bluuebunny/crossref_metadata_2025_split huggingface dataset:
Married women decision making autonomy on health care utilization in high fertility sub-Saharan African countries: A multilevel analysis of recent Demographic and Health Survey
Authors: Negash Wubshet Debebe , Kefale Getachew Teshale , Belachew Tadele Biresaw , Asmamaw Desale Bihonegn 
Published: July 2023

Background
Women’s decision-making autonomy has a potential impact on the scale-up of health care utilization. In high fertility countries, evidence regarding women’s decision-making autonomy on their health care utilization and its associated factors is limited and inconclusive. Hence, it is important to investigate women decision-making autonomy on their health care utilization and associated factors in high fertility countries in sub-Saharan Africa.

Methods
The data source for this study was obtained from recent Demographic and Health Surveys that were comprised of a weighted sample of 178875 reproductive age women. A multilevel mixed-effect binary logistic regression model was fitted. The odds ratios, along with the 95% confidence interval were generated to identify individual and community-level factors associated with women’s autonomy in health care decision-making. A p-value less than 0.05 was declared as statistical significance.

Results
In this study, 42% (95% CI: 41.7, 42.3) of women were able to exercise their reproductive autonomy. The highest (74.8%) and the lowest (19.74%) magnitude of women autonomy was found in Angola and Mali, respectively. In multilevel analysis; age of women 25–34 years, 35 and above (AOR = 1.34, 95% CI: 1.29, 1.39), and (AOR = 1.78, 95% CI: 1.75, 1.90), women’s primary and secondary educational level (AOR = 1.25, 95% CI: 1.20, 1.31), and (AOR = 1.44, 95% CI: 1.32, 1.54), husband primary and secondary educational level (AOR = 1.24, 95% CI: 1.18, 1.29), and (AOR = 1.21, 95% CI: 1.15, 1.27), women who had work (AOR = 1.67, 95% CI: 1.59, 1.74) female household heads (AOR = 1.44, 95% CI: 1.37, 1.51), media exposure (AOR = 1.04, 95% CI: 1.09, 1.18), health insurance coverage (AOR = 1.26, 95% CI: 1.17, 1.36), urban residence (AOR = 1.14, 95% CI: 1.09, 1.19), community education (AOR = 2.43, 95% CI: 2.07, 2.85) and low community poverty level (AOR = 1.27, 95% CI: 1.08, 1.49) were predictor variables.

Conclusion and recommendation
Although every woman has the right to make her own health care decisions, this study showed that almost 58% of them had no role in making decisions about their health care utilization. Thus, each country Government should support women’s decision making autonomy regarding their healthcare utilization through mass media and extensive behavioral education.
Learning curve for flexible bronchoscope-guided orotracheal intubation for anesthesiology residents: A cumulative sum analysis
Authors: Cai Xingzhi , Yue Mingming , Liu Xiaohui , Zhang Lize , Wu Shanshan , Shen Wenlong , Yu Ailan 
Published: July 2023

BackgroundEndotracheal intubation with a flexible bronchoscope is a well-recognized airway management technique that anesthesiologists must master. Skill acquisition and knowledge must reach an appropriate level before trainees perform independent practice on patients. There are a paucity of evidence-based outcome measures of trainee competence in performing flexible bronchoscopy. The objectives of this study were to 1) construct a learning curve for flexible bronchoscope-guided orotracheal intubation for anesthesiology residents using the CUSUM method and 2) determine the number of procedures required to achieve proficiency.MethodsThis study included 12 first-year anesthesiology residents with no previous experience with flexible bronchoscopic intubation. Trainees attended theoretical and simulation training and performed flexible bronchoscope-guided orotracheal intubation in adult patients with normal airways under general anesthesia. Number of intubation attempts, intubation success rate, time to intubation, and incidence of dental and mucosal injuries were recorded. The cumulative sum (CUSUM) method was used to evaluate the learning curve of flexible bronchoscope-guided orotracheal intubation.ResultsTrainees performed flexible bronchoscope-guided orotracheal intubation on 364 patients. First-attempt intubation success occurred in 317 (87.1%) patients. Second-attempt intubation success occurred in 23 (6.3%) patients. Overall, the flexible bronchoscope-guided orotracheal intubation success rate was 93.4% (range, 85.3% to 100%). The mean number of orotracheal intubation procedures per trainee was 31 ± 5 (range, 23 to 40). All trainees crossed the lower decision boundary (H0) after 15.1 ± 5.6 procedures (range, 8 to 25 procedures). There was a significant decrease in median intubation time [39s (IQR: 30, 50) vs. 76s (IQR: 54, 119)] (P< 0.001) after crossing the lower decision boundary (H0) compared to before. There were no dental, mucosa, arytenoid or vocal cord trauma events associated with intubation.ConclusionsLearning curves constructed with CUSUM analysis showed that all trainees (anesthesiologist residents) included in this study achieved competence (intubation success rates ≥ 80%) in flexible bronchoscope-guided orotracheal intubation. Trainees needed to perform 15 (range, 8 to 25) procedures to achieve proficiency. There was wide variability between trainees.Trial registrationTrial registration:Chinese Clinical Trial Register,ChiCTR 2000032166.
Validation of epigenetic markers for prediction of response to topical corticosteroid treatment in eosinophilic esophagitis
Authors: Jensen Elizabeth T. , Langefeld Carl D. , Howard Timothy D. , Dellon Evan S. 
Published: July 2023

