bluuebunny/crossref_metadata_2025_split huggingface dataset:
Ply-stacking effects on mechanical properties of Kevlar-29/banana woven mats reinforced epoxy hybrid composites
Authors: Muralidharan M , Sathishkumar TP , Rajini N , Navaneethakrishan P , Ismail Sikiru Oluwarotimi , Senthilkumar K , Siengchin Suchart , Mohammad Faruq , Al-Lohedan Hamad A 
Published: November 2022

Development of new hybrid laminated composites of Kevlar-29 (K-29)/banana fiber ( Musa acuminata) mats to meet future demand for fiber reinforced polymer (FRP) composites has been investigated. The different ply-stacking sequenced Kevlar (K)/natural (N) banana reinforced epoxy polymeric hybrid composite samples were designated as KN1, KN2, KN3, KN4, KN5 and KN6, in addition to NN7 and KK8 for single or non-hybrid FRP (control) composite samples. The ply-stacking effects on mechanical properties of all the laminated composite were investigated. The maximum tensile, flexural, impact and interlaminar shear strengths (ILSS) were obtained with sample KN4, because of the stacking of its Kevlar and natural banana mats, which was K2/N4/K2 of 8 layers and different from other stacking sequences. The percentage improvements on tensile strength of sample KN4 when compared with other hybrid composite samples KN1, KN2, KN3, KN5 and KN6 were 6.3, 4.4, 3.6, 13.1 and 11.3%, respectively. While, same optimum sample KN4 recorded highest flexural strength among hybrid samples with percentage improvements of 122.19, 70.97, 31.03 and 83.68% when compared with other hybrid samples KN2, KN3, KN5 and KN6, respectively. Similar trend of results was obtained for their tensile and flexural moduli. But, both hybrid composite samples KN3 and KN4 recorded higher impact strengths of 3.0 and 2.8 J, respectively, when compared with other hybrid counterparts. The tensile and flexural strengths of sample KN4 were 147.48 and 223.69 MPa, respectively. The tensile properties of various theoretical model were compared with experimental values.
Machine learning based outcome prediction of large vessel occlusion of the anterior circulation prior to thrombectomy in patients with wake-up stroke
Authors: Feyen Ludger , Blockhaus Christian , Katoh Marcus , Haage Patrick , Schaub Christina , Rohde Stefan 
Published: November 2022

Purpose Outcome prediction of large vessel occlusion of the anterior circulation in patients with wake-up stroke is important to identify patients that will benefit from thrombectomy. Currently, mismatch concepts that require MRI or CT-Perfusion (CTP) are recommended to identify these patients. We evaluated machine learning algorithms in their ability to discriminate between patients with favorable (defined as a modified Rankin Scale (mRS) score of 0–2) and unfavorable (mRS 3–6) outcome and between patients with poor (mRS5–6) and non-poor (mRS 0–4) outcome. Methods Data of 8395 patients that were treated between 2018 and 2020 from the nationwide registry of the German Society for Neuroradiology was retrospectively analyzed. Five models were trained with clinical variables and Alberta Stroke Program Early CT Score (ASPECTS). The model with the highest accuracy was validated with a test dataset with known stroke onset and with a test dataset that consisted only of wake-up strokes. Results 2419 patients showed poor and 3310 patients showed favorable outcome. The best performing Random Forest model achieved a sensitivity of 0.65, a specificity of 0.81 and an AUC of 0.79 on the test dataset of patients with wake-up stroke in the classification analysis between favorable and unfavorable outcome and a sensitivity of 0.42, a specificity of 0.83 and an AUC of 0.72 in the classification analysis between poor and non-poor outcome. Conclusion Machine learning algorithms have the potential to aid in the decision making for thrombectomy in patients with wake-up stroke especially in hospitals, where emergency CTP or MRI imaging is not available.
Menstrual abnormality, maternal illiteracy, and household factors as main predictors of anemia among adolescent girls in Ethiopia: Systematic review and meta-analysis
Authors: Endale Fitsum , Woldeyohannes Demelash , Belayneh Fanuel , Tamene Aiggan , Habte Aklilu , Gizachew Addisalem , Sulamo Dawit , Yirga Demessie Yohannes , Yohannes Janet , Mekonen Tadesse , Akiso Denebo 
Published: November 2022

