bluuebunny/crossref_metadata_2025_split huggingface dataset:
The burden of unintended pregnancies among Indian adolescent girls in Bihar and Uttar Pradesh: findings from the UDAYA survey (2015–16 & 2018–19)
Authors: Sharma Himani , Singh Shri Kant 
Published: April 2023

Abstract
Background
Unintended pregnancy severely affects the health and welfare of women and children, specifically if women are young and vulnerable. This study aims to determine the prevalence of unintended pregnancy and its determinants among adolescent girls and young adult females in Bihar and Uttar Pradesh. We believe the present study is unique as it examines the association between unintended pregnancy and sociodemographic factors among young female population in two states of India from 2015–19.

Methods
The data for the present study is derived from the two-wave longitudinal survey “Understanding the lives of adolescents and young adults” (UDAYA) conducted in 2015–16 (Wave 1) and 2018–19 (Wave 2). Univariate, bivariate analysis along with logistic regression models were employed.

Results
The results revealed that 40.1 per cent of all currently pregnant adolescents and young adult females reported their pregnancy as unintended (mistimed and unwanted) in Uttar Pradesh at Wave 1 of the survey, which decreased to 34.2 per cent at Wave 2. On the contrary, almost 99 per cent of all currently pregnant adolescents in Bihar reported their pregnancy as unintended at Wave 1, which decreased to 44.8 per cent at Wave 2. The sociodemographic factors like age, caste, religion, education, wealth, media and internet use, knowledge and effective contraception highly impacted unintended pregnancy in Bihar and Uttar Pradesh. The longitudinal results of the study revealed that place of residence, internet use, number of wanted children, heard about contraception and SATHIYA, use of contraception, side effects of contraception, and the confidence in getting contraceptives from ASHA/ANM did not appear significant predictors at Wave 1. However, they emerge significant over time (Wave 2).

Conclusions
Despite many recently launched policies for adolescents and the youth population, this study comprehended that the level of unintended pregnancies in Bihar and Uttar Pradesh stands worrisome. Therefore, adolescents and young females need more comprehensive family planning services to improve their awareness and knowledge about contraceptive methods and use.
Predictors of in-hospital mortality among patients with symptoms of stroke, Mashhad, Iran: an application of auto-logistic regression model
Authors: Hadianfar Ali , Sasannezhad Payam , Nazar Eisa , Yousefi Razieh , Shakeri Mohammadtaghi , Jafari Zahra , Hashtarkhani Soheil 
Published: April 2023

AbstractBackgroundStroke is the second leading cause of death in adults worldwide. There are remarkable geographical variations in the accessibility to emergency medical services (EMS). Moreover, transport delays have been documented to affect stroke outcomes. This study aimed to examine the spatial variations in in-hospital mortality among patients with symptoms of stroke transferred by EMS, and determine its related factors using the auto-logistic regression model.MethodsIn this historical cohort study, we included patients with symptoms of stroke transferred to Ghaem Hospital of Mashhad, as the referral center for stroke patients, from April 2018 to March 2019. The auto-logistic regression model was applied to examine the possible geographical variations of in-hospital mortality and its related factors. All analysis was performed using the Statistical Package for the Social Sciences (SPSS, v. 16) and R 4.0.0 software at the significance level of 0.05.ResultsIn this study, a total of 1,170 patients with stroke symptoms were included. The overall mortality rate in the hospital was 14.2% and there was an uneven geographical distribution. The results of auto-logistic regression model showed that in-hospital stroke mortality was associated with age (OR = 1.03, 95% CI: 1.01–1.04), accessibility rate of ambulance vehicle (OR = 0.97, 95% CI: 0.94–0.99), final stroke diagnosis (OR = 1.60, 95% CI: 1.07–2.39), triage level (OR = 2.11, 95% CI: 1.31–3.54), and length of stay (LOS) in hospital (OR = 1.02, 95% CI: 1.01–1.04).ConclusionOur results showed considerable geographical variations in the odds of in-hospital stroke mortality in Mashhad neighborhoods. Also, the age- and sex-adjusted results highlighted the direct association between such variables as accessibility rate of an ambulance, screening time, and LOS in hospital with in-hospital stroke mortality. Thus, the prognosis of in-hospital stroke mortality could be improved by reducing delay time and increasing the EMS access rate.
An empirical link between motivation gain and NBA statistics: applying hierarchical linear modelling
Authors: Shim Yunsik , Shin Myoungjin 
Published: April 2023

Abstract
Background
This study tested whether the motivation gain in groups is the result of social compensation or the Köhler effect by examining scaled individual salaries of National Basketball Association (NBA) players. Both factors explain the positive effects of a group, unlike social loafing. However, differing causes in motivation gain relate to whether players are low or high performers and the Köhler effect or social compensation.