Abstract

Background:
We previously identified 18 CpG methylation biomarkers associated with treatment response to topical steroids (tCS) in eosinophilic esophagitis (EoE). Here, in an independent cohort, we assessed the validity of these CpG sites as treatment response biomarkers.

Methods:
DNA was extracted from prospectively biobanked esophageal biopsies from newly diagnosed EoE patients enrolled in a randomized trial of two tCS formulations. Histologic response was defined as <15 eosinophils per high-power field (eos/hpf). Pre-treatment DNA methylation was assayed on the Illumina Human MethylationEPIC BeadChip. Logistic regression and area under the ROC (AUC) analyses, adjusting for chip, position on the chip, age, sex, and baseline eosinophil count, were computed to test for an association between DNA methylation and treatment response at the 18 previously identified CpG sites.

Results:
We analyzed 88 patients (58 histologic responders, 30 non-responders), with a mean age of 38±16 years, 64% male, 97% White race. Of the 18 CpG sites, 13 met quality control criteria, and three were associated with responder status (p<0.012), including sites within UNC5B (cg26152017), ITGA6 (cg01044293), and LRRC8A (cg13962589). All three showed evidence of reduced methylation in treatment responders, consistent with the original discovery associations. The predictive probability for non-response with all three CpG sites was strong (AUC=0.79).

Discussion:
We validated epigenetic biomarkers (CpG methylation sites) for prediction of tCS response in EoE patients in an independent population. While not all previously identified markers replicated, three demonstrated a relatively high predictive probability for response to treatment and hold promise for guiding tCS treatment in EoE.
Acolhimento de crianças de origem cigana em escola pública de Minas Gerais, Brasil
Authors: Ferreira Telma Ellen Drumond 
Published: July 2023

Apesar de sua riqueza cultural, o povo cigano, como muitas outras minorias étnicas, sofre grande discriminação e preconceito em todos os países, inclusive no Brasil. Os ciganos brasileiros têm a matrícula escolar garantida por lei nas escolas (LDB 9.394/96), mas o caráter nômade ou seminômade de seus acampamentos dificulta um processo efetivo de frequência, acompanhamento do rendimento e intervenção escolar, resultando em baixo aproveitamento e consequente discriminação social. Diante desse contexto, este projeto de extensão universitária tem como objetivo principal promover ações de socialização dos alunos de origem cigana (calé) em uma escola pública da cidade de Santa Bárbara, Minas Gerais. Por meio de oficinas de arte, a equipe do projeto permitiu e incentivou que as crianças ciganas falassem livremente de seus anseios, aspirações e dificuldades. Essas ações são importantes para uma consequente melhoria da socialização e rendimento escolar delas, tendo como foco as políticas de combate à exclusão escolar e social. Ao trabalhar com as dificuldades, as ansiedades e os medos das crianças originárias de famílias ciganas, os graduandos da Universidade do Estado de Minas Gerais vivenciaram um importante momento de aprendizagens sociais, o que contribui para a formação de um profissional da área de Engenharia mais integrado às demandas da sociedade.
Local therapy of the knee osteoarthritis: results of a multicenter study of meloxicam
Authors: Toroptsova N. V. , Bagretsova A. A. , Bursikov A. V. , Kuzmicheva E. V. 
Published: July 2023