Background: Adolescent girls are more likely to develop anemia as a result of physical and physiological changes that place a greater strain on their nutritional needs. Primary studies, on the other hand, may not be sufficient to provide a complete picture of anemia in adolescent girls and its major risk factors. Objective: The study aimed to describe the pooled prevalence of adolescent girls’ anemia and the factors that contribute. Methods: We conducted a systematic review of observational studies using the databases CINAHL (EBSCO), PubMed, Science Direct, Cochrane Library, and Google Scholar. The Newcastle-Ottawa Scale was used to assess the quality of the articles, and studies of fair to good quality were included. We pooled anemia prevalence among adolescents and odds ratio estimates for risk factors. Subgroup analysis employing sample size and study setup was computed to determine the source of heterogeneity, and the I2 test was used to identify the existence or absence of substantial heterogeneity during subgroup analysis. The pooled prevalence of adolescent girls’ anemia was calculated using a random-effects meta-analysis model. Results: The overall pooled prevalence of anemia among adolescent girls in Ethiopia was 23.03% (95% confidence interval: 17.07, 28.98). Low dietary diversity (odds ratio: 1.56; 95% confidence interval: 1.05, 2.32), illiterate mothers (odds ratio: 1.45; 95% confidence interval: 1.13, 1.86), household size greater than five (odds ratio: 1.65; 95% confidence interval: 1.14, 2.38), food-insecure households (odds ratio: 1.48; 95% confidence interval: 1.21, 1.82), and menstrual blood flow more than 5 days (odds ratio: 6.21; 95% confidence interval: 1.67, 23.12) were the identified factors associated with anemia among adolescent girls. Conclusion: The pooled prevalence of anemia among adolescent girls in Ethiopia was moderately high. Therefore, to combat the burden of anemia among adolescent girls offering nutritional education is crucial. Iron supplementation is also recommended for adolescent females who have a menstrual cycle that lasts longer than 5 days.
Journalistic narratives amid the US and Chinese media expansion in Africa: What it means to tell an African journalistic story
Authors: Gondwe Gregory 
Published: November 2022

With the Joe Biden–Kamala Harris administration working toward the resetting of policies and strategies toward Africa and China, the question of whether African journalists will be accorded a chance to tell an African narrative amid the trilateral relationship has become more apparent. The influence exerted by China in African poses questions of whether China is “constructively” reporting Africa and whether journalists do see themselves as telling an African story. This study interrogates the role of African journalistic paradigms within a broader framework of what it means to constructively report Africa. It argues that despite the overwhelming challenges, the African media can tell its narrative if, (a). it seriously interrogates its journalism education system, (b). focus on in-depth reporting as opposed to efficiency and convenience, and (c). value its epistemologies and localize its content.
Assessing the immune response to SARS-CoV-2 mRNA vaccines in siponimod-treated patients: a nonrandomized controlled clinical trial (AMA-VACC)
Authors: Ziemssen Tjalf , Groth Marie , Rauser Benedict , Bopp Tobias 
Published: November 2022

Background: Systematic data are lacking on the immune response toward SARS-CoV-2 mRNA vaccination in SPMS patients on disease-modifying therapies (DMTs). Objective: The AMA-VACC clinical trial was designed to characterize immune responses to SARS-CoV-2 mRNA vaccines in siponimod-treated SPMS patients. Design: AMA-VACC is an ongoing three-cohort, multicenter, open-label, prospective clinical study. Methods: The study included patients at risk for SPMS or patients with SPMS diagnosis. Patients received SARS-CoV-2 mRNA vaccine as part of their clinical routine during ongoing siponimod treatment (cohort 1), during siponimod treatment interruption (cohort 2), or while on dimethyl fumarate, glatiramer acetate, beta-interferons, teriflunomide, or no current therapy (cohort 3). SARS-CoV-2-specific neutralizing antibodies and T-cell responses were measured 1 week and 1 month after the second dose of vaccination. Results: In total, 17 patients, 4 patients, and 20 patients were recruited into cohorts 1, 2, and 3, respectively. The primary endpoint of seroconversion for SARS-CoV-2-neutralizing antibodies at week 1 was reached by 52.9%, 75.0%, and 90.0% of patients in cohorts 1, 2, and 3, respectively. For 64.7% of patients in cohort 1, all patients in cohort 2, and 95% of patients in cohort 3, seroconversion was observed at either week 1 or month 1 or both time points. After 1 week, 71.4% of cohort 1, 75.0% of cohort 2, and 85.0% of cohort 3 were positive for either SARS-CoV-2-neutralizing antibodies or SARS-CoV-2-specific T-cells or both. After 1 month, the rates were 56.3%, 100.0%, and 95.0%, respectively. Conclusion: The study shows that the majority of siponimod patients mount humoral and cellular immune response under continuous siponimod treatment. The data do not sufficiently support interruption of treatment for the purpose of vaccination. Registration: EU Clinical Trials Register: EudraCT 2020-005752-38 ( www.clinicaltrialsregister.eu ); ClinicalTrials.gov: NCT04792567 ( https://clinicaltrials.gov ).
A meta-analysis on burden of postpartum depression and its predictors among lactating women in East African countries from 1998 up to 2018
Authors: Negesse Ayenew , Hune Yidersail , Temesgen Habtamu , Getaneh Temesgen , Bekalu Amare 
Published: November 2022

