bluuebunny/crossref_metadata_2025_split huggingface dataset:
Availability, pricing, and affordability of antithrombotic medicines in Addis Ababa, Ethiopia: implications for health policy
Authors: Birhanu Selam , Tamiru Melaku Tileku , Kedir Hanan Muzeyin , Tadesse Tamrat Assefa 
Published: January 2025

Abstract
Background
Antithrombotic medications are essential for the management of abnormal clot formation. However, their availability, pricing, and affordability in Ethiopia, particularly in Addis Ababa, have not been comprehensively studied.

Methods
A cross-sectional study was conducted in Addis Ababa, Ethiopia to assess the availability, pricing, and affordability of essential antithrombotic medicines. This study utilized the World Health Organization (WHO) and International Health Action Organization methodology. Five public hospital outpatient pharmacies, four private hospitals, ten private pharmacies, four Kenema pharmacies, and two Red Cross pharmacies in Addis Ababa, Ethiopia, were included in the study. All essential antithrombotic medicines in the 6th edition of Ethiopia’s Essential Medicines List were included in this study. Data were collected for originator brands and the lowest-priced generic medicines available at each medicine outlet.

Results
The availability of low-priced generic (LPG) antithrombotic medicines was 31%, with private hospitals having the highest availability (52%). Original-brand antithrombotic medicines were rarely available, averaging only 3%, with private pharmacies showing a slightly higher availability (10%). The median price of LPG antithrombotic medicines is higher in private settings. Original-brand (OB) antithrombotic medicines in private hospitals and pharmacies were unaffordable, costing between 256.14 and 3,418 days of wages.

Conclusion
The availability of most antithrombotic medicines was low across all sectors compared with the WHO target. Private hospitals showed relatively higher availability of LPG medicines than other pharmacy outlets included in the study. There is a significant disparity between the availability and affordability of LPG and OB medicines. To address these issues, the national drug procurement and distribution systems must be strengthened. Exploring local production and financial assistance programs, implementing effective stock management, regulating medicine prices, promoting high-quality generic medicines, and conducting further research to understand the national landscape are all essential.
A proposal of a fecal scoring system based on physicochemical analyses of suckling pig feces
Authors: Pons Ana Maria , González Blanca , Pujols Joan , Serratosa Jordi , Segalés Joaquim , Gómez Ernesto A. , Martínez Jorge 
Published: January 2025

Abstract
Background
Digestive disorders are one of the main health problems in suckling piglets. The correct visual identification of feces in suckling piglets is an important tool for the diagnosis of enteric diseases. The aim of the present observational study was to analyze different physicochemical parameters of the feces of suckling piglets aged 0 to 21 days: visual appearance (color and consistency), fecal dry matter (FDM) content and pH. A total of 482 fecal samples were collected and visually classified into six categories: meconium, colostrum stage feces and 4 further scores according to the degree of consistency: 0 = form; 1 = pasty; 2 = liquid; and 3 = watery feces. The percentage of FDM was estimated by two drying methods, oven and microwave, doing duplicates in each one to evaluate methods, and both were compared.

Results
The most frequent colors of each feces category were dark green or dark brown for meconium; orange for colostrum; formed feces were mostly ocher and for the rest of the feces, the colors varied predominantly cream and ocher. Regarding FDM, liquid and watery categories had no statistically significant differences between them; meconium and colostrum feces FDM were not statistically different from pasty feces. The correlation coefficient between the FDM values of the duplicate analyses of the samples by both methods (oven and microwave) was very high (> 0.988). Importantly, no differences were found while comparing the results between both methods (p = 0.078), and the correlation coefficient between all samples analyzed with both methods was very high (> 0.98). Meconium was the only one that differed significantly from the rest in terms of pH.