Osteoarthritis (OA) is a chronic progressive joint disease that leads to disability. One of the main treatment approaches in OA is to reduce pain and increase the functional activity of patients.Objective: to evaluate the efficacy, tolerability and safety of Meloxicam Canon (MC) in the form of a 1% gel for external use as a symptomatic therapy in patients with knee OA, accompanied by pain.Material and methods. The randomized, open, multicenter study included 100 patients aged 50 to 80 years with stage II–III knee OA, who were randomized into two groups in a 1:1 ratio. In the main group, patients applied MC gel topically, and in the comparison group –Amelotex® gel. Patients were examined at baseline, and after 7, 14 and 28 days. The following indicators were studied: intensity of pain during movement on a visual analogue scale (VAS), affected knee circumference (AKC); Lequesne and WOMAC indices; patient global health assessment (PGHA) according to VAS; response to therapy, tolerability according to the number of adverse reactions (AR), safety according to blood and urine tests.Results and discussion. Pain intensity according to VAS by the end of the observation period decreased on average by 65.0±25.6% in the main group, and by 62.8±29.1% in the comparison group (p<0.0001 for each group). AKS significantly decreased by visit 3 in both groups. There was an improvement in PGHA by VAS by 69.7±24.3 and 66.6±26.8% on average, respectively (p><0.0001 for each group). The average decrease in the Lequesne index was 55.0±30.1 and 52.8±38.3%, and in the WOMAC index – 58.9±30.8 and 59.3±31.8%, respectively, in the main group and comparison group (p><0.0001 in each group for both indices), while there were no differences in the dynamics of all indicators between the two groups (p>0.05). During the observation, no negative dynamics in patients’ condition in both groups was noted. No serious ARs or deaths were recorded during the study.Conclusion. The conducted multicenter study demonstrated that MC gel is an effective and safe drug for local use in OA, accompanied by pain.
A prospective comparative randomized trial of the efficacy and safety of topical tenoxicam and diclofenac in knee osteoarthritis
Authors: Kashevarova N. G. , Taskina E. A. , Strebkova E. A. , Sharapova E. P. , Savushkina N. M. , Korotkova T. A. , Alekseeva L. I. , Lila A. M. 
Published: July 2023

Local forms of non-steroidal anti-inflammatory drugs (NSAIDs) are characterized by a high safety profile due to low systemic absorption. They do not increase the risk of developing class-specific gastrointestinal, cardiovascular and kidney adverse events (AEs), which makes it possible to prescribe them even in severe comorbid pathology, which is typical for patients with osteoarthritis (OA).Objective: to evaluate the efficacy and safety of Artoxan gel (tenoxicam) 1% in comparison with Diclofenac gel 1% in patients with knee OA in a prospective comparative randomized trial.Material and methods. The study included 60 patients with Kellgren–Lawrence stages II–III knee OA, aged 41 to 78 years. The patients were randomly divided into two groups: the 1st group received Artoxan gel 1%, 5 cm 2 times a day for 14 days; 2nd – Diclofenac gel 1% according to the same scheme. During therapy, we assessed pain using a visual analog scale, the WOMAC index, quality of life using the EQ-5D questionnaire, satisfaction with therapy, and time to effect.Results and discussion. It has been demonstrated that local forms of NSAIDs have a positive effect on all clinical manifestations of OA: effectively reduce pain, stiffness, improve the functional state of the joints and quality of life. They also have a good safety profile and a fast symptomatic response. Comparison of the two groups showed that in patients receiving the local form of tenoxicam, there was a tendency to a more rapid and pronounced analgesic effect.Conclusion. The results of the study confirm the good efficacy and safety of local forms of NSAIDs.
Clinical masks of marble disease
Authors: Radaikina O. G. , Usanova A. A. , Fazlova I. Kh. , Guranova N. N. , Radaikina E. V. 
Published: July 2023

Marble disease, or osteopetrosis (OPT), is rare in the practice of a rheumatologist, internist or pediatrician. This group of hereditary diseases is based on a defect in the formation, development and functioning of osteoclasts (OCL), which leads to disruption of the processes of resorption and remodeling of bone tissue. Disturbance of resorption leads to increased density and changes in the quality of the bones, as a result of which they become more fragile. As a rule, the disease manifests with pathological fractures. In recent decades, 70% of patients with OPT have been found to have mutations in at least 10 genes that lead to impaired functioning of the OCL. Depending on the variant of inheritance, autosomal dominant, autosomal recessive and intermediate types of OPT are distinguished. Autosomal dominant OPT has a benign course that can be asymptomatic or characterized by multiple bone fractures and other spinal anomalies. The disease usually manifests in adulthood or adolescence. Life expectancy in patients of this group does not differ from that in the general population. Malignant, or infantile, OPT is associated with an autosomal recessive inheritance pattern. Its clinical manifestations are observed from the moment of birth, without treatment, patients die within the first decade of life. In such patients, in addition to the skeletal pathology, there is involvement of the hematopoietic system, compression of the cranial nerves and their function disturbance.The article presents a clinical case of autosomal dominant OPT diagnosed in adulthood (at the age of 38), when the patient referred to the doctor for the first time. Differential diagnosis with ankylosing spondylitis and paraneoplastic spondyloarthritis was performed.
Aspects of Visual Content Covered in the Audio Description of Arabic Series: A Corpus-assisted Study
Authors: Darwish Noor , Haider Ahmad S. , Saed Hadeel 
Published: July 2023

