bluuebunny/crossref_metadata_2025_split huggingface dataset:
Effect of a valgus brace on medial tibiofemoral joint contact force in knee osteoarthritis with varus malalignment: A within-participant cross-over randomised study with an uncontrolled observational longitudinal follow-up
Authors: Hall Michelle , Starkey Scott , Hinman Rana S. , Diamond Laura E. , Lenton Gavin K. , Knox Gabrielle , Pizzolato Claudio , Saxby David J. 
Published: June 2022

Background
Previous investigations on valgus knee bracing have mostly used the external knee adduction moment. This is a critical limitation, as the external knee adduction moment does not account for muscle forces that contribute substantially to the medial tibiofemoral contact force (MTCF) during walking. The aims of this pilot study were to: 1) determine the effect of a valgus knee brace on MTCF; 2) determine whether the effect is more pronounced after 8 weeks of brace use; 3) assess the feasibility of an 8-week brace intervention.

Methods
Participants with medial radiographic knee OA and varus malalignment were fitted with an Össur Unloader One© brace. Participants were instructed to wear the brace for 8 weeks. The MTCF was estimated via an electromyogram-assisted neuromuscular model with and without the knee brace at week 0 and week 8. Feasibility outcomes included change in symptoms, quality of life, confidence, acceptability, adherence and adverse events.

Results
Of the 30 (60% male) participants enrolled, 28 (93%) completed 8-week outcome assessments. There was a main effect of the brace (p<0.001) on peak MTCF and MTCF impulse, but no main effect for time (week 0 and week 8, p = 0.10), and no interaction between brace and time (p = 0.62). Wearing the brace during walking significantly reduced the peak MTCF (-0.05 BW 95%CI [-0.10, -0.01]) and MTCF impulse (-0.07 BW.s 95%CI [-0.09, -0.05]). Symptoms and quality of life improved by clinically relevant magnitudes over the 8-week intervention. Items relating to confidence and acceptability were rated relatively highly. Participants wore the brace on average 6 hrs per day. Seventeen participants reported 30 minor adverse events over an 8-week period.

Conclusion
Although significant, reductions in the peak MTCF and MTCF while wearing the knee brace were small. No effect of time on MTCF was observed. Although there were numerous minor adverse events, feasibility outcomes were generally favourable.

Trial registration
Australian and New Zealand Clinical Trials Registry (12619000622101).
Emergency department utilisation among older adults—Protocol for a systematic review of determinants and conceptual frameworks
Authors: Tang Xuan Rong , Zarisfi Faraz , Pek Pin Pin , Siddiqui Fahad Javaid , Malhotra Rahul , Kwan Yu Heng , Ling Tiah , Ho Andrew Fu Wah , Ong Marcus Eng Hock 
Published: June 2022

Background
Older adults aged 65 years and above have a disproportionately higher utilization of emergency healthcare, of which Emergency Department (ED) visits are a key component. They experience higher degree of multimorbidity and mobility issues compared to younger patients, and are consequently more likely to experience a health event which requires an ED visit. During their visit, older adults tend to require more extensive workup, therefore spending a greater amount of time in the ED. Compared to the younger population, older adults are more susceptible to adverse events following discharge. Considering these factors, investigating the determinants of ED utilisation would be valuable. In this paper, we present a protocol for a systematic review of the determinants of ED utilisation among communitydwelling older adults aged 65 years and above, applying Andersen and Newman’s model of healthcare utilisation. Furthermore, we aim to present other conceptual frameworks for healthcare utilisation and propose a holistic approach for understanding the determinants of ED utilisation by older persons.

Methods
The protocol is developed in accordance with the standards of Campbell Collaboration guidelines for systematic reviews, with reference to the Cochrane Handbook for Systematic Review of Interventions. Medline, Embase and Scopus will be searched for studies published from 2000 to 2020. Studies evaluating more than one determinant for ED utilisation among older adults aged 65 years and above will be included. Search process and selection of studies will be presented in a PRISMA flow chart. Statistically significant (p < 0.05) determinants of ED utilisation will be grouped according to individual and societal determinants. Quality of the studies will be assessed using Newcastle Ottawa Scale (NOS).

