bluuebunny/crossref_metadata_2025_split huggingface dataset:
Utilization of Latrine and Associated Factors Among Rural Households in Takussa District, Northwest Ethiopia: A Community-Based Cross-Sectional Study
Authors: Omer Nuruhusan , Bitew Bikes Destaw , Engdaw Garedew Tadege , Getachew Atalay 
Published: April 2022

Background: The use of sanitation facilities is known to interrupt the transmission of fecal-oral related diseases. However, the evidence was limited about the utilization of latrines within the rural community of Takussa district. Therefore, this study was conducted to assess the utilization of latrines and associated factors among households in Takussa district, northwest Ethiopia. Methods: A community-based cross-sectional study design was employed to survey 801 rural households among initially computed 812 participants from February 15 to March 15, 2019. A structured questionnaire with face-to-face interviews was used to collect the data. SPSS version 20 was used to analyze the completed data. A binary logistic regression model was used to process bivariate and multivariable analysis of the data. The adjusted odds ratio was used for the interpretation of the data after controlling for the confounders. Results: The proper latrine utilization rate was 41.9%, with a 95% confidence interval of (38.8, 45.3). Households with school-aged children (AOR: 2.27, 95% CI: (1.44, 3.56), a clean latrine (AOR: 3.34, 95% CI: (1.26, 4.93), the optimal distance from the living room (AOR: 1.56, 95% CI: (1.09, 2.25), and perceived benefit (AOR: 3.64, 95% CI: (1.13, 11.67) were statistically associated factors. Conclusion: The Proper utilization of latrines was low among rural households in the Takussa district. School children, distance, cleanliness, and the benefit of latrines were statistically associated factors. As a result, encouraging health extension workers integrated into district schools to pay special attention to frequent follow-up in order to promote proper latrine utilization at the household level.
Playing the harmonica with chronic obstructive pulmonary disease. A qualitative study
Authors: Lewis Adam , Conway Joy , Middleton Jack , Startup Chris K , Wyatt James 
Published: April 2022

Objectives: To investigate the experience of playing the harmonica for individuals with COPD. Methods: A qualitative, phenomenological study using semi-structured interviews and reflexive thematic analysis. Results: Eight people living with COPD (six females, two males) were recruited, who had attended at least six weeks of harmonica group sessions, either face-to-face prior to the COVID-19 pandemic or remotely. Five themes were generated. Themes included ‘hard in the beginning’, ‘holding the condition’, ‘breathing control’, ‘gives you a high’ and ‘needing the Zoom class’. Discussion: Playing the harmonica with COPD is difficult at first, particularly drawing a breath through the harmonica. With practice, experience in a fun activity and quality teaching, individuals were able to become more attuned and embodied with their breathing, and playing the harmonica offered a breathing control strategy. Songs, rather than breathing, became the focus, and participants were able to escape living with respiratory disease when playing. Participants reported the harmonica helped mucous expectoration. The group was a priority in the weekly lives of participants, even though the ‘buzz’ of being part of a group was lost when participating online. Further mechanistic studies and randomised controlled trials are needed to investigate the biopsychosocial benefits of playing the harmonica with COPD.
Laparoscopic Management of Concomitant Sigmoid Colon Cancer and Type 2 Endoleak Following Endovascular Aneurysm Repair
Authors: Bakopoulos Anargyros , Koliakos Nikolaos , Papaconstantinou Dimitrios , Bistarakis Dimitrios , Zymvragoudakis Vassilios , Schizas Dimitrios , Pikoulis Emmanouil , Lazaris Andreas M. 
Published: April 2022

The co-occurrence of abdominal aortic aneurysm (AAA) and colorectal malignancy creates a significant surgical dilemma over which entity should be addressed first. A 73-year-old male was referred to our hospital due to a painful pulsatile abdominal mass. Computed tomographic angiography revealed an infrarenal aortic aneurysm measuring 5.8 cm in diameter and incidentally, a synchronous mass lesion in the sigmoid colon. The patient underwent an emergency EVAR using a Gore Excluder endograft. Postoperative CT staging for colon cancer revealed a type 2 endoleak on the grounds of a patent wide inferior mesenteric artery. The patient underwent a standard laparoscopic left colectomy with high ligation of the inferior mesenteric artery in order to simultaneously address the ongoing type 2 endoleak. Follow-up examinations with computed tomographic angiography were performed confirming the resolution of the endoleak. Synchronous laparoscopic sigmoidectomy and high ligation of inferior mesenteric artery for type 2 endoleak treatment appears to be applicable with hopeful results.
Deflux® (NASHATM/Dx) urethral bulking injections: Outcomes over a decade in women with stress urinary incontinence
Authors: Yang Bob , Hobbs Catherine , Foley Steve 
Published: April 2022