Conclusion
The physicochemical study of the feces of suckling piglets including color, FDM and pH allowed the establishment of an objective fecal score to characterize the stools in this age group.
Tracing the ties that bind: navigating the static and dynamic connectedness between NFTs and equity markets in ASEAN based on QVAR-approach
Authors: Naveed Muhammad , Ali Shoaib , Tiwari Aviral Kumar 
Published: January 2025

AbstractBased on market integration theory, we investigate the static and dynamic connectedness between nonfungible tokens (NFTs) and the Association of Southeast Asian Nations (ASEAN) equity markets using the Quantile Vector Auto Regressive model. We also compute optimal weights and hedge ratios for our variable of interest to establish their diversification and hedging potential. Our analysis infers a moderate level of return transmission at the median quantile, where equity markets evolved as the net recipients of return spillover from the system, while NFTs emerge as key transmitters. In extreme market conditions, transmission between variables is amplified, but the increase is symmetrical across extreme quantiles, suggesting a similar impact. However, the interlinkage among assets is symmetric across conditional quantiles. The dynamic analysis demonstrates that the system integration amplifies during uncertain times (e.g., COVID-19 and the Russia–Ukraine conflict). Our portfolio analysis shows that NFTs provide diversification and hedging in all market conditions. However, the period of turmoil dampened the diversification potential, and hedging became expensive. Our study offers detailed and insightful information about the transmission mechanism and enables the participants of financial markets to diversify and hedge their portfolio.
ESG disagreement and corporate debt maturity: evidence from China
Authors: Jiang Kangqi , Zhang Jie , Zhou Mengling , Chen Zhongfei 
Published: January 2025

AbstractThis study explores the relationship between corporate environmental, social, and governance (ESG) disagreements and corporate debt maturity. By examining panel samples from Chinese non-financial listed companies covering 2007 to 2020, we find that ESG disagreements negatively influence corporate debt maturity. Even after conducting a series of robustness tests and addressing endogeneity concerns, the adverse effects of ESG disagreements persisted. A heterogeneity analysis shows that this negative impact is more significant for non-state-owned enterprises, small enterprises, enterprises with high capital intensity, enterprises with low analyst attention, and enterprises in high-tech industries. Through a mechanism analysis, we discovered that ESG disagreements can lead to information asymmetry and heightened default risk, subsequently affecting the maturity of corporate debt. Further analysis confirms that the negative impact of ESG on the debt structure inhibits long-term investment and exacerbates the mismatch between investment and financing terms.
Faricimab efficacy in type 1 macular neovascularization: AI-assisted quantification of pigment epithelium detachment (PED) volume reduction over 12 months in Naïve and switch eyes
Authors: Cattaneo Jennifer , Forte Paolo , Forte Giovanni , Eandi Chiara M. 
Published: January 2025

Abstract
Background
This study evaluates the efficacy of intravitreal Faricimab in reducing pigment epithelium detachment (PED) and fluid volumes in both treatment-naïve eyes and eyes unresponsive to anti-VEGF mono-therapies, all diagnosed with type 1 macular neovascularization (T1 MNV) over a period of 12-month.

Methods
A retrospective, single-center cohort study was conducted at the Jules Gonin Eye Hospital, Lausanne, Switzerland. Clinical records of treatment-naïve and non-responder switch patients presenting T1 MNV secondary to neovascular age-related macular degeneration (nAMD) from September 2022 to March 2023 were reviewed. Patients received a loading dose of three monthly Faricimab injections followed by a treat-and-extend (T&E) regimen. Multimodal imaging, including structural OCT and AI-assisted analysis, was used to quantify PED volumes and related fluid biomarkers at baseline, 3-month, 6-month, and 12-month follow-up. Statistical analyses included linear mixed models to evaluate differences and trends in intraretinal (IRF), subretinal fluid (SRF) and PED volumes.

Results
65 eyes of 65 patients were enrolled (female: 70.7%; mean age = 80.7yrs, SD = 6.9yrs). 80% had received anti-VEGF treatment (Switch group) and 20% were treatment-Naïve at baseline. At 12 months, intravitreal treatments were more frequent in the Switch group (mean number = 8.3 vs. 6.0; p = 0.009). BCVA improved at the 12-month follow-up in Naïve eyes (+ 6.9 ETDRS letters from baseline, p = 0.053) and was maintained in Switch eyes. No cases of intraocular inflammation were observed. Significant reduction in SRF and IRF volumes were noted in both groups. A significant reduction in PED volume was observed over the follow-up period in both groups (mean slope = -206 nL, 95%CL = -273/-138; p-value < 0.001).