Discussion
In Andersen and Newman’s model, individual determinants include predisposing factors, enabling and illness factors, and societal determinants include technology and social norms. Additional conceptual frameworks for healthcare utilisation include Health Belief Model, Social Determinants of Health and Big Five personality traits. By incorporating the concepts of these models, we hope to develop a holistic approach of conceptualizing the factors that influence ED utilisation among older people.

Systematic review registration
This protocol is registered on 8 May 2021 with PROSPERO’s International Prospective Register of Systematic Reviews (CRD42021253770).
Post-abortion family planning utilization and associated factors in health facilities of Wolaita Zone, Southern Ethiopia: Mixed study
Authors: Tekle Lencha Tizita , Alemayehu Gube Addisu , Mesele Gessese Molalegn , Tsegay Abadi Mulugeta 
Published: June 2022

Background
Unintended pregnancy due to disuse of family planning is the main cause of abortion globally. Women with a history of abortion are at higher risk of developing another unintended pregnancy, which may lead to repeated abortions and life-threatening complications. The immediate post-abortion period before women leave health institutions is a crucial time to provide family planning services. In Ethiopia, many women leave health facilities without using family planning methods. Therefore, this study aimed to determine the utilization of post-abortion family planning and its associated factors in health institutions in Wolaita Zone, Southern Ethiopia.

Methods
Facility-based mixed cross sectional study was conducted between April 1 and June 30, 2018. A systematic sampling method was used to select the 408 participants. Seven key informants were selected for in-depth interviews and observations were made using a checklist. Data were collected through face-to-face interviews using a structured questionnaire. Data were entered into EPI INFO 3.5.1 and exported to SPSS 21 for cleaning and analysis. Bivariate analysis was employed and a P-value <0.25 was considered for the multivariable analysis. Qualitative data were coded and thematically analyzed to support the quantitative findings.

Results
Data were obtained from 400 participants (response rate, 98%). The magnitude of post-abortion family planning was 67.3% [95% CI (62.8, 71.8)]. Marital status [AOR 95% CI 3.86(1.9, 7.8)], Good knowledge about post-abortion family planning [AOR 95% CI 2.48(1.22, 5.03)], Non-governmental health facility [AOR 95% CI 6.62(3.47, 12.6)] Counseling [AOR 95% CI 3.6(2.02, 6.4)] and husbands’ support [AOR 95% CI 3.21(1.81–5.7)] were significantly associated with Post-abortion family planning utilization.

Conclusion
The utilization of post-abortion family planning was low in Wolaita Sodo health institutions. Marital status, knowledge of post-abortion family planning, use of services at non-governmental health facilities, counseling, and husbands’ support were determinants of post-abortion family planning.
Chronic snus use in healthy males alters endothelial function and increases arterial stiffness
Authors: Antoniewicz Lukasz , Kabele Mikael , Nilsson Ulf , Pourazar Jamshid , Rankin Gregory , Bosson Jenny A. , Lundbäck Magnus 
Published: June 2022

Background
Snus usage is commonly touted as a safer alternative to cigarette smoking. However, recent studies have demonstrated possible adverse cardiovascular effects in chronic snus users. The present study evaluates the effects of chronic snus use on vascular function by assessing central arterial stiffness and endothelial vasodilatory function in healthy chronic snus users as compared to matched non-users.

Methods and results
Fifty healthy males (24 snus users, 26 age-matched controls) with a mean age of 44 years were included in the study. Arterial stiffness was assessed employing both pulse wave velocity and pulse wave analysis. Endothelial vasodilatory function was measured by venous occlusion plethysmography, utilizing intra-arterial administration of acetylcholine, glyceryl trinitrate and bradykinin to further gauge endothelium-dependent and -independent vasodilatory function. Arterial stiffness was significantly higher in chronic snus users as compared to controls: pulse wave velocity [m/s]: 6.6±0.8 vs 7.1±0.9 resp. (p = 0.026), augmentation index corrected for heart rate [%]: 0.1±13.2 vs 7.3±7.8 resp. (p = 0.023). Endothelial independent vasodilation, i.e. the reaction to glyceryl trinitrate, was significantly lower in snus users as measured by venous occlusion plethysmography.