Objectives: Urethral bulking injections are thought to be a low risk minimally invasive but temporary treatment option for women with stress urinary incontinence (SUI) with increasing prominence especially in the current era of the mesh controversy. However, little is known about their long-term effects. This study aims to evaluate the efficacy and long-term outcomes of Deflux®, a non-animal stabilised hyaluronic acid/dextranomer (NASHATM/Dx) gel, when used as a urethral bulking agent in the treatment of SUI in women. Methods: All women with SUI treated with Deflux® from 2001 to 2007 were analysed. The success rates, duration of efficacy and short- and long-term complications of the treatment were recorded. Results: A total of 142 women with a follow-up of up to 13 years (mean 8.8 years) were included. Subjective treatment success was achieved in 92/142 (65%) patients. In those who achieved continence, the mean efficacy was 4.7 years. Side effects were uncommon with 12 (6%) of 209 experiencing transient urinary retention and 11 (5%) of 209 experiencing pseudocyst formation. All pseudocysts were treated successfully with an incision and drainage under either general or local anaesthetic. Sixty (42%) of 142 patients went on to have subsequent definitive incontinence surgery, and Deflux® treatment was found not to have negatively impacted the operation. Conclusion: Deflux® urethral bulking injections appear to be efficacious and safe when used as a treatment for SUI in women with a longer duration of efficacy than previously thought and a low side effect profile. This study provides a valuable timeline to help manage the expectations of patients considering urethral bulking treatment. Level of evidence: 4
Long-term complications of bulking agents in the treatment of stress urinary incontinence: Results of a national survey
Authors: Patel Sana , Lazarowicz Henry , Hamm Rebecca 
Published: April 2022

Introduction and Objectives: Bulking agents have been used for decades as an alternative treatment for patients with stress urinary incontinence who are not appropriate for surgery. Despite this their long-term complications are poorly documented and can be misdiagnosed. This paper presents a literature review and the results of a national survey of members of the Section of Female, Neurological and Urodynamic Urology (FNUU) of the British Association of Urological Surgeons (BAUS) identifying the common long-term complications of widely used bulking agents in clinical practice. Methods: Following a comprehensive literature review an electronic survey was sent to members of the BAUS Section of FNUU. Data included hospital trust, use of urethral bulking agents (including type), the approximate number of procedures performed and whether any long-term complications had been observed and managed in their practice. Long-term complications were defined as those arising more than 12 months after treatment. Results: The literature review revealed multiple case reports of complications secondary to bulking agent injection but no high-level evidence regarding frequency or severity. The survey revealed complications including granulomas, erosions, abscesses and misdiagnoses of urethral diverticula and calculi formation. 88% of urologists who responded to the survey had performed a urethral bulking agent injection and 51% of urologists had observed or treated a long-term complication, some many decades after injection. Conclusion: Patients should be made aware of possible long-term complications of what appears to be a minimally invasive procedure in order for them to make an informed choice about treatment options. Level of evidence: Not applicable
Analyzing program data and promotional approaches to inform best practices from a mobile phone-based reproductive health message program in Afghanistan
Authors: Lorenzetti Lara , Plourde Kate F. , Rastagar Sayed Haroon , Afzali Arzoo S. , Sultani Ahmad S. , Khalil Abdul Khaleq , Adeeb Abdul Waheed , Hemat Shafiqullah , Todd Catherine S. 
Published: April 2022

