bluuebunny/crossref_metadata_2025_split huggingface dataset:
Decreased Elastic Modulus of Knee Articular Cartilage Based on New Macroscopic Methods Accurately Represents Early Histological Findings of Degeneration
Authors: Maeda Takahiro , Kuriyama Shinichi , Yoshida Shigeo , Nishitani Kohei , Nakamura Shinichiro , Matsuda Shuichi 
Published: September 2023

Objective Ex vivo nanoindentation measurement has reported that elastic modulus decreases as cartilage degenerates, but no method has been established to macroscopically evaluate mechanical properties in vivo. The objective of this study was to evaluate the elastic modulus of knee joint cartilage based on macroscopic methods and to compare it with gross and histological findings of degeneration. Design Osteochondral sections were taken from 50 knees with osteoarthritis (average age, 75 years) undergoing total knee arthroplasty. The elastic modulus of the cartilage was measured with a specialized elasticity tester. Gross findings were recorded as International Cartilage Repair Society (ICRS) grade. Histological findings were graded as Mankin score and microscopic cartilage thickness measurement. Results In ICRS grades 0 to 2 knees with normal to moderate cartilage abnormalities, the elastic modulus of cartilage decreased significantly as cartilage degeneration progressed. The elastic modulus of cartilage was 12.2 ± 3.8 N/mm for ICRS grade 0, 6.3 ± 2.6 N/mm for ICRS grade 1, and 3.8 ± 2.4 N/mm for ICRS grade 2. Similarly, elastic modulus was correlated with Mankin score ( r = −0.51, P < 0.001). Multiple regression analyses showed that increased Mankin score is the most relevant factor associated with decreased elastic modulus of the cartilage ( t-value, −4.53; P < 0.001), followed by increased histological thickness of the cartilage ( t-value, −3.15; P = 0.002). Conclusions Mechanical properties of damaged knee cartilage assessed with new macroscopic methods are strongly correlated with histological findings. The method has potential to become a nondestructive diagnostic modality for early cartilage damage in the clinical setting.
HIV/AIDS patients’ knowledge, attitude, and practice toward anti-retroviral therapy medications’ adverse effects and associated factors in Tikur Anbessa Specialized Hospital
Authors: Negash Zenebe , Yibeltal Yohannes , Ayele Akeberegn Gorems 
Published: September 2023

Background: Adverse effects (AEs) have been reported with all antiretroviral therapy (ART) medications, and it was among the most common cause for switching or terminating therapy and drug non-adherence. Even though AEs of ART medications are common and to be expected, little study has been conducted on the understanding of patients on the AEs. Therefore, this study aimed to assess patients’ knowledge, attitude, and practice (KAP) toward ART medications’ AEs and associated factors. Methods: A cross-sectional study design was applied using an interviewer-administered questionnaire from June to September 2021 on human immunodeficiency virus/acquired immunodeficiency syndrome patients on follow-up at Tikur Anbessa Specialized Hospital, Ethiopia. Data was gathered, cleaned, and analyzed using SPSS version 23. Logistic regression analysis was performed to assess the relationship between the independent variable and patients’ knowledge and attitude about the AEs of ART medication. A p-value of 0.05 was used to determine the statistical significance. Results: About 230 people were enrolled in this study, with 51.3% of them female. Study participants had a mean age of 36 years (standard deviation = 14.19). Of 230 participants, 67.8% had received advice on the AEs of ART medications. Poor knowledge and attitude were observed among 47.8 and 51.3% of respondents, respectively. Prior AEs experience, lack of experiencing opportunistic infection, and lack of counseling about ART medications’ AEs were associated with poor knowledge, whereas female gender and a lack of counseling regarding ART medications’ AEs were associated with a negative attitude ( p < 0.05). Even though most patients (81.7%) report AEs of the medication to professionals, a significant number of patients involved in malpractices such as taking other drugs to treat AEs (24.3%), not prepared to do anything (27.1%), change the suspected drug (24.3%), reduce the dose (18.7%), and use local herbal medicines to treat suspected AEs (20.2%). Conclusion: Overall, the study participants had poor knowledge, lack of positive attitudes, and non-adherence to the actual recommended practice toward AEs of ART medications. Lack of comorbidity, having prior AEs experience, and lack of counseling regarding ART medication AEs were associated with poor knowledge. Female gender and a lack of counseling on the AEs of ART medications were associated with a negative attitude.
An evaluation of risk factors for readmission in patients receiving outpatient parenteral antimicrobial therapy
Authors: Bradley Abby C. , Wingler Mary Joyce B. , Artman Katherine L. , Ward Lori M. , Lucar Jose 
Published: September 2023