Conclusions
The results of this study show an increased arterial stiffness and an underlying endothelial dysfunction in daily snus users as compared to matched non-tobacco controls. These findings indicate that long-term use of snus may alter the function of the endothelium and therefore reinforces the assertion that chronic snus use is correlated to an increased risk of development of cardiovascular disease.
The impact of laboratory staff training workshops on coagulation specimen rejection rates
Authors: du Toit Marcel , Chapanduka Zivanai C. , Zemlin Annalise E. 
Published: June 2022

Background
Pre-analytical variables can have a significant adverse impact on the quality and credibility of coagulation test results. Therefore, correct and consistent identification of pre-analytical variables that compromise coagulation specimen quality is of paramount importance. Lack of standardization and heterogeneity among laboratory staff when assessing coagulation specimens can lead to inconsistent identification of these variables. Failure to recognize such pre-analytical variables results in the analysis of poor quality specimens and the authorization of spurious test results.

Objectives
To determine the impact of a laboratory staff training workshop on coagulation specimen rejection rates and to ascertain the level of knowledge of laboratory personnel concerning coagulation specimen rejection criteria before and after the workshop.

Methods
A retrospective three-month audit was performed with rejection data of incorrect blood to additive ratio, clotted, aged and haemolysed specimens collected. Training workshops and evaluation sessions were subsequently presented. A revised standard operating procedure delineating coagulation specimen rejection criteria was implemented and a repeat three-month audit was conducted.

Results
In total, 13 162 coagulation specimens were received during the initial audit with 1 104 specimens (8.39%) rejected. Following the workshops, the rejection rate increased by 3.49% to 11.88% with 12 743 coagulation specimens received and 1 514 specimens rejected. Evaluation sessions performed before and after the workshops revealed that 95.2% of attendees attained improved knowledge.

Conclusion
This study demonstrated the pivotal importance of regular laboratory staff training. The increase in specimen rejection following the workshops signifies their success in educating laboratory personnel regarding the correct identification of pre-analytical variables. Since most pre-analytical variables occur outside the laboratory, educational workshops need to be extended to non-laboratory personnel responsible for specimen collection and transport.
An analysis of government-sponsored health insurance enrolment and claims data from Meghalaya: Insights into the provision of health care in North East India
Authors: Dutta Eliza K. , Kumar Sampath , Venkatachalam Selvaraju , Downey Laura E. , Albert Sandra 
Published: June 2022

Introduction
The Megha Health Insurance Scheme (MHIS) was launched in 2013 in the North-East Indian state of Meghalaya to reduce household out-of-pocket expenditure on health and provide access to high-quality essential healthcare. Despite substantial expansion of the MHIS since the scheme’s inception, there is a lack of comprehensive documentation and evaluation of the scheme’s performance against its Universal Health Care (UHC) objectives.

Methods
We analysed six years of enrolment and claims data (2013–2018) covering three phases of the scheme to understand the pattern of enrolment, utilisation and care provision under the MHIS during this period. De-identified data files included information on age, sex, district of residence, the district of provider hospital, type of hospital, date of admission, status at discharge, claimed category of care, package codes, and amount claimed. Descriptive statistics were generated to investigate key trends in enrolment, service utilisation, and Government health spending under the MHIS.

Results
Approximately 55% of the eligible population are currently enrolled in MHIS. Enrolment increased consistently from phase I through III and remained broadly stable across districts, gender, age group and occupation categories, with a small decline in males 19–60 years. Claims were disproportionately skewed towards private provision; 57% of all claims accrued to the 18 empanelled private hospitals and 39% to the 159 public sector facilities. The package ‘General Ward Unspecified’ was responsible for the highest volume of claims and highest financial dispensation across all three phases of the scheme. This likely indicates substantial administrative error and is potentially masking both true burden of disease and accurate financial provision for care under the MHIS. Anti-rabies injections for dog/cat bite contributed to 11% of total claims under MHIS III, and 1.6% of all claims under MHIS II. This warrants investigation to better understand the burden of animal bites on the Meghalayan population and inform the implementation of cost-effective strategies to reduce this burden.

