bluuebunny/crossref_metadata_2025_split huggingface dataset:
How do changes in motivation to prevent pregnancy influence contraceptive continuation? Results from a longitudinal study with women who receive family planning services from Community Pharmacists and Patent and Proprietary Medicine Vendors in Nigeria
Authors: Chace Dwyer Sara , Baruwa Sikiru , Okafor Emeka , Daini Babajide Oluseyi , Ubuane Osimhen , Jain Aparna 
Published: February 2022

AbstractBackgroundStudies have shown that motivation to avoid pregnancy is associated with contraceptive use and continuation. These motivations can change, however, even within a short period of time. This paper uses longitudinal data to look at women’s motivation to avoid pregnancy at two time points, and how changes in motivation influence contraceptive continuation.MethodsData for this analysis came from an evaluation of the IntegratE project which seeks to expand access to family planning (FP) in Nigeria through community pharmacies and drug shops. 491 women were interviewed within 10 days after receiving a FP service from these sources and again approximately 9 months later. The dependent variable was contraceptive continuation at the follow-up interview. A categorical independent variable was used to represent changes in motivation to avoid pregnancy from enrollment to the follow-up interview. Univariate and multivariate logistic regression models were used to assess the association between changes in motivation and contraceptive continuation.Results89% of women continued using contraception approximately 9 months after the enrollment interview. Women who remained highly motivated to avoid pregnancy were significantly more likely to continue using contraception compared to women who became more motivated (AOR 2.5; 95% CI 1.0–6.0). Women who became less motivated were 64% less likely to continue using contraception compared to who became more motivated (AOR 0.36 95% CI 0.1–0.9).ConclusionFP providers, including private sector pharmacists and drug shop owners, should continuously check-in with women about their motivations around pregnancy to support continuation among those who wish to avoid pregnancy.
Contraception after in vitro fertilisation (IVF): a qualitative study of the views of women who have had spontaneous pregnancies after successful IVF
Authors: Thwaites Annette , Hall Jennifer , Barrett Geraldine , Stephenson Judith 
Published: February 2022

Abstract
Background
The use of in vitro fertilisation (IVF) has increased rapidly since its inception in 1978. Women seeking IVF have a wide range of subfertility causes including unexplained subfertility. A growing subgroup of women seek treatment for other reasons than fertility problems, for example, women in same sex relationships and single women. This study aims to better understand the contraceptive needs of women after successful IVF pregnancy in order to improve service delivery and prevent unplanned and rapid-repeat pregnancies.

Methods
A qualitative study of views of women who have had spontaneous pregnancies after successful IVF. Participants were recruited using purposive and snowballing sampling methods from social media and peer networks. The framework method was used for analysis using NVivo12.

Results
The sample comprised 21 interviewees from the United Kingdom (UK), having a range of spontaneous pregnancy outcomes, including single and multiple livebirths, miscarriage, ectopic pregnancy and termination of pregnancy. Contraceptive choices were subject to a complex and dynamic interaction of influencing factors including beliefs regarding subfertility, desire for children and views on contraception. None of the women recalled receiving any information or useful counselling about contraception during fertility or maternity care. After IVF pregnancy, most women (n = 16) used no or ineffective contraception. Spontaneous pregnancy was not universally welcomed in this group and inter-pregnancy intervals were often short (n = 16, less than 18 months). Even after subsequent spontaneous pregnancy, use of contraception and the most effective methods remained low. Women held persistent beliefs regarding their subfertility despite subsequent spontaneous pregnancy. They associated aspects of the IVF process with a sense of personal failure, despite an ultimately “successful” outcome of livebirth. These aspects may reinforce their self-belief in subfertility. Other barriers to contraception use in women having IVF included: lack of knowledge of likelihood of spontaneous pregnancy, lack of contraceptive experience and inherent incentives towards shorter inter-pregnancy intervals.

Conclusions
The contraceptive needs of women having IVF pregnancies are real and are being overlooked. Fertility services should take responsibility for providing information on the risks of subsequent spontaneous pregnancy. Maternity and community healthcare professionals must address women’s perceptions of their fertility in order to engage them in contraception counselling.
A cross-sectional investigation of the mental health and wellbeing among individuals who have been negatively impacted by the COVID-19 international border closure in Australia
Authors: Ali Kathina , Iasiello Matthew , van Agteren Joep , Mavrangelos Teri , Kyrios Michael , Fassnacht Daniel B. 
Published: February 2022

Abstract
Background
The COVID-19 pandemic resulted in the Australian government implementing strict international border closures. However, research has not yet investigated the mental health status of individuals impacted negatively by these international border closures.