Abstract
People with visual impairment need a special form of audio-visual translation (AVT) to have access to multimedia products such as series and movies. Audio description (AD) is an AVT mode that describes what is happening in the images through words. It is a necessary accessibility tool that allows the blind and visually impaired to visualize scenes through spoken material. This study examines the types of information covered in the AD of the Jordanian Netflix drama series ‘Madrast Al-Rawabi LilBanat’ (AlRawabi School for Girls) following a corpus-assisted approach. Subsequent to watching the series and transcribing the verbal AD content, the researchers conducted frequency and concordance (KWIC) analyses using the Wordsmith 6 (WS6) software package to identify the categories of information covered in the AD. The findings showed six categories, namely description of characters, description of actions, interpersonal interactions, description of settings, emotional states, and on-screen texts. This study recommends conducting further research on AD in the Arab world to expand the accessibility services provided by official TV channels and streaming platforms.
Lessons in clinical reasoning – pitfalls, myths, and pearls: a case of crushing, substernal chest pain
Authors: Trumbull Denslow Allerton , Braschi Erica L. , Jain Ankur , Southwick Frederick S. , Parsons Andrew S. , Radhakrishnan Nila S. 
Published: July 2023

Abstract

Objectives
Diagnostic error is not uncommon and diagnostic accuracy can be improved with the use of problem representation, pre-test probability, and Bayesian analysis for improved clinical reasoning.

Case presentation
A 48-year-old female presented as a transfer from another Emergency Department (ED) to our ED with crushing, substernal pain associated with dyspnea, diaphoresis, nausea, and a tingling sensation down both arms with radiation to the back and neck. Troponins were elevated along with an abnormal electrocardiogram. A negative myocardial perfusion scan led to the patient’s discharge. The patient presented to the ED 10 days later with an anterior ST-elevation myocardial infarction.

Conclusions
An overemphasis on a single testing modality led to diagnostic error and a severe event. The use of pre-test probabilities guided by history-taking can lead to improved interpretation of test results, ultimately improving diagnostic accuracy and preventing serious medical errors.
Língua e raça no Brasil colonial
Authors: Severo Cristine , Makoni Sinfree 
Published: July 2023

Resumo
Neste artigo, exploramos e analisamos o processo de racialização da língua portuguesa e dos sujeitos africanos no contexto colonial brasileiro. Para tal, exploramos a relação entre as dimensões econômica e política do colonialismo e as práticas linguísticas dos povos africanos escravizados no Brasil. À luz do aparato colonial português – que combinava interesses religiosos, políticos e econômicos – este artigo analisa o papel desempenhado pelas línguas e pelas ideologias linguísticas racializadas, tanto na promoção da exploração como na resistência à dominação colonial. A partir de uma perspectiva histórica e crítica, analisamos o dispositivo econômico e social que sustentou os africanos escravizados no Brasil, profundamente orientado por um sistema baseado no modelo do engenho. Exploramos quatro exemplos: o uso dos termos boçal, ladino, crioulo e língua; a aprendizagem do português pelos africanos escravizados e o papel da proficiência em português; a política de nomeação e etnização; e as ideologias linguísticas missionárias. Apontamos para a relação entre quatro elementos inter-relacionados: as dimensões ideológicas da língua, os processos de racialização, a dominação econômica e as práticas de resistência. Concluímos em defesa de um conceito descolonizador de língua em contextos coloniais que considere a pluralidade de vozes e a epistemologia crítica inscrita na noção de multilinguismos diaspóricos coloniais do Sul Global.
Uniqueness theorems of the Hahn difference operator of entire function with a Picard exceptional value
Authors: Zhang Xiaomei , Wu Zhaojun 
Published: July 2023

Abstract
Let

f

f

be a transcendental entire function of finite order with a Picard exceptional value

β
∈
C

\beta \in {\mathbb{C}}

,

q
∈
C
\

{

0
,
1

}

q\in {\mathbb{C}}\setminus \left\{0,1\right\}

and

c

c

are complex constants. The authors prove that

D

q
,
c

f

(

z

)

−
a

f

(

z

)

−
a

=

a

a
−
β

,

\frac{{{\mathfrak{D}}}_{q,c}f\left(z)-a}{f\left(z)-a}=\frac{a}{a-\beta },

if

D

q
,
c

f

(

z

)