Methods
To test motivation gain, this study used 11-year NBA statistical data of 3247 players by applying hierarchical linear modelling (HLM) and HLM 7.0 was used for analysis. The players’ individual statistics and annual salaries were collected from the NBA and ESPN websites, respectively. Whereas previous studies have looked at motivation gain through track-and-field and swimming relay records, this study verified motivation gain through salary variations among NBA players and their affiliated teams.

Results
The high performers, while selecting teams with larger performance gaps among team members, earned a higher salary than while selecting teams with lower performance gaps among team members. This study found that motivation gain existed in high performers, which can be interpreted as support for social compensation rather than the Köhler effect.

Conclusions
We used our result to elucidate the basis for play-by-play decisions made by individuals and team behaviour. Our results are applicable for the enhancement of coaching strategies, ultimately improving team morale and performance. It can be interpreted that the motivation gains of high performers in the NBA are driven by the Cost Component of the Team member Effort Expenditure Model (TEEM), rather than the Expectancy and Value Components.
Functional scales used by the Egyptian physiotherapist in the assessment of low back pain: a cross-sectional study
Authors: Elhafez Haytham Mohamed , Sweed Maha Mabrouk , Abd El-hay Mohamed Ibrahim 
Published: April 2023

Abstract
Background
The use of functional scales is crucial for the management of low back pain. Numerous pertinent outcome measures are available; however, it is unknown how much use Egyptian physiotherapists make of these scales and measurements when diagnosing and treating patients with low back pain.

Aim
The purpose of this study was to investigate how Egyptian physical therapists working in Egypt used functional outcome measures and scales when treating low back pain.

Design and methods
A cross-section study used an online web-based survey which was accessible to all Egyptian physiotherapists practicing in Egypt.

Results
334 Egyptian physical therapists participated in this study. The use of the pain disability index and back pain functional scale represents the highest frequency of (always/often) of 56.3% and 53.6% respectively, whereas the use of the Quebec Back Pain Disability Scale or the Roland-Morris Disability Questionnaire represents the highest frequency of (rarely/never) 45.8% and 53%, respectively. There was no significant association between gender, years of experience, educational level, and work setting with the use of functional outcome measures (p > 0.05).

Conclusion
Egyptian physiotherapists more usually utilize the pain disability index and back pain functional scale (PDI and BPFS), when evaluating their patients with low back pain, although they did not commonly use the Roland-Morris Disability Questionnaire or the Quebec Back Pain Disability Scale
Higher Peripheral Thyroid Sensitivity Is Linked to a Lower Risk of Heart Failure After Acute Myocardial Infarction
Authors: Lang Xueyan , Zhao Bing , Fang Shaohong , Li Lulu , Li Zhaoying , Wu Nilian , Zhang Yuheng , Xing Lei , Li Yilan , Zhang Yao 
Published: April 2023

Abstract

Context
It is still not clear how the free triiodothyronine (FT3) to free thyroxine (FT4) ratio affects the prognosis of acute myocardial infarction (AMI), especially the risk of heart failure (HF) subsequent to AMI.

Objective
The purpose of this study was to see how peripheral sensitivity to thyroid hormones, as measured by the FT3/FT4 ratio, affected HF and mortality after AMI.

Methods
Our study was a retrospective cohort study. The primary endpoint was HF after AMI during and after hospitalization. The secondary endpoints were all-cause death and cardiovascular death after hospitalization.