Objective Digital health technologies have contributed to the adoption of beneficial reproductive, maternal, newborn, and child health (RMNCH) behaviors through social and behavior change programming, including in hard-to-reach settings. On-demand digital health interventions rely on promotions to build awareness and increase use among target audiences. There is little research on preferred content and use of promotional approaches for RMNCH digital health activities. Methods We conducted a retrospective descriptive analysis of Mobile for Reproductive Health (m4RH) data in Afghanistan to assess the use and changes in call volume via the 2-3-4 platform by promotional approaches over 23 months between October 2017 and August 2019. Results There were 103,859 completed messages (CM) heard. Most callers reporting demographics were under 18 years, with roughly even distribution by gender. The number of CMs listened to across all menus increased with time. The basic m4RH family planning menu was most popular, with callers most frequently selecting information on intrauterine contraceptive devices. Nine types of promotional approaches were implemented. Compared against call volume, SMS blast promotion was the most productive promotional approach, radio broadcasts had modest increases, and social media and interpersonal communication demonstrated no clear change. Conclusions m4RH use increased over time, particularly among younger people. The number of promotional approaches used does not appear as important as the type of approach used to generate program awareness. Mass media communications, including SMS blast promotions and radio broadcasts, may be the most effective strategies. Deeper program data analysis can guide tailoring of message content and promotional approaches to reach target audiences with the RMNCH content they most value.
Bridging the Cervicothoracic Junction During Multi-Level Posterior Cervical Decompression and Fusion: A Systematic Review and Meta-Analysis
Authors: Truumees Eeric , Singh Devender , Ennis Darlene , Livingston Heather , Duncan Ashley , Lavelle William , Riesenburger Ron , Yu Anthony , Geck Matthew , Mroz Thomas , Stokes John 
Published: April 2022

Study Design Systematic review and Meta-analysis. Objective This systematic review seeks to compare fusion, reoperation and complication rates, estimated blood loss (EBL), and surgical time between multi-level instrumented fusions with LIVs (lowest instrumented vertebra) in the cervical spine and those that extend into the thoracic spine. Summary of Background Data Several studies address the question of whether to extend a long-segment, posterior cervical fusions, performed for degenerative disease, into the upper thoracic spine. Recommendations for appropriate LIV continue to vary. Methods A comprehensive computerized literature search through multiple electronic databases without date limits up until April 3rd, 2020 using combinations of key search terms and sets of inclusion/exclusion criteria was performed. Results Our comprehensive literature search yielded 3852 studies. Of these, 8 articles consisting of 1162 patients were included in the meta-analysis. In 61.2% of the patients, the fusion did not cross the cervicothoracic junction (CTJ) (cervical LIV, CLV). In the remaining 38.8%, the fusion extended into the upper thoracic spine (thoracic LIV, TLV). Overall, mean patient age was 62.5 years (range: 58.8-66.1 years). Our direct analysis showed that odds of fusion were not statistically different between the CLV and TLV groups (OR: .648, 95% CI: .336-1.252, P = .197). Similarly, odds of reoperation (OR: 0.726, 95% CI: 0.493-1.068, P = .104) and complication rates were similar between the 2 groups (OR: 1.214, 95% CI: 0.0.750-1.965, P = .430). Standardized mean difference (SMD) for the blood loss (SMD: .728, 95% CI: 0.554-.901, P = .000) and operative (SMD: 0.653, 95% CI: .479-.826, P = .000) differed significantly between the 2 groups. The indirect analysis showed similar fusion (Effect Size (ES)TLV: .892, 95% CI: .840-.928 vs ESCLV:0.894, 95% CI:0.849-.926); reoperation rate (ESTLV:0.112, 95% CI: 0.075-.164 vs ESCLV: .125, 95% CI: .071-.211) and complication rates (ESTLV: .108, 95% CI: .074-.154 vs ESCLV:0.081, 95% CI: .040-.156). Conclusions Our meta-analysis showed that fusion, complication, and reoperation rates did not differ significantly between patients in whom multi-level posterior fusions ended in the cervical spine vs those of which was extended into the thoracic spine. The mean blood loss, operative time and length of stay were significantly lower in patients with CLV at C6 or C7, compared to their counterparts. These data suggest that, absent focal, C7-T1 pathology, extension of long, posterior cervical fusions into the thoracic spine may not be necessary.
Incidence of Symptomatic Femoroacetabular Impingement: A 4-Year Study at a National Collegiate Athletic Association Division I Institution
Authors: Safran Marc R. , Foard Sara James , Robell Kevin , Pullen W. Michael 
Published: April 2022