Conclusions
This paper describes the first analysis of health insurance enrolment and claims data in the state of Meghalaya. The analysis has generated an important evidence base to inform future MHIS enrolment and care provision policies as the scheme expands to provide Universal Health Coverage to the state’s entire population.
Insights into the relationship between usability and willingness to use a robot in the future workplaces: Studying the mediating role of trust and the moderating roles of age and STARA
Authors: Babamiri Mohammad , Heidarimoghadam Rashid , Ghasemi Fakhradin , Tapak Leili , Mortezapour Alireza 
Published: June 2022

Background and aim
Human–robot collaboration is the key component of the fourth industrial revolution concept. Workers’ willingness to collaborate with industrial robots is a basic requirement for an efficient and effective interaction. The roles of human-robot trust and technology affinity as mediators in the relationship between robot usability and worker willingness were analyzed in this study. As other critical variables, the mediator roles of Age and STARA were also calculated.

Materials and methods
This study included 400 workers from a car company who interacted with industrial robots in their daily work activities. After examining the questionnaires’ validity and reliability, the main variables were determined to be willingness to use robots and robot usability. AMOS software also considered human-robot trust and worker technology affinity as mediators. The bootstrapping method was used to evaluate indirect relationships. A set of goodness-of-fit indices were presented to determine the adequacy of the goodness of fit between the proposed model and the data.

Results
Based on model fit indices, an overall satisfactory model fit was obtained for the direct/indirect relationship between robot usability and worker willingness to use it (with mediating role of human-robot trust). Workers’ age and fear of Smart Technology, Artificial Intelligence, Robotics, and Algorithms (STARA) were identified as moderators in the relationship between usability and willingness.

Conclusion
Attention to the robot usability and the role of workers’ trust in robots appears to be required to ensure workers’ willingness to use robots and the success of human-robot collaboration in future workplaces. As the workers age and their fear of robots grows, usability can play a larger role in increasing their willingness to put robots to work.
Knowledge, practice, and impact of COVID-19 on mental health among patients with chronic health conditions at selected hospitals of Sidama regional state, Ethiopia
Authors: Simachew Yilkal , Ejeso Amanuel , Dejene Sisay , Ayalew Mohammed 
Published: June 2022

Background
COVID-19 causes worse outcomes and a higher mortality rate in adults with chronic medical conditions. In addition, the pandemic is influencing mental health and causing psychological distress in people with chronic medical illnesses.

Objective
To assess the knowledge, practice, and impact of COVID-19 on mental health among chronic disease patients at selected hospitals in Sidama regional state.

Method
A facility-based cross-sectional study was conducted. A total of 422 study subjects were enrolled in the study using a two-stage sampling technique. Data were coded and entered using Epi Data version 3.1 and exported to SPSS-20 for analysis. Descriptive analysis was used to present the data using tables and figures. Bivariate and multivariate logistic analyses were used to identify factors associated with the initiation of preventive behavior of COVID-19. Variables with a P-value of less than 0.25 in bivariate analysis were considered as candidate variables for multivariable analysis. The statistical significance was declared at a P-value less than 0.05.

Result
More than half 237 (56.2%, 95% CI: 50.7–60.9) of the study participants had good knowledge of COVID-19. The practice of preventive measures toward COVID-19 was found to be low (42.4%, 95% CI: 37.9–47.2). Being widowed (AOR = 0.31, 95% CI (0.10, 0.92)), secondary and above educational status (AOR = 2.21, 95% CI (1.01, 4.84)), urban residence (AOR = 2.33, 95% CI (1.30, 4.19)) and good knowledge (AOR = 4.87, 95% CI (2.96, 8.00)) were significantly associated with good practice. In addition, more than one-third of the study participants 37% (95% CI 32.7, 41.5) were experiencing anxiety. While more than a quarter of respondents 26.8% (95% CI 22.5, 31.5) had depression.