Objective: Postpartum depression is a common mental illness that affects lactating women. This not only makes daily activities difficult for them, but it also affects child’s future lives. There is little evidence of about postpartum depression and its factors in East African countries, which piqued the authors’ interest in conducting a study on this matter for future decision- and policy-making. Methods: The protocol for Preferred Reporting Items for Systematic Reviews and Meta-Analyses was followed. To identify published articles, all major databases such as PubMed/MEDLINE, WHOLIS, Cochrane Library, Embase, PsycINFO, ScienceDirect, Web of Science, and reference lists were used. In addition, shelves, author contact, Google and Google Scholar were also used to identify unpublished studies. Joanna Briggs Institute—Meta-Analysis of Statistical Assessment and Review Instrument was used for critical appraisal of studies. STATA software version 14 was used for the analysis. The random-effect model was used to estimate postpartum depression with 95% confidence interval, while subgroup analysis and meta-regression were used to identify potential sources of heterogeneity and associated factors, respectively. Furthermore, Egger’s test and trim-and-fill analysis were used to check for publication bias. Results: Postpartum depression was found in 24% of lactating women in East African countries (95% confidence interval: 17.79–30.20). Postpartum depression was associated with being married (odds ratio = 2; 95% confidence interval: 1.05–3.81), domestic violence (odds ratio = 6.34; 95% confidence interval: 4:11–9.78), a lack of support (odds ratio = 6.59; 95% confidence interval: 1.98–21.89), and a lack of empowerment (odds ratio = 2.79; 95% confidence interval: 1.12–6.92). Conclusion: In East Africa, the prevalence of postpartum depression among lactating women is high and rising, as per global postpartum depression estimates. Therefore, the primary focus should be on women’s domestic violence prevention mechanisms. Existing national policies and development agendas must prioritize strategies for women’s support and empowerment. Future research into the relationship between marriage and postpartum depression is required.
Primary Care Providers’ Use of Genetic Services in the Southeast United States: Barriers, Facilitators, and Strategies
Authors: Seibel Erin , Gunn Gwen , Ali Nadia , Jordan Ellen , Kenneson Aileen 
Published: November 2022