Methods
The present study was a cross-sectional online survey of 3968 adults who reported being negatively affected by the border closure during June and July 2021. Psychological distress was measured with the Kessler Psychological Distress Scale (K10), stress with the Perceived Stress Scale (PSS) and wellbeing with the Mental Health Continuum Short Form (MHC-SF).

Results
In total, 3968 participants reported being negatively affected by the current restrictions (63.4% in Australia, 36.6% overseas). The vast majority of respondents (83.6%) reported high or very high levels of psychological distress (mean K10 score > 22), and 74.8% reported poor mental wellbeing, with similar risk profiles for participants in Australia or overseas. The most common scenarios of affected individuals included 1) wanting to enter Australia (30.8%), 2) wanting to leave Australia (29.6%) and 3) wanting someone to enter Australia (25.6%). Reasons included wanting to be with partners, family and friends (81.1%), for employment/economic reasons (4.9%), study (4.1%), personal safety/health (2.6%) or holiday (1.4%). While psychological distress was extremely high across all groups, separated partners and those with interrupted study experienced the highest distress (mean K10 = 35.7, n = 155).

Conclusion
The data suggests a highly elevated mental health risk profile among individuals who report being negatively affected by current Australian international border closures. The results provide valuable data to inform future policy decisions and have clear implications regarding effective service provision for this vulnerable group.
An ecological study on the association between International Health Regulations (IHR) core capacity scores and the Universal Health Coverage (UHC) service coverage index
Authors: Lee Yuri , Kim Siwoo , Oh Jungju , Lee Sieun 
Published: February 2022

Abstract
Background
The pandemic situation due to COVID-19 highlighted the importance of global health security preparedness and response. Since the revision of the International Health Regulations (IHR) in 2005, Joint External Evaluation (JEE) and States Parties Self-Assessment Annual Reporting (SPAR) have been adopted to track the IHR implementation stage in each country. While national IHR core capacities support the concept of Universal Health Coverage (UHC), there have been limited studies verifying the relationship between the two concepts. This study aimed to investigate empirically the association between IHR core capacity scores and the UHC service coverage index.

Method
JEE score, SPAR score and UHC service coverage index data from 96 countries were collected and analyzed using an ecological study design. The independent variable was IHR core capacity scores, measured by JEE 2016-2019 and SPAR 2019 from the World Health Organization (WHO) and the dependent variable, UHC service coverage index, was extracted from the 2019 UHC monitoring report. For examining the association between IHR core capacities and the UHC service coverage index, Spearman’s correlation analysis was used. The correlation between IHR core capacities and UHC index was demonstrated using a scatter plot between JEE score and UHC service coverage index, and the SPAR score and UHC service coverage index were also presented.

Result
While the correlation value between JEE and SPAR was 0.92 (p < 0.001), the countries’ external evaluation scores were lower than their self-evaluation scores. Some areas such as available human resources and points of entry were mismatched between JEE and SPAR. JEE was associated with the UHC score (r = 0.85, p < 0.001) and SPAR was also associated with the UHC service coverage index (r = 0.81, p < 0.001). The JEE and SPAR scores showed a significant positive correlation with the UHC service coverage index after adjusting for several confounding variables.

Conclusion
The study result supports the premise that strengthening national health security capacities would in turn contribute to the achievement of UHC. With the help of the empirical result, it would further guide each country for better implementation of IHR.
The global landscape of neoadjuvant and adjuvant anti-PD-1/PD-L1 clinical trials
Authors: Wu Dawei , Huang Huiyao , Zhang Minghui , Li Ziwei , Wang Shuhang , Yu Yue , Fang Yuan , Jiang Ning , Miao Huilei , Ma Peiwen , Tang Yu , Li Ning 
Published: February 2022