Conclusion and recommendation
Despite more than half of the participants had good knowledge, the prevention practice was low. Hence, multiple information dissemination strategies should be implemented continuously among chronic disease patients. In addition, the magnitude of concurrent depression and anxiety in the current study was high.
The impairment of the deep vascular complex in prolonged type 2 diabetes patients without clinical diabetic retinopathy
Authors: Kim Tae-Yeon , Song Yong-Yeon , Il-Jung  , Na Yong-Jin , Lee Young-Hoon , Kim Jung-Yeul , Lee Min-Woo 
Published: June 2022

PurposeTo identify the effects of prolonged type 2 diabetes (T2DM) on the retinal microvasculature of each retinal capillary plexus in patients without clinical diabetic retinopathy (DR).MethodsSubjects were divided into three groups: the control group (98 eyes), patients with T2DM < 10 years (DM group 1, 84 eyes), and patients with T2DM ≥ 10 years (DM group 2, 55 eyes). The vessel densities (VD) of the superficial and deep capillary plexus (SCP and DCP) were compared. Linear regression analyses were performed to identify factors associated with the VD.ResultsThe mean VDs of the SCP in the control group, DM group 1, and DM group 2 were 35.9 ± 4.2, 34.9 ± 3.9, and 34.6 ± 5.1, respectively (P =0.042). The mean VDs of the DCP in the three groups were 36.1 ± 3.1, 35.9 ± 3.0, and 34.0 ± 3.3, respectively (P <0.001). In multivariate analyses, the BCVA was a significant factor associated with both the superficial VD (B = −7.10,P= 0.019) and deep VD (B = −5.70,P= 0.039). Hypertension (B = −1.22,P= 0.021) and DM duration (B = −0.20,P< 0.001) were significant factors associated with deep VD.ConclusionsT2DM patients without DR showed decreased VD in the SCP and DCP. The microvascular impairment of the DCP in patients with T2DM ≥ 10 years was in particular, more severe. Additionally, ischemia caused by hypertension and accumulated impairment of microvasculature due to prolonged T2DM would affect the DCP.
Determinants of COVID-19 vaccine acceptance in Ethiopia: A systematic review and meta-analysis
Authors: Mose Ayenew , Wasie Abebaw , Shitu Solomon , Haile Kassahun , Timerga Abebe , Melis Tamirat , Sahle Tadesse , Zewdie Amare 
Published: June 2022

Background
Vaccination is the promising strategy to control the coronavirus disease 2019 (COVID-19) pandemic. However, the success of this strategy will rely mainly on the rate of vaccine acceptance among the general population. Therefore, this systematic review and meta-analysis aimed to estimate the pooled prevalence of COVID-19 vaccine acceptance and its determinants in Ethiopia.

Methods
We searched PubMed, Scopus, Google Scholar, African Journals Online, and Web of Sciences database to retrieve related articles. Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) guidelines were used for this study. Funnel plot and Eggers test were done to assess publication bias. Cochrane Q-test and I2 statistic were done to chick evidence of heterogeneity. Subgroup analysis was computed based on the study region and the study population. Data were extracted using a Microsoft Excel spreadsheet and analyzed using STATA version 14 statistical software. Weighted inverse variance random effect model was run to estimate the pooled prevalence of COVID-19 vaccine acceptance.

Results
A total of 12 studies with 5,029 study participants were included. The pooled prevalence of COVID-19 vaccine acceptance in Ethiopia was 51.64% (95%CI; 43.95%-59.34%). Being male (AOR = 4.46, 1.19–16.77, I2 = 88%), having secondary and above educational status (AOR = 3.97, 1.94–8.12, I2 = 69%), good knowledge (AOR = 3.36, 1.71–6.61, I2 = 93%), and positive attitude (AOR = 5.40, 2.43–12.00, I2 = 87%) were determinants of COVID-19 vaccine acceptance in Ethiopia.

Conclusion
The pooled prevalence of COVID-19 vaccine acceptance was low. Being male, having secondary and above educational status, good knowledge, and positive attitude were the determinants of COVID-19 vaccine acceptance. High level of COVID-19 vaccine acceptance among the general population is crucial to achieve herd immunity in the community. Therefore, policymakers, vaccine campaign program planners, and stakeholders should target to improve public awareness of vaccination that enhances vaccine acceptance and in turn helps to control the pandemic.