{{\mathfrak{D}}}_{q,c}f\left(z)

and

f

(

z

)

f\left(z)

share value

a

(

≠
β

)

a\left(\ne \beta )

CM, where

D

q
,
c

f

(

z

)

=

f

(

q
z
+
c

)

−
f

(

z

)

(

q
−
1

)

z
+
c

{{\mathfrak{D}}}_{q,c}f\left(z)=\frac{f\left(qz+c)-f\left(z)}{\left(q-1)z+c}

is the Hahn difference operator. This result generalizes the related results of Zongxuan Chen [On the difference counterpart of Brück’s conjecture, Acta Math. Sci. 34B (2014), 653–659].
Predicting the incidence of chronic kidney disease in patients with myocardial infarction and acute kidney injury
Authors: Demchuk O. V. , Sukmanova I. A. 
Published: July 2023

Aim. To estimate the incidence of chronic kidney disease (CKD) and develop a calculator to estimate the CKD probability in patients with myocardial infarction (MI) and acute kidney injury (AKI).Material and methods. A total of 193 patients with MI aged 34-79 years were examined: 123 patients with MI and signs of AKI, 70 patients without AKI. In all patients, the levels of C-reactive protein, troponin I, N-terminal pro-brain natriuretic peptide (NT-proBNP), microalbuminuria (MA), creatinine, and glomerular filtration rate (GFR) were determined. In the presence of AKI criteria on the 3rd day and at discharge, the level of kidney injury molecule-1 (KIM-1) molecule and interleukin-18 was examined in the urine. Six months after discharge, GFR was assessed over time. Patients of both groups underwent coronary angiography with stenting of infarct-related artery.Results. The GFR at admission in patients with AKI was lower than in the group without AKI with normal creatinine levels. Following correlations between AKI and markers of cardiovascular events were revealed: KIM-1 and NT-proBNP (r=0,29 p=0,031), GFR and NT-proBNP (r=-0,22 p=0,015), NT-proBNP and IL-18 (r=0,18 p=0,045), MA with troponin I and CRP (r=0,20 p=0,048 and r=0,29 p=0,001). After six months, persistent renal function decline was more frequently diagnosed in patients with acute MI and AKI on index hospitalization. An equation for a multifactorial model for CKD risk was created: P(CKD)=exp(z)/(1+exp(z)), z=-1,113092e+01 — 4,082006e-02 * troponin I + 8,553826e-04 * NT-proBNP (discharge) + 1,620188e-01 * age + 3,411724e-02 * systolic blood pressure -7,753111e-03 * MA. ROC analysis revealed the most reliable sensitivity of 83% and specificity of 88,2% for the threshold value of CKD probability of 86,1%.Conclusion. Patients with MI and AKI have a significant risk of CKD within 6 months after ACS. The created mathematical model and calculator determine the likelihood of CKD.
Stress test with physical activity: features of hemodynamics and kinetics of carotid arteries in atherosclerotic stenosis
Authors: Fedorina M. A. , Davydkin I. L. , Germanova O. A. 
Published: July 2023

Aim. To analyze the effect of exercise on cerebral hemodynamics in borderline ste­­nosis of internal carotid artery (ICA) (40-69%) in asymptomatic patients.Material and methods. The study included 120 patients: group I (n=40) — without signs of carotid bifurcation atherosclerosis; II (40) — with hemo­dynamically insignificant stenosis of ICA (40-69%): IIA — with ICA stenosis of 40-59% (18); IIB — 60-69% (22); III (40) — with hemodynamically significant stenosis of ICA (≥70%, without occlusion). All patients underwent following investigations: blood coagulation and lipid profile tests; doppler ultrasound of extracranial vessels, sphygmography of the common carotid artery (CCA), brain computed tomography, transcranial doppler ultrasound, cycle ergometer stress echocardiography with determination of ICA stenosis hemo­dynamics.Results. In most (29 (72,5%)) patients of group II, stress test revealed a de­crease in ICA flow, CCA kinetics according to sphygmography compared with group I, as well as a direct correlation between the degree of stenosis and a blood flow decrease. The indicators approached the data of group III patients.Conclusion. With stenosis of the ICA (40-69%), when a submaximal heart rate (HR) is reached, a functional hemodynamically significant stenosis of the ICA develops. An additional indication for carotid endarterectomy is a combination of 40-69% stenosis and functional hemodynamically significant stenosis when submaximal heart rate is reached. Patients with ICA stenosis (40-69%) require a stress test to assess functional hemodynamically significant stenosis when submaximal heart rate is reached.