Background: Outpatient parenteral antimicrobial therapy (OPAT), when required, is beneficial to patients and healthcare systems by reducing hospital length-of-stay, providing cost savings, and improving patient satisfaction. Objectives: The purpose of this study is to determine readmission rates and associated risk factors in patients receiving OPAT at home. Methods: This retrospective study included hospitalized patients 15 years and older who were discharged on intravenous antimicrobial therapy via OPAT at home between January 2018 and December 2019. Patients receiving antimicrobials at a skilled nursing facility, long-term acute care, or dialysis center, and those who began OPAT at home directly from the outpatient setting were excluded. The primary outcome of this study was all-cause 30-day readmission rate. Secondary outcomes included 90-day readmission rate, rates of complications related to OPAT, emergency department visits during OPAT, and predictors of all-cause 30-day readmission through a logistic regression analysis. Results: Two hundred individual patients were included in the analysis; 60% were male and the mean age was 49 years. The most common indications for OPAT at home were bone and joint infection (52%) and bacteremia (26%). Forty patients (20%) experienced an unplanned, all-cause 30-day readmission, with a total of 48 readmission events. Of the 40 patients who were readmitted within 30 days, 20 (50%) were due to non-OPAT related reasons. Sixty patients (30%) experienced an OPAT-related complication, and chronic kidney disease was found to be an independent predictor of readmission (OR: 2.8, 95% CI: 1.0–7.6). Conclusions: Patients receiving OPAT at home are at increased risk for early hospital readmission, but it is often due to reasons not associated with OPAT. Patients with chronic kidney disease beginning OPAT at home should be closely monitored after discharge.
MDMA-assisted psychotherapy with adolescents suffering from PTSD: Do or don’t? a qualitative study with youth, parents, and clinicians
Authors: van Vugt Anoek S , Zijlmans Josjan , Lindauer Ramon , van Dam Levi 
Published: September 2023

Background PTSD in adolescence causes much suffering and has substantial health-care costs. Many patients with severe PTSD do not respond to psychotherapy or continue to have symptoms despite trauma-focused psychotherapies and psychopharmacological treatment. A recent alternative in the search for cost-effective treatments for PTSD in adults is 3,4-methylenedioxymethamphetamine-assisted psychotherapy (MDMA-assisted psychotherapy). However, no research has yet been conducted on the therapeutic potential of MDMA for adolescents. Aims of the study The purpose of this study is to investigate the perspectives of adolescents, parents, and clinicians about the possible clinical application of MDMA-assisted psychotherapy for adolescents with PTSD. Method We performed focus groups in three samples: (a) 16–24-year-olds who had undergone trauma therapy ( N  =  9), (b) parents of traumatized children ( N  =  4), and (c) trauma clinicians ( N  =  6). Focus group topics included: perception of and associations with MDMA, opinions on MDMA-assisted psychotherapy, risks/benefits, and precautions to take prior to possible adolescent clinical trials with MDMA-assisted psychotherapy. Results In all groups, initial participant attitudes towards MDMA were predominantly unfavorable, except for several adolescents who had conducted preliminary research on the subject. After a standardized explanation of MDMA-assisted psychotherapy, provided in each group, all but one participant changed their minds and supported the idea of implementing MDMA-assisted psychotherapy for adolescents. They all emphasized the importance of conducting research first. Conclusion Our findings suggest that when provided with information on what MDMA-assisted psychotherapy entails, adolescents, parents, and clinicians are open to the idea of exploring this type of treatment for adolescents.
Performance Assessment of Anti-Xa Assay–Based Heparin Dosing Protocol in Pediatric Patients on Extracorporeal Membrane Oxygenation
Authors: Al-Jazairi Abdulrazaq S. , Shorog Eman M. , Owaidah Tarek M. , Al dalaty Hani , Alheriash Yasser A. , Almehizia Rayd A. , Alahmadi Mamdouh D. 
Published: September 2023