Results
The main sample included 3648 inpatients with AMI with a median age of 61.0 years; 68.9% were male. In the fully adjusted model, compared with patients in the lowest Q1 of the FT3/FT4 ratio, the risk of in-hospital HF in the highest Q4 patients was reduced by 44% (OR 0.56, 95% CI 0.44-0.72, P trend &lt; .001), the risk of out-of-hospital HF was reduced by 37% (HR 0.63, 95% CI 0.48-0.84, P trend &lt; .001), and the risks of all-cause and cardiovascular death were also significantly reduced. The analysis of different subgroups is consistent with the overall results. Furthermore, the sensitivity analysis of the euthyroid sample of 2484 patients was consistent with the main sample. Mediation analysis showed that altered levels of amino-terminal pro-B-type natriuretic peptide were mediators between the FT3/FT4 ratio and all endpoints in our study.

Conclusion
The thyroid hormone peripheral sensitivity of the FT3/FT4 ratio is an independent predictor of HF and mortality after AMI.
Pregnancies in the United States by Desire for Pregnancy: Estimates for 2009, 2011, 2013, and 2015
Authors: Kost Kathryn , Zolna Mia , Murro Rachel 
Published: April 2023

Abstract
We examine whether changes in U.S. pregnancy, birth, and abortion rates between 2009 and 2015 reflect underlying change in the incidence of pregnancies classified by retrospectively reported pregnancy desires: pregnancies reported as having occurred at about the right time, later than wanted, too soon, or not wanted at all, and those for which individuals expressed other feelings, including uncertainty, ambivalence, or indifference. We calculate the proportionate distributions of these pregnancies and rates among U.S. women aged 15–44, as well as change over time, overall and among age groups. Characterization of desires for a past pregnancy shifted in a number of ways between 2009 and 2015, and changes across age groups were not uniform. Rates of pregnancies reported as occurring later than wanted increased among older women, while rates of pregnancies reported as occurring too soon decreased among all women. These findings shed light on previous research documenting an increasing age at first birth, increasing rates of pregnancy and childbearing among the oldest age groups, and changes in patterns of contraceptive use, particularly among young women. Our analysis explores limitations and challenges of two major sources of data on pregnancies in the United States and their measures of retrospectively reported pregnancy desires.
Shared retinoic acid responsive enhancers coordinately regulate nascent transcription of Hoxb coding and non-coding RNAs in the developing mouse neural tube
Authors: Afzal Zainab , Lange Jeffrey J. , Nolte Christof , McKinney Sean , Wood Christopher , Paulson Ariel , De Kumar Bony , Unruh Jay , Slaughter Brian D. , Krumlauf Robb 
Published: April 2023

ABSTRACT
Signaling pathways regulate the patterns of Hox gene expression that underlie their functions in the specification of axial identity. Little is known about the properties of cis-regulatory elements and underlying transcriptional mechanisms that integrate graded signaling inputs to coordinately control Hox expression. Here, we optimized a single molecule fluorescent in situ hybridization (smFISH) technique with probes spanning introns to evaluate how three shared retinoic acid response element (RARE)-dependent enhancers in the Hoxb cluster regulate patterns of nascent transcription in vivo at the level of single cells in wild-type and mutant embryos. We predominately detect nascent transcription of only a single Hoxb gene in each cell, with no evidence for simultaneous co-transcriptional coupling of all or specific subsets of genes. Single and/or compound RARE mutations indicate that each enhancer differentially impacts global and local patterns of nascent transcription, suggesting that selectivity and competitive interactions between these enhancers is important to robustly maintain the proper levels and patterns of nascent Hoxb transcription. This implies that rapid and dynamic regulatory interactions potentiate transcription of genes through combined inputs from these enhancers in coordinating the retinoic acid response.
Biological Advantage of the Arrangements of C-Phycocyanin Chromophores in Phycobilisome from the Electronic Energy Transfer Viewpoint
Authors: Mishima Kenji , Shoji Mitsuo , Umena Yasufumi , Shigeta Yasuteru 
Published: April 2023