Introduction/Objectives: Collectively, genetic diseases are not that rare, and with increasing availability of genetics-informed healthcare management, primary care providers (PCPs) are more often asked to screen for or provide genetic services. Previous studies have identified barriers that impact PCPs’ ability to provide genetic services, including limited knowledge, training, and time/resources. This study set out to identify specific barriers limiting genetics service provision by PCPs within the Southeastern Regional Genetics Network (SERN) and resources that would help eliminate those barriers. Methods: PCPs were recruited through provider networks and invited to participate in semi-structured interviews, conducted via Zoom, recorded, and transcribed verbatim. Interview transcripts were independently coded by 2 coders using MAXQDA software. Thematic analysis was conducted. Results: Eleven interviews were conducted. Three predominant themes emerged from the data regarding factors impacting use of genetic services: system-wide factors, provider-specific factors, and patient factors. System-wide barriers included a lack of genetics providers and logistic challenges, which led to some PCPs coordinating referrals with other specialists or independently managing patients. Regarding provider-specific barriers, PCPs reported lack of genetics knowledge making referrals challenging. When possible, many PCPs contacted genetics providers for assistance. When not possible, some PCPs reached out to other colleagues or specialists for guidance. Patient-specific barriers included concerns or lack of information regarding genetics and unmet social needs. Many PCPs provided additional education regarding genetics appointments or testing benefits to their patients. Assistance from genetic counselors, electronic medical record systems that support referral to genetics, prior experience referring to genetics, established communication channels with genetics professionals, and highly motivated patients all facilitated improved collaboration with genetic services. PCPs provided suggestions for future resources to support interactions with genetics, including clear referral guidelines, increased access to genetics providers, improved test ordering processes, increased access to genetic education, and communication systems. Conclusions: PCPs face barriers at 3 different levels when engaging with genetic services: systems, providers, and patients. This study identified strategies that PCPs use to address these barriers, which are dependent on individual resources and practice settings. These strategies demonstrate resourcefulness in working to incorporate genetics into clinics operating at maximum capacity. By targeting barriers that uniquely impact providers, systems, and patients, as well as building upon strategies that PCPs are already using, medical providers can support PCPs to help with the provision of genetic services.
What Radiographic and Clinical Factors Ultimately Necessitate a C2-Sacrum Instrumented Posterior Spinal Fusion?
Authors: Mathew Justin , Zuckerman Scott L , Marciano Gerard , Simhon Matthew , Lin Hannah , Cerpa Meghan , Lee Nathan J , Boddapati Venkat , Lehman Ronald A , Sardar Zeeshan M , Dyrszka Marc D , Lombardi Joseph M , Lenke Lawrence G 
Published: November 2022

Objective /Hypothesis: Patients undergoing C2-sacrum PSF have unique medical histories and multiple prior operations over an extended period. Design Single center, retrospective cohort Methods Consecutive C2-sacrum PSF patients operated on by 4 surgeons at a single-center from 2015-2020 were reviewed. Demographics, comorbidities, indications, surgical history, and radiographic parameters were collected. Results 23 patients underwent C2-sacrum PSF. 13 (57%) were male, and 21 (91.3%) were adults. Mean age at time of first spine surgery was 44 years (range 5-71) and 53 years (range 14-72) at the time of C2-sacrum PSF. Six patients (26%) had osteoporosis, and 6 patients (26%) had neurologic comorbidities—including Parkinson’s disease (4), cerebral palsy (1), and Brown Sequard syndrome (1). Four (17%) had connective tissue disease. Two patients underwent C2-sacrum PSF as an index procedure: (1) 67M with myelomatous fractures and 124° of cervicothoracic kyphosis; (2) 28F with severe Marfan syndrome with 140° thoracic scoliosis and 130° thoracic kyphosis. The remaining 21 (91%) underwent C2-sacrum PSF as a revision following prior spinal surgeries on average, 4 previous surgeries (range 1-13) over 10.5 years (range .3-37.4). Indications for the remaining 21 C2-sacrum PSF revision procedures included 17 (81%) for kyphosis (5 of whom also had significant coronal deformity), 1 (5%) for only coronal malalignment, 2 (10%) for instrumentation failure, and 1 (5%) for myelopathy. Conclusions 91% (21/23) of patients requiring C2-sacrum PSF were treated as revisions of prior fusions, with a mean of 4 prior surgeries over 10 years. Over 80% of these patients underwent C2-sacrum PSF to address kyphosis. 26% had neurologic conditions, and 26% had osteoporosis.
Perceived Occupational Stressors and the General Health of Critical Care Nurses During COVID-19 Pandemic
Authors: Al-Ghabeesh Suhair Hussni , Al-Awayssa Raid Mahmmud , Rayan Ahmad Hussien , Assaf Enas A 
Published: November 2022

Introduction The COVID-19 situation is placing nurses under great stress which may negatively influence their health. Objective The purpose of this study was to examine the association between occupational stress and general health of critical care nurses during COVID-19 pandemic. Methods A descriptive, cross-sectional design was used. A convenience sample of 150 Jordanian critical care nurses completed the study. Results Occupational stress was a significant predictor of nurses’ general health. Female gender, young, living with elderly or persons having chronic diseases, and little nursing experience were associated with worse general health, while living with elderly or persons having chronic diseases were associated with more occupational stress. Conclusion Providing psychological support services for critical care nurses is required to reduce the impact of occupational stress on nurses’ poor general health.
Can breeders prevent pathogen adaptation when selecting for increased resistance to infectious diseases?
Authors: Hulst Andries D. , Bijma Piter , De Jong Mart C. M. 
Published: November 2022