Conclusions
Intravitreal Faricimab significantly reduced PED volumes in both treatment-Naïve and non-responder Switch patients over 12 months. The study highlights Faricimab’s potential as an effective treatment option for T1 MNV in nAMD, offering significant improvements in PED volume and related fluid biomarkers.
A high number of tumor deposits (≥ 4) is an isolated predictor of local recurrence and distant metastasis in non-metastatic colorectal cancer: a single center study
Authors: Bendari Ahmed , Ucar Ebubekir , Bendari Alaa , Hammoud Hamed , Kiran FNU , Al-Refai Reham , Sham Sunder , Kumar Sanjay Kirshan , Jean Ryan Des , Harshan Manju 
Published: January 2025

Abstract
Introduction
Local recurrence and distant metastasis after curative surgery and chemotherapy for colorectal cancer (CRC) is a serious complication and is considered a failure of the therapeutic strategy. The aim of this study is to identify the different prognostic factors associated with tumor recurrence and distant metastasis in CRC.

Design
An analytical cross-sectional design was employed, and our hospital clinical and pathology databases were queried for non-metastatic CRC (stage I-III). Patients were included if they underwent surgery and chemotherapy between 01/2016 to 12/2018 and demographic information, tumor characteristics and postoperative outcomes were extracted from each case. The data were entered into a database using SPSS version 21. Univariate analysis was initially performed, followed by a multivariate analysis to develop a prognostic model for tumor recurrence and distant metastasis in CRC.

Result
A total of 138 non-metastatic CRC patients were enrolled in this study. The demographic characteristics of all patients are summarized in Table 1. Our study included 65 male and 73 female patients with a Median (IQR) age of 69 (17.7) years. Among the cases, 91 (65.9%) patients had no recurrence, and 47 (34.1%) patients developed a recurrence during follow-up. Univariate analysis revealed that positive lymph nodes (p = 0.03) and tumor deposits ≥ 4 (p = 0.04) were significantly associated with colorectal tumor recurrence and/or metastasis. However, variables such as age, sex, smoking, alcohol consumption, family history of CRC, PNI, LVI, tumor size, and histological features like mucinous or signet ring cell morphology did not show any statistical significance (p > 0.05). Multivariate analysis adjusted for age, lymph node status, and tumor deposits, identified that tumor deposits ≥ 4 was the only predictor of tumor recurrence following colorectal surgery and chemotherapy. Conversely, positive lymph node status did not show statistical significance (p = 0.3). Further analysis revealed that patients who had tumor deposit number ≥ 4 tend to experience local recurrence/distant metastasis more than patients with tumor deposit number < 4.

Conclusion
In non-metastatic CRC patients, TD ≥ 4 is a strong predictor of local tumor recurrence and distant metastasis. Based on these findings, patients who have TDs in primary CRC resection should be subjected to enhanced surveillance.
Racial, socioeconomic, and payer status disparities in utilization of unicompartmental knee arthroplasty in the USA
Authors: Dhanjani Suraj A. , Schmerler Jessica , Hussain Nauman , Badin Daniel , Srikumaran Uma , Hegde Vishal , Oni Julius K. 
Published: January 2025

Abstract
Background
Unicompartmental knee arthroplasty (UKA) is a surgical treatment for knee osteoarthritis associated with lower morbidity compared with total knee arthroplasty (TKA) in patients with isolated unicompartmental knee arthritis. As disparities have been noted broadly in arthroplasty care, it follows that such disparities might be present in the utilization of UKA relative to TKA. This study therefore examined racial/ethnic, socioeconomic, and payer status differences in utilization of UKA.

Methods
Patients who underwent UKA or TKA between 2016 and 2020 in the National Inpatient Sample were identified. Multivariable Poisson regression models adjusted for hospital geographic region and patient characteristics [age, sex, and Elixhauser Comorbidity Index (ECI)] were used to examine the effect of race/ethnicity, socioeconomic status, and payer status on incidence rate ratio of UKA relative to TKA.