Background: Femoroacetabular impingement (FAI) is an increasingly recognized cause of hip pain in young athletes. Although there are multiple studies that describe the radiographic prevalence of FAI in athletes, its true incidence within this population is unknown. Purpose: To report on the overall and sport-specific incidence of symptomatic FAI in National Collegiate Athletic Association (NCAA) Division I athletes. Return-to-sport times were reported for patients treated operatively. Study Design: Cohort study; Level of evidence, 3. Methods: A retrospective review was conducted to identify all reported hip injuries within a large, multisport NCAA Division I institution. Hip injuries were stratified into FAI, general pain/dysfunction, musculotendinous, ligament, bursitis, bone stress, contusion, and other. FAI was diagnosed based on history, physical examinations, imaging, and symptomatic relief after a diagnostic injection. Descriptive statistics were used to calculate the overall and sport-specific incidence, and chi-square analysis was performed to identify contingency data. Results: In a 3-year period, a total of 5319 musculoskeletal injuries occurred in 1072 athletes. There were 491 (9.2%) hip injuries that occurred in 288 athletes, of which 40 injuries were FAI. The overall incidence of symptomatic FAI was 3.0% of the total population, 3.7% of all injured athletes, and 13.9% of athletic hip injuries. There were no statistically significant differences in FAI rates among male and female athletes overall or among male and female athletes within similar sports. Of the 19 athletes who were treated nonoperatively, 2 failed to return to play: 1 secondary to multiple musculoskeletal injuries and 1 related to cardiac issues. There were 21 hips in 20 patients that were treated operatively, with 1 athlete failing to return to sport. Return to play occurred at a mean of 202 days (range, 81-360 days) after hip arthroscopic surgery. Conclusion: In this large, multisport NCAA Division I cohort, the overall incidence of symptomatic FAI was 3.0% and represented 13.9% of hip injuries. The successful management of FAI with return to play was achieved by both nonoperative and operative treatment methods. The relatively low incidence of symptomatic FAI, despite reports of a high prevalence of FAI morphology in athletes, serves to emphasize the importance of clinical evaluations in treating patients with FAI.
Student Interviews Exploring the Influence of the Coronavirus Pandemic on Graduate Nursing Education
Authors: Nodine Priscilla , Carrington Suzanne , Jenkins Peggy A. , Rosenthal Laura , Jones Jacqueline 
Published: April 2022

Introduction Advanced practice nurses are needed to fill the primary healthcare gap in the United States. Advanced practice/graduate nursing students were profoundly affected by the coronavirus pandemic in ways that may impact their educational experience. Objective The objective of this study was to explore the influence of the coronavirus pandemic on the educational experience of graduate nursing students. Methods An exploratory descriptive qualitative study using semistructured video conferencing interviews of 11 graduate nursing students at one university in the United States was conducted during July 2020. Data were explored using theme analysis. Results Four themes expressing the pandemic's impact on graduate student experience were identified: Alteration in human connections; Agility in action; Collaborative construction of change; and Metamorphosis emerging from disruption. The pandemic brought an alteration in how students connected with faculty, other students, and family. Many faculty and students responded with agility to the new mandates for social distancing. The students and faculty worked together to construct changes needed to provide the students with the required components of graduate education. These factors together created a metamorphosis in the functioning of the institution, breaking through hierarchical barriers in academia. Conclusion The disruption in graduate nursing education due to the pandemic led to opportunities, including swift faculty innovation, a collaborative spirit between faculty and students, and new appreciation for connections with faculty and fellow students. Continuing intentional implementation of these opportunities would benefit students’ experiences moving forward.
Clinical profile and surgical outcome of pars plana vitrectomy in non-diabetic vitreous hemorrhage
Authors: Shrestha Ruchi , Shah Ritesh Kumar , Joshi Purushottam , Parajuli Sanket 
Published: April 2022