Background The use of extracorporeal membrane oxygenation (ECMO) in the postoperative cardiac critical care setting is evolving. Anticoagulation monitoring is among the most challenging aspects of pediatrics. However, there is no consensus on the optimal dosing and monitoring of unfractionated heparin in this setting. To address this, we developed an anti-Xa assay–based protocol derived from the best available clinical and anecdotal evidence of ECMO use and assessed its effectiveness in achieving the anti-Xa assay therapeutic target. Methods This prospective single-arm study was conducted in the pediatric carcardiac-surgery intensive care unit of a large tertiary hospital. We used two different anti-Xa assay intensity levels based on the patients’ bleeding status. Results The median patient age was 7 (interquartile range [IQR]: 5-11.25) months, and the median weight was 5.7 (IQR: 3.8-13.82) kg. The median ECMO duration was 6 (IQR: 4.5-7.5) days. The bleeding protocol was used for most patients. Seventy percent achieved the anti-Xa assay therapeutic target during the study period (median: 75.5 h, IQR: 60.5-117.5 h). Hemorrhagic complications were reported in 40% of the patients, and thrombotic complications were reported in 25%. The median length of stay was 37 (IQR: 22-43) days, with a survival-to-discharge rate of 75%. Conclusions Despite a failure to achieve the anti-Xa assay target within the first ECMO days, most patients achieved the target by the median ECMO duration. Moreover, using two different anti-Xa assay levels reduced thrombotic complications.
Prevalence of premature ovarian insufficiency (POI) and its relationship with female reproductive factors in Iranian women: a cross-sectional study from the Persian (Shahedieh) cohort data
Authors: Jambarsang Sara , Khodayarian Mahsa , Sefidkar Reyhane , Yoshany Nooshin 
Published: September 2023

Abstract
Background
In premature ovarian insufficiency, the cessation of menstruation, and cessation of ovarian function occurs before the age of 40, and this phenomenon is associated with many complications and problems for women. Since several factors can affect this situation, this study was conducted to determine the relationship between fertility history, and premature ovarian failure.

Methods
This cross-sectional study was conducted on the data of the first phase of cohort study, which was a sample of 10,000 people from an Iranian adult population (age: 35–70 years). 1276 women were included who naturally experienced menopause from this population. They were separated into three groups based on the age of menopause: premature ovarian failure for those who reached menopause before the age of 40, early menopause for those who reached menopause between the ages of 40 and 45, and natural menopause for those who reached menopause at or after the age of 45. The demographic and fertility characteristics of two groups of women, one with premature ovarian failure and the other with early menopause, were compared with a group of women experiencing normal menopause. The comparison was based on frequency and percentage. Moreover, the odds ratio (OR) of these two groups compared to normal group was crudely calculated, and adjusted based on age at the time of the interview using a logistic regression model. SPSS 23 software was used to fit models and calculations.

Results
The prevalence of premature ovarian failure was 3%. The likelihood of premature ovarian failure decreases as the number of live births rises. The risk is considerably higher for births ranging from zero to three children compared to those with more than four. Increased duration of breastfeeding is associated to a reduced risk of premature ovarian failure compared to the spontaneous occurrence (OR = 0.98, 95% CI (0.97, 0.99)). This relationship is maintained even after adjusting for age (OR = 0.98, 95% CI (0.97, 0.99).