Results
Of the 8472 UKA patients and 639,937 TKA patients identified between 2016 and 2020, 8027 (94.7%) UKA patients and 606,028 (94.7%) TKA patients met inclusion criteria. Patients who underwent UKA were significantly younger (63.5 ± 10.7 years) than patients who underwent TKA (66.8 ± 9.5 years; p < 0.001) and had significantly lower ECI scores (1.8 ± 1.5) than patients who underwent TKA (2.2 ± 1.6; p < 0.001). Black patients were less likely to undergo UKA relative to TKA compared with white patients [incidence rate ratio (IRR) 0.64, confidence interval (CI) 0.58–0.71, p < 0.001]. Compared with patients in income quartile 4, patients in income quartiles 1 and 2 underwent UKA at a lower relative rate (IRR 0.85, CI 0.79–0.90, p < 0.001 and IRR 0.87, CI 0.82–0.93, p < 0.001, respectively). Compared with patients with private insurance, patients with Medicare underwent UKA at a lower relative rate (IRR 0.83, CI 0.79–0.88, p < 0.001).

Conclusions
Black patients, lower-income patients, and Medicare-insured patients undergo UKA at a lower relative rate than white, higher-income, and privately insured patients, respectively. Further research may help elucidate reasons for these differences and identify targets for intervention.
Adherence to the 24-hour movement behavior guidelines and depression risk among older adults from the United States
Authors: Zamora Astrid N. , Walia Arjan S. , King Abby C. 
Published: January 2025

Abstract
Background
While recent studies, primarily among Asian cohorts, have linked adherence to 24-hour movement behavior (24-HMB) guidelines with improved mental health—some of which show sex differences—few studies have explored these relationships among older adults from the United States.

Methods
National Health and Nutrition Examination Survey data from 2011-2018 were examined in 2,812 older adults (≥ 65years). Those considered adherent to 24-HMB guidelines had a sleep duration of 7–8 h./night, moderate-vigorous physical activity (MVPA) ≥ 150 min/wk., and sedentary behavior (SB) < 8 h./day. Sleep duration, SB, and MVPA were self-reported, with SB and MVPA obtained from the validated Global Physical Activity Questionnaire. Depression was measured using the Patient Health Questionnaire (PHQ-9), with a score of ≥ 10 indicating depression. Logistic regression was used to evaluate overall and sex-stratified associations between non-adherence to all three behaviors, combinations of two behaviors, or individual behavior guidelines, with odds of depression, adjusted for putative confounders.

Results
Among the full sample, non-adherence to all three 24-HMB guidelines was associated with 1.7 [95% confidence interval (CI):1.1, 3.1; p = 0.02] higher odds of depression versus those that adhered to all three behaviors. After sex stratification, the association only persisted among males [OR = 2.5 (95% CI:1.1, 5.4); p = 0.02]. Within the overall sample, higher odds of depression were observed for those who did not adhere to the SB + sleep duration guidelines and the sleep duration + MVPA guidelines. Sex-stratified findings revealed that associations only remained significant in males. While in the overall sample of older adults, non-adherence to the sleep duration guideline was associated with 2.1 (95% CI:1.4, 3.3; p = 0.001) higher odds of depression compared to those that adhered to the guideline.

Conclusions
Results provide evidence of associations between non-adherence to 24-HMB and higher odds of depression, specifically in older males, suggesting a potential sex-specific effect that warrants further investigation. Future studies using longitudinal designs are needed to confirm these findings and explore the mechanisms underlying these associations.
Optimizing Intravenous Patient-Controlled Analgesia for Cancer Pain: A Randomized Controlled Trial on Adjusted Background Infusion Rates
Authors: Geum Min Jung , Lee Si Won , Lee Choong-kun , Jung Minkyu , Kim Do-Hyeong , Yoo Young Chul , Choi Hye Jin 
Published: January 2025

PURPOSE
Patient-controlled analgesia (PCA) has been considered for managing cancer pain; however, limited research has been conducted on optimizing continuous infusion rates with PCA. This study aimed to evaluate the efficacy and safety of a method that optimizes background infusion (BI) alongside PCA for titrating intravenous (IV) morphine in managing cancer-related pain.

METHODS
Forty-four patients with solid tumors who could not manage pain with oral or transdermal opioid analgesics were randomly assigned in a 1:1 ratio to receive IV morphine through PCA or the conventional method. In the PCA group, the BI rate was automatically adjusted on the basis of the frequency and interval of bolus button presses; contrastingly, BI rate in the conventional group was adjusted at the discretion of the medical staff. The primary outcome was the daily number of patient complaints of breakthrough pain (numeric rating scale ≥4).