Background: Spontaneous vitreous hemorrhage is one of the common causes of ocular emergency. There are very few prospective studies on the clinical profile and surgical outcomes for patients with dense vitreous hemorrhage caused by non-diabetic and non-traumatic till date to our knowledge. Objectives: This study was conducted to better understand the etiologies, clinical profile, surgical outcome, and visual prognosis following pars plana vitrectomy for dense vitreous hemorrhage in adults with non-traumatic and non-diabetic retinopathy. Design: This was a prospective interventional study. Methods: This study was conducted in Mechi Eye Hospital (Birtamod, Nepal) from October 2018 to September 2019. All consecutive cases, 46 eyes of 46 patients, with vitreous hemorrhage that underwent vitrectomy were included in our study. There were 14 (30.4%) female and 32 (69.6%) male patients, and the average age at presentation was 43.74 ± 16.19 (17–84) years. The success rate of surgery in terms of visual outcome was evaluated. Results: The most common cause of vitreous hemorrhage was retinal vasculitis with fibrovascular changes and vascular sheathing 19 (41%). The indication of vitrectomy on patient demand was 20 (43.5%). Success rate of surgery in terms of visual outcome (functional outcome) was defined as final visual acuity of >6/60 which was 86.9%. Conclusion: The most common cause of spontaneous vitreous hemorrhage in our study was retinal vasculitis with fibrovascular changes and vascular sheathing. Vitrectomy has a good surgical outcome for spontaneous vitreous hemorrhage in terms of visual outcome (functional outcome) unless guarded by other factors like chorioretinal atrophy followed by optic atrophy and epiretinal membrane.
Adoption of Online Learning Models by Business Enterprises to Harness the Benefits of An Age-Diverse Workforce
Authors: Krishnan Dulles 
Published: April 2022

In the changing future of work, employers will need new approaches to workforce-skilling as organisations become increasingly ‘age-diverse’, and technology changes jobs and skills at an accelerated pace. Driving meaningful skill development will be crucial to channel the diversity of a multi-generational workforce. Agility and adaptability, not age, will determine the extent to which employees contribute and thrive. By leveraging new digital and online learning models, enterprises can build critical skills flexibly across a multi-generational workforce while paving the way for continuous skill development. Digital learning can help organisations identify skills gaps for employees across the age spectrum personalise programs to narrow these gaps while tracking and measuring progress towards larger learning goals that meet organisational objectives. This article examines skilling trends that are enabling organisations to inclusively build a resilient workforce by maximising the potential of multi-generational talent and empowering employees across the age spectrum to contribute cohesively and drive business impact.
Structural, functional, and immunogenicity implications of F9 gene recoding
Authors: Katneni Upendra K. , Alexaki Aikaterini , Hunt Ryan C. , Hamasaki-Katagiri Nobuko , Hettiarachchi Gaya K. , Kames Jacob M. , McGill Joseph R. , Holcomb David D. , Athey John C. , Lin Brian , Parunov Leonid A. , Kafri Tal , Lu Qi , Peters Robert , Ovanesov Mikhail V. , Freedberg Darón I. , Bar Haim , Komar Anton A. , Sauna Zuben E. , Kimchi-Sarfaty Chava 
Published: April 2022

Abstract
Hemophilia B is a blood clotting disorder caused by deficient activity of coagulation factor IX (FIX). Multiple recombinant FIX proteins are currently approved to treat hemophilia B, and several gene therapy products are currently being developed. Codon optimization is a frequently used technique in the pharmaceutical industry to improve recombinant protein expression by recoding a coding sequence using multiple synonymous codon substitutions. The underlying assumption of this gene recoding is that synonymous substitutions do not alter protein characteristics because the primary sequence of the protein remains unchanged. However, a critical body of evidence shows that synonymous variants can affect cotranslational folding and protein function. Gene recoding could potentially alter the structure, function, and in vivo immunogenicity of recoded therapeutic proteins. Here, we evaluated multiple recoded variants of F9 designed to further explore the effects of codon usage bias on protein properties. The detailed evaluation of these constructs showed altered conformations, and assessment of translation kinetics by ribosome profiling revealed differences in local translation kinetics. Assessment of wild-type and recoded constructs using a major histocompatibility complex (MHC)-associated peptide proteomics assay showed distinct presentation of FIX-derived peptides bound to MHC class II molecules, suggesting that despite identical amino acid sequence, recoded proteins could exhibit different immunogenicity risks. Posttranslational modification analysis indicated that overexpression from gene recoding results in suboptimal posttranslational processing. Overall, our results highlight potential functional and immunogenicity concerns associated with gene-recoded F9 products. These findings have general applicability and implications for other gene-recoded recombinant proteins.