Abstract
Background
Recent research shows that genetic selection has high potential to reduce the prevalence of infectious diseases in livestock. However, like all interventions that target infectious diseases, genetic selection of livestock can exert selection pressure on pathogen populations. Such selection on the pathogen may lead to escape strategies and reduce the effect of selection of livestock for disease resistance. Thus, to successfully breed livestock for lower disease prevalence, it is essential to develop strategies that prevent the invasion of pathogen mutants that escape host resistance. Here we investigate the conditions under which such “escape mutants” can replace wild-type pathogens in a closed livestock population using a mathematical model of disease transmission.

Results
Assuming a single gene that confers sufficient resistance, results show that genetic selection for resistance in livestock typically leads to an “invasion window” within which an escape mutant of the pathogen can invade. The bounds of the invasion window are determined by the frequency of resistant hosts in the population. The lower bound occurs when the escape mutant has an advantage over the wild-type pathogen in the population. The upper bound occurs when local eradication of the pathogen is expected. The invasion window is smallest when host resistance is strong and when infection with the wild-type pathogen provides cross immunity to infection with the escape mutant.

Conclusions
To minimise opportunities for pathogens to adapt, under the assumptions of our model, the aim of disease control through genetic selection should be to achieve herd-level eradication of the infection faster than the rate of emergence of escape mutants of the pathogen. Especially for microparasitic infections, this could be achieved by placing animals into herds according to their genetic resistance, such that these herds stay completely out of the invasion window. In contrast to classical breeding theory, our model suggests that multi-trait selection with gradual improvement of each trait of the breeding goal might not be the best strategy when resistance to infectious disease is part of the breeding goal. Temporally, combining genetic selection with other interventions helps to make the invasion window smaller, and thereby reduces the risk of invasion of escape mutants.
Design and feasibility of an implementation strategy to address Chagas guidelines engagement focused on attending women of childbearing age and children at the primary healthcare level in Argentina: a pilot study
Authors: Klein Karen , Roberti Javier , Rouvier Mariel , Belizan Maria , Cafferata Maria Luisa , Berrueta Amanda Mabel , Alonso Juan Pedro 
Published: November 2022

Abstract
Background
Chagas is a public health problem, especially in Latin America, exacerbated by migratory movements and increasing urbanization. Argentina is among the countries with the highest estimated prevalence in the region, with 1,500,000 people infected, with mother to child as the main mode of transmission. Vertical transmission has been significantly reduced by treating women of childbearing age; several guidelines in the region recommend treatment as a primary prevention strategy for the child and a secondary prevention strategy for women and their families. Despite recommendations, women of childbearing age are not always treated, and children do not receive timely diagnosis and treatment. The objective of this research was to design an implementation strategy to improve using Chagas guidelines focused on attending women of childbearing age and children at the primary healthcare level and pilot it in three primary health care centers in Argentina.

Methods
We conducted a pilot feasibility study using the Consolidated Framework for Implementation Research. A qualitative process evaluation was conducted using semi-structured interviews with health care providers and observations in primary health care centers.

Results
We developed a multifaceted implementation strategy including training, flowcharts and reminders, a register of suspected and confirmed cases, and the selection of a management facilitator. The pilot study took place between September 2019 and May 2020. The implementation level was heterogeneous and varied depending on the components, being the facilitating factors, the simplicity of the intervention, professionals’ willingness to expand the indication of serologic tests, and staff commitment to the adoption of intervention components. The main barriers found were the change of authorities at the local level, some professionals´ reluctance to administer etiological treatment, staff shortages, lack of diagnostic supplies, and the health emergency caused by the COVID-19 pandemic.

Conclusions
Behavioral change strategies should be applied to improve implementation to address some of the main barriers, including support actions offered by opinion leaders, medical experts, and local health authorities. Rapid diagnostic tests should be readily available to maintain behavior changes. We suggest further refinement of the strategy and its implementation in more centers to assess outcomes prospectively with a hybrid implementation research design.