Conclusion
Based on the results of present study, it can be concluded that the factor of the number of births, and the duration of breastfeeding affect reducing the occurrence of POI, therefore, in health and treatment programs and policies, encouragement to have children, which is now part of the policies population of Iran, and the importance, and benefits of breastfeeding for mother and baby should be emphasized more.
Gastroblastoma without GLI1 and EWSR1 gene breaks
Authors: Gong Can , Xu Junyi , Qiao Shuye , Zhang Xuemei , Yi Min 
Published: September 2023

Abstract
Objective
To report a rare gastroblastoma; discuss its clinical features, histopathological morphology, diagnosis, differential diagnosis, treatment, and prognosis; and so as to improve the understanding on this disease and provide reference for its diagnosis, treatment, and prognosis.

Methods
The diagnosis and treatment, imaging examination, pathological, and genetic data of a 19-year-old young female patient with gastroblastoma were analyzed retrospectively, and the relevant literature was reviewed and summarized.

Results
The patient was found to have a “gastrointestinal stromal tumor” for 3 days by physical examination in another hospital. Abdominal CT and MRI considered “solid pseudopapilloma of pancreas” and clinically planned to perform “radical pancreatoduodenectomy.” During the operation, the tumor was observed to bulge from the posterior wall of the gastric antrum, and the root was located in the gastric antrum, so it was changed to “partial gastrectomy + Ronx-y gastrojejunal anastomosis.” The postoperative pathology showed that the tumor was bi-differentiated between gastric epithelium and mesenchymal. Combined with the results of IHC and the opinions of several consultation units, the diagnosis of gastric blastoma (low-grade malignancy) was supported. However, the fracture rearrangement of GLI1 and EWSR1 genes was not detected by FISH. After 19 months of follow-up, no signs of tumor recurrence and metastasis were found.

Conclusion
Combined with existing literature reports, gastroblastoma occurs in young people, equally in men and women, and tends to occur in the gastric antrum. The biological behavior of the tumor tends to be inert, and the prognosis of most cases is good. Postoperative pathology and IHC are reliable methods for the diagnosis of gastric blastoma, and surgical resection of the lesion is the preferred treatment.
Breastfeeding needs of mothers of preterm infants in China: a qualitative study informed by the behaviour change wheel
Authors: Yu Yaqi , Liu Qianru , Xiong Xiaoju , Luo Ying , Xie Wen , Song Wenshuai , Fu Maoling , Yang Qiaoyue , Yu Genzhen 
Published: September 2023

Abstract
Background
Although breastfeeding is strongly recommended, the breastfeeding rate of preterm infants in China remains significantly low. In addition to the global structural challenges to breastfeeding and the physiological immaturity of preterm infants, Chinese mothers of preterm infants face unique challenges of maternal-infant separation after birth. Moreover, little is known about Chinese mothers’ specific needs in coping with the difficulties posed by these challenges. This study utilized the Behaviour Change Wheel to investigate the breastfeeding needs of Chinese preterm mothers that may facilitate its practice in the future.

Method
A qualitative descriptive design was implemented in Wuhan in 2022. Based on purposeful sampling, 13 preterm mothers were recruited from a NICU in a Grade III Class A hospital in Wuhan, China. Face-to-face semi-structured interviews were conducted to collect data using the interview guide developed by the Theoretical Domains Framework. Theoretical Thematic Analysis was used to review the data in 6 steps to identify themes.

Results
Five major themes emerged: (1) capability: ability to interpret infants’ cues and identify problems, and need for breastfeeding knowledge and skills training; (2) physical opportunity: cleanliness and quietness in household environment, private lactation spaces and breastfeeding tools in workplaces and hospitals; (3) social opportunity: family support, peer support, and authoritative support from healthcare providers; (4) reflective motivation: information on health impacts of breastfeeding; (5) automatic motivation: maternal-infant bonding, free of aversive stimulus.