Abstract
In the present study, we report the electronic energy transfer (EET) rate and the EET dynamics in the hexamer of C-phycocyanin (C-PC). The EET rate for the Förster theory was calculated by a quantum chemical method and a master equation was used to describe the dynamics. Our calculation results suggest that the natural arrangements of phycocyanobilin (PCB) chromophores α84, β84, and β155 in C-PC are cooperatively well-adjusted to achieve the shortest EET time-length. It is the appropriate regular periodicity of the intermolecular distances and intermolecular angles of the ground and the first excited transition dipole moments of PCBs α84, β84, and β155, i.e., the three-fold symmetry and stacking order of their layers found in terrestrial plants and algae, that are some of the most important requisites in achieving such a highly efficient EET in PBS.
Clinical progression, disease severity, and mortality among adults hospitalized with COVID-19 caused by the Omicron and Delta SARS-CoV-2 variants: A population-based, matched cohort study
Authors:   COVID-19 Omicron Delta study group
Published: April 2023

BackgroundTo compare the intrinsic virulence of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) omicron variant with the delta variant in hospitalized adults with coronavirus disease 2019 (COVID-19).MethodsAll adults hospitalized in the Capital Region of Copenhagen with a positive reverse transcription polymerase chain reaction test for SARS-CoV-2 and an available variant determination from 1 September 2021 to 11 February 2022. Data from health registries and patient files were used. Omicron and Delta patients were matched (1:1) by age, sex, comorbidities, and vaccination status. We calculated crude and adjusted hazard ratios (aHRs) for severe hypoxemia and mortality at 30 and 60 days.Results1,043 patients were included. Patients with Omicron were older, had more comorbidities, were frailer, and more often had three vaccine doses than those with Delta. Fewer patients with Omicron developed severe hypoxemia than those with Delta (aHR, 0.55; 95% confidence interval, 0.38–0.78). Omicron patients exhibited decreased aHR for 30-day mortality compared to Delta (aHR, 0.61; 0.39–0.95). Omicron patients who had received three vaccine doses had lower mortality compared to Delta patients who received three doses (aHR, 0.31;0.16–0.59), but not among those who received two or 0–1 doses (aHR, 0.86; 0.41–1.84 and 0.94; 0.49–1.81 respectively). Similar findings were observed for mortality at 60 days. Similar outcomes were obtained in the analyses of 316 individually matched patients.ConclusionsAmong adults hospitalized with COVID-19, those with Omicron had less severe hypoxemia and nearly 40% higher 30- and 60-day survival, as compared with those with Delta, mainly driven by a larger proportion of Omicron patients vaccinated with three doses of an mRNA vaccine.
Readiness, barriers, and attitude of students towards online medical education amidst COVID-19 pandemic: A study among medical students of Ebonyi State University Abakaliki, Nigeria
Authors: Ossai Edmund Ndudi , Eze Irene Ifeyinwa , Umeokonkwo Chukwuma David , Izuagba Chukwuemeka Obioma , Ogbonnaya Lawrence Ulu 
Published: April 2023

Introduction
The COVID-19 pandemic caused massive disruption to medical education in Nigeria, necessitating the call for online medical education in the country. This study assessed the readiness, barriers, and attitude of medical students of Ebonyi State University Abakaliki, Nigeria, to online medical education.

Methods
A cross-sectional study design was employed. All matriculated medical students of the university participated in the study. Information was obtained using a pre-tested, semi-structured questionnaire which was self-administered. Good attitude towards information and communication technology (ICT) based medical education was determined by the proportion of respondents correctly answering 60% of nine variables. Readiness for online classes was determined by the proportion of students who preferred either a combination of physical and online lectures or only online medical education amidst the COVID-19 pandemic. Chi-square test and multivariate analysis using binary logistic regression analysis were used in the study. A p-value of <0.05 determined the level of statistical significance.

Results
Four hundred and forty-three students participated in the study (response rate; 73.3%). The mean age of the students was 23.0±3.2 years. The majority of the respondents, 52.4%, were males. The students’ most preferred sources for studying before the COVID-19 pandemic included textbooks, 55.1% and lecture notes, 19.0%. The commonly visited websites included Google, 75.2%, WhatsApp, 70.0% and YouTube, 59.1%. Less than half, 41.1%, have a functional laptop. The majority, 96.4%, have a functioning email address, while 33.2% participated in a webinar during the COVID-19 pandemic. Though 59.2% had a good attitude towards online medical education, only 56.0% expressed readiness for online medical education. The major barriers to online medical education included poor internet connectivity, 27.1%, poor e-learning infrastructure, 12.9% and students not having laptops, 8.6%. Predictors of readiness for online medical education included previous participation in a webinar, AOR = 2.1, (95%CI: 1.3–3.2) and having a good attitude towards IT-based medical education, AOR = 3.5, (95%CI: 2.3–5.2).

