound tibial shaft fractures are conventionally managed by debridement and primary stabilization by external fixators, followed by definitive fixation after the wound healing; however, many problems such as infection, difficult soft tissue reconstruction, and psychosocial effects encountered. Hence, a technique of antibiotic-impregnated cement-coated intramedullary nailing has been advocated.

Aims:
The aim of the study is to compare functional and biological outcomes of antibiotic-impregnated cement-coated nail with external fixators.

Settings and Design:
This was a prospective interventional study.

Subjects and Methods:
A total of 20 patients with Compound Grade 3A and 3B (Gustilo and Anderson) tibial shaft fractures who met the inclusion and exclusion criteria from January 2020 to June 2021 were selected. Group 1 was operated with antibiotic-impregnated cement-coated nails. Group 2 was operated with external fixators. Clinical and laboratory parameters were used to evaluate infection control. Final follow-up was taken at 6 weeks.

Results:
The infection rate after nailing was 10% in Group 1 (1/10) and 50% in Group 2 (5/10). Intraoperative time taken for soft tissue reconstruction procedures after primary fixation such as flap cover and skin grafting was comparatively less in Group 1 (mean time – 32 min ± 6.23) compared to Group 2 (51 min ± 5.83). Duration between primary and definite fixation was comparably less in Group 1 (mean duration 5.7 weeks ± 0.45) compared to Group 2 (6.3 weeks ± 1.004).

Conclusions:
Primary antibiotic-impregnated cement-coated nail is better than external fixator in terms of infection control and providing stability in compound fractures of shaft of tibia.
Type of Microbial Flora in Patients with Bone and Joint Infections
Authors: Singh Anupama , Singh Ranjit Kumar , Bimal Bimlesh Kumar , Runu Ritesh 
Published: December 2022

Introduction:
Bone and joint infections are very common in eastern India. Due to the lack of authentic data on the type of bacteriology in our region, this study was planned.

Materials and Methods:
After ethical clearance, retrospective data of 2 years from 2019 to 2021 were collected. Out of 115 patients, 77 patients were included in the study whereas 38 were excluded due to nonbacterial infections and incomplete data.

Results:
The average age of patients was 21.14 years. Pediatric patients were 58.66%. The common clinical condition was chronic osteomyelitis, followed by septic arthritis. The most common bone affected was femur, followed by tibia. The most common organism noted was methicillin-resistant Staphylococcus aureus (MRSA) and coagulase-negative Staphylococcus aureus (CNSA). Gram-negative infections were also noted.

Conclusions:
Eastern India has a high incidence of bone and joint infection. MRSA followed by CNSA is the most common isolate affecting large bones such as femur and tibia.