Conclusion
Preterm mothers’ needs to enable breastfeeding were diverse, including increasing their capability, physical and social opportunities, and reflective and automatic motivation. People, resources and environments associated with these needs should be engaged together to stablish a conducive structural environment for breastfeeding. The policy change for “zero separation” and implementation of kangaroo care should also be implemented in Chinese neonatal intensive care units. Future studies are needed to design effective interventions according to mothers’ specific needs.
Factors related to information and communication technologies adoption in small businesses in Colombia
Authors: Duran Julian , Castillo Rubén 
Published: September 2023

AbstractThis study is an analysis of how a set of factors influenced the decision to adopt information and communication technologies (ICTs) in small businesses in Colombia; for this purpose, a logistic modeling is applied, wherein the explained variable represents the companies’ decision to adopt ICTs. The main explanatory elements include demographic aspects of the owner, the company characteristics, and the legal practice of the company and its social capital. Data from the Microbusiness Survey 2019 conducted by the National Administrative Department of Statistics of Colombia were employed. The results show that traits such as owner age and gender affect adoption. Furthermore, variables such as the age and size of the company, the amount of computer equipment, business formalization practices, and social capital influence the use of these technologies. Therefore, it follows that the individual features of business owners are also determinants of technology adoption, and their inclusion becomes essential to supplement the analysis of these issues. In addition, the study supports the evidence that the acceptance of these technologies is positively related to the business size and infrastructure. By exploring, for example, the business formalization factor, a positive effect is obtained; consequently, the implementation of legal practices is linked to the ICT use. Thus, some of the areas for policy implementation would be, on one hand, the endowment of computer equipment, since it is a critical aspect in these small businesses, for which a subsidy policy for the acquisition of devices would be useful. In addition, the promotion of business formalization practices could lead to an improvement in the firm’s culture of technology use.
Industrial policy and labour productivity growth in Africa: does the technology choice matter?
Authors: SIÉ Kouakou Jean Fidele 
Published: September 2023

AbstractThe persistent gaps in African sectoral labour productivity and the disappointing growth in the manufacturing and service sectors have revived interest among academics and policymakers. In search of ways to boost labour productivity, this study explores how the technology choice as a proxy for industrial policy can affect labour productivity growth. First, I identify the different sources of growth with the decomposition method of shift–share analysis and a recent dataset from 1960 to 2017 of nine sectors. Then I investigate the impact of comparative advantage development strategy on growth components (within effects and structural effects). The shift and share decomposition analysis results suggest a changing role of growth components. While the structural change effect is driven by the “static gains” which still plays an important role, the within effect has been more prevalent during the MDGs and SDGs period. The empirical results indicate that defying comparative advantage hinders the within effect component mitigated by a weak and positive dynamic effect component. The evidence emphasises the design of industrial development based on the comparative advantage in SSA, complemented with policies and strategies aiming at increasing labour productivity in the agriculture sector due to its large employment share.
Socioeconomic factors of global food loss
Authors: Chrisendo Daniel , Piipponen Johannes , Heino Matias , Kummu Matti 
Published: September 2023

AbstractA considerable amount of food produced is lost globally. Food loss indicates not only the amount of edible food that humans do not consume but also the waste of resources used in production and distribution, linked with multifold problems such as climate change, biodiversity loss, and economic loss. While there has been a growing body of literature about magnitudes and technical solutions to reduce food loss, little is known about how different socioeconomic factors are potentially related to the losses. Here we assess the relationships between various relevant socioeconomic factors and food loss within the early stages of the food supply chain (i.e., farm, harvest, storage, and transport parts of it) using the most comprehensive data available. We found that factors such as high gross national income (GNI) per capita and high employment in agriculture are significantly associated with low food loss. It suggests that income might be invested in technology or infrastructure while labor is still vital to reduce food loss, especially in technology-inferior countries. Other important factors related to low food loss are access to electricity in rural areas and export volume index, although the significance and directions vary in each commodity and food supply stage. Our results provide valuable insights into socioeconomic factors around food loss that are beneficial to formulating relevant policy, especially in countries where substantial food losses in the early stages of the food supply chain considerably risk to food security.