Conclusions
The majority of the students showed readiness for online medical education. Lessons from COVID-19 pandemic necessitate the initiation of online medical education. University authorities should ensure that every enrolled medical student owns or have access to a dedicated laptop through a university-mediated arrangement. Adequate attention should be given to the development of e-learning infrastructure, including steady internet services within the confines of the university.
Qualitative assessment of healthy volunteer experience receiving subcutaneous infusions of high-dose benzathine penicillin G (SCIP) provides insights into design of late phase clinical studies
Authors: Enkel Stephanie L. , Kado Joseph , Hla Thel K. , Salman Sam , Bennett Julie , Anderson Anneka , Carapetis Jonathan R. , Manning Laurens 
Published: April 2023

Introduction
Secondary prophylaxis to prevent rheumatic heart disease (RHD) progression, in the form of four-weekly intramuscular benzathine benzylpenicillin G (BPG) injections, has remained unchanged since 1955. Qualitative investigations into patient preference have highlighted the need for long-acting penicillins to be delivered less frequently, ideally with reduced pain. We describe the experience of healthy volunteers participating in a phase-I safety, tolerability and pharmacokinetic trial of subcutaneous infusions of high-dose benzathine penicillin G (BPG)–the SCIP study (Australian New Zealand Clinical Trials Registry ACTRN12622000916741).

Methods
Participants (n = 24) received between 6.9 mL to 20.7 mL (3–9 times the standard dose) of BPG as a single infusion into the abdominal subcutaneous tissues via a spring-driven syringe pump over approximately 20 minutes. Semi-structured interviews at four time points were recorded, transcribed verbatim and thematically analysed. Tolerability and specific descriptors of the experience were explored, alongside thoughts on how the intervention could be improved for future trials in children and young adults receiving monthly BPG intramuscular injections for RHD.

Results
Participants tolerated the infusion well and were able describe their experiences throughout. Most reported minimal pain, substantiated via quantitative pain scores. Abdominal bruising at the infusion site did not concern participants nor impair normal activities. Insight into how SCIP could be improved for children included the use of topical analgesia, distractions via television or personal devices, a drawn-out infusion time with reduced delivery speed, and alternative infusion sites. Trust in the trial team was high.

Conclusion
Qualitative research is an important adjunct for early-phase clinical trials, particularly when adherence to the planned intervention is a key driver of success. These results will inform later-phase SCIP trials in people living with RHD and other indications.
The role of PEEP for cannulation of the subclavian vein: A prospective observational study
Authors: Eimer Christine , Rump Knut G. , Elke Gunnar , Becher Tobias H. , Weiler Norbert , Caliebe Amke , Schädler Dirk 
Published: April 2023

Purpose
The role of positive endexpiratory pressure (PEEP) for successful cannulation of the subclavian vein (SCV) remains inconclusive. The aim of our study was to assess the effect of different levels of PEEP on distance from SCV to parietal pleura (DVP) and on the cross-sectional area (CSA) of the SCV.

Methods
Invasive mechanically ventilated adult patients with a clinical indication for a stepwise PEEP-trial (0, 5, 10, and 15 cm H2O) were included in this prospective observational single-center study. Ultrasound examinations of SCV were performed with a linear ultrasound probe using the infraclavicular view. DVP and CSA were measured on the right and left bodyside. Examinations were repeated at each PEEP step.

Results
27 patients were enrolled (12 female; 60±21 years; BMI 24.6±4.9 kg/m2; 20 patients on controlled, 7 on assisted ventilation). A statistically significant increase of DVP in the in-plane view was found on the left side which was not clinically relevant. No significant differences of DVP were observed in all other views. PEEP induced changes in CSAs were statistically significant but clinically not relevant on both sides. The largest change in CSA (2mm2) was observed when comparing PEEP 10 with PEEP 0 cm H2O.

Conclusion
A stepwise PEEP increase was not associated with clinically relevant changes of the DVP and CSA. Thus, a PEEP-optimization for the cannulation of the subclavian vein is not indicated.