RESULTS

The PCA group reported a significant decrease in breakthrough pain complaints at 24 hours (median, 0
v
3 times/d;
P
= .012) and a lower proportion of nonresponders at 24 hours (21%
v
55%;
P
= .048) compared with the conventional group. The total daily IV dose of morphine increased in the PCA group and exhibited a significant difference between two groups within 48 hours (median, 76.80
v
44.42 mg/d;
P
= .036). No uncontrolled opioid-related adverse effects were observed in either group.

CONCLUSION
PCA, with an optimized BI rate, facilitated faster titration of IV morphine than the conventional method, achieving tolerable and rapid pain relief.
Early and Mid-Term Disposition of α-PVP and its unknown Metabolites in Urine and Oral Fluid Through a Multi-Analytical Hyphenated Approach Following a Single Non-Controlled Administration to Healthy Volunteers
Authors: Di Trana Annagiulia , La Maida Nunzia , de la Rosa Georgina , Di Giorgi Alessandro , Graziano Silvia , Aldhaehri Khaled , Papaseit Esther , Hladun Olga , Farré Magí , Pérez Clara , Pichini Simona 
Published: January 2025

Abstract
Nowadays, synthetic cathinones (SCs) is the second more representative subclass of New Psychoactive Substances, accounting for 104 analogues in the illegal market. Since its first report in 2011, α-pyrrolidinovalerophenone (α-PVP) gained popularity among drug users, provoking an increased number of intoxications. Nonetheless, pharmacokinetics data is still limited in the literature. An observational non-controlled naturalistic study on 8 healthy volunteers was conducted to assess the α-PVP and β-OH-α-PVP concentrations in OF and urine, after snorting 10 mg or 20 mg of α-PVP. A multi-analytical approach based on GC-EI-MS/MS and LC-HESI-HRMS/MS was developed and fully validated for the analytes quantification, while four untargeted LC-HESI-HRMS/MS methods in full-MS and ddMS2 were set up for unknown metabolites characterization in urine samples assisted by a dedicated data mining software. In OF, α-PVP reached a mean Cmax of 762 ± 323 ng/mL at 1 h after 10 mg administration, while a Cmax of 2,900 ± 1,373 ng/mL at 47 min after 20 mg dose. In urine, a total α-PVP mean amount of 179.2 ± 94.9 µg was accumulated after 10 mg dose, (27.2 ± 9.8 µg between 0-2 h and 152.0 ± 98.2 µg between 2-5 h), while a total amount of 122.9 ± 44.0 µg, of (36.2 ± 16.5 and 86.7 ± 28.3 µg between 0–2 and 2-5 h, respectively) was detected after 20 mg dose. Among the 10 identified metabolites, β-OH-α-PVP was a minor metabolite (total amount: 56.4 ± 27.1 and 69.1 ± 38.1 µg after 10 mg and 20 mg). The N-butanoic acid metabolite was the most abundant, detected also as glucuronide. In conclusion, α-PVP showed a later time peak than non-pyrrolidine SCs, with comparable Cmax. The pyrrolidine ring oxidative opening produced the most abundant urinary metabolite, independently from the dose.
Factors that support the wellbeing of healthcare professionals: an interpretivist phenomenological study
Authors: Sanan Payal 
Published: January 2025

Background/Aims There is limited knowledge about the complex experiences that contribute to the wellbeing of healthcare professionals emerging from positive elements of this high-stress job environment. It is crucial to explore the underlying mechanisms that promote positive emotions, rather than concentrating solely on the absence of negative emotions. This study aimed to understand the factors affecting the wellbeing of healthcare professionals through the lens of positive psychology. Methods An interpretivist phenomenological study was conducted, focusing on how healthcare professionals interpret the experience of wellbeing. A sample of 12 healthcare professionals, comprising six doctors and six nurses, were interviewed via telephone. Interviews were recorded, transcribed verbatim and analysed using the PERMA framework from positive psychology. Results Several factors were identified as contributing to participants' wellbeing in each domain of the PERMA framework. These included feelings of warmth and joy (positive emotions), a strong sense of interest and immersion in their work (engagement), positive relationships with colleagues and patients (relationships), the ability to derive fulfilment and purpose from their work (meaning) and a sense of their achievements being recognised (accomplishment). Conclusions Exploring the factors that can support the wellbeing of healthcare professionals could help managers and organisations to ensure a more positive experience for staff, which could have benefits for patient care.