AbstractThe neoadjuvant and adjuvant anti-PD-1/PD-L1 treatment has been increasingly noticed. To summarize the global landscape of these clinical trials will provide essential data for all the stakeholders of drug development. Based on the Trialtrove database, a total of 668 clinical trials initiated by the end of 2020 were retrospectively analyzed. We found that a rising capability of global neoadjuvant and adjuvant anti-PD-1/PD-L1 clinical development has been achieved. High prevalent cancer types were extensively studied though the priorities in China and the United States were different. However, a lack of phase III trials and industry-sponsored trials was addressed. The confirmatory neoadjuvant trials were particularly insufficient, and the combination strategy mainly focused on chemotherapy. Thus, more public funding and accelerated regulatory strategies are needed in this field. Efforts should be made to confirm the benefit of neoadjuvant treatment and explore novel combination strategies.
Virtual Arm Boot Camp (V-ABC): study protocol for a mixed-methods study to increase upper limb recovery after stroke with an intensive program coupled with a grasp count device
Authors: Simpson Lisa A. , Barclay Ruth , Bayley Mark T. , Dukelow Sean P. , MacIntosh Bradley J. , MacKay-Lyons Marilyn , Menon Carlo , Mortenson W. Ben , Peng Tzu-Hsuan , Pollock Courtney L. , Pooyania Sepideh , Teasell Robert , Yang Chieh-ling , Yao Jennifer , Eng Janice J. 
Published: February 2022

Abstract
Background
Encouraging upper limb use and increasing intensity of practice in rehabilitation are two important goals for optimizing upper limb recovery post stroke. Feedback from novel wearable sensors may influence practice behaviour to promote achieving these goals. A wearable sensor can potentially be used in conjunction with a virtually monitored home program for greater patient convenience, or due to restrictions that preclude in-person visits, such as COVID-19. This trial aims to (1) determine the efficacy of a virtual behaviour change program that relies on feedback from a custom wearable sensor to increase use and function of the upper limb post stroke; and (2) explore the experiences and perceptions of using a program coupled with wearable sensors to increase arm use from the perspective of people with stroke.

Methods
This mixed-methods study will utilize a prospective controlled trial with random allocation to immediate or 3-week delayed entry to determine the efficacy of a 3-week behaviour change program with a nested qualitative description study. The intervention, the Virtual Arm Boot Camp (V-ABC) features feedback from a wearable device, which is intended to increase upper limb use post stroke, as well as 6 virtual sessions with a therapist. Sixty-four adults within 1-year post stroke onset will be recruited from seven rehabilitation centres. All outcomes will be collected virtually. The primary outcome measure is upper limb use measured by grasp counts over 3 days from the wearable sensor (TENZR) after the 3-week intervention. Secondary outcomes include upper limb function (Arm Capacity and Movement Test) and self-reported function (Hand Function and Strength subscale from the Stroke Impact Scale). Outcome data will be collected at baseline, post-intervention and at 2 months retention. The qualitative component will explore the experiences and acceptability of using a home program with a wearable sensor for increasing arm use from the point of view of individuals with stroke. Semi-structured interviews will be conducted with participants after they have experienced the intervention. Qualitative data will be analysed using content analysis.

Discussion
This study will provide novel information regarding the efficacy and acceptability of virtually delivered programs to improve upper extremity recovery, and the use of wearable sensors to assist with behaviour change.

Trial registration
ClinicalTrials.govNCT04232163. January 18, 2020.
Vaccination of cattle with synthetic peptides corresponding to predicted extracellular domains of Rhipicephalus (Boophilus) microplus aquaporin 2 reduced the number of ticks feeding to repletion
Authors: Scoles Glen A. , Hussein Hala E. , Olds Cassandra L. , Mason Kathleen L. , Davis Sara K. 
Published: February 2022

Abstract
Background
There have been ongoing efforts to identify anti-tick vaccine targets to protect cattle from infestation with cattle fever ticks Rhipicephalus (Boophilus) microplus. Two commercial vaccines based on the tick gut protein Bm86 have had variable effectiveness, which has led to poor acceptance, and numerous studies have attempted to identify vaccine antigens that will provide more consistently effective protection. Transcriptomic analysis of R. microplus led to identification of three aquaporin genes annotated to code for transmembrane proteins involved in the transport of water across cell membranes. Previous work showed that vaccination with full-length recombinant aquaporin 1 (RmAQP1) reduced tick burdens on cattle. Targeted silencing of aquaporin 2 (RmAQP2) expression suggested it might also be a good anti-tick vaccination target.

Methods
Three synthetic peptides from the predicted extracellular domains of RmAQP2 were used to vaccinate cattle. Peptides were conjugated to keyhole limpet hemocyanin (KLH) as an antigenic carrier molecule. We monitored the antibody response with ELISA and challenged vaccinated cattle with R. microplus larvae.

Results
There was a 25% reduction overall in the numbers of ticks feeding to repletion on the vaccinated cattle. Immune sera from vaccinated cattle recognized native tick proteins on a western blot and reacted to the three individual synthetic peptides in an ELISA. The vaccinated calf with the highest total IgG titer was not the most effective at controlling ticks; ratios of IgG isotypes 1 and 2 differed greatly among the three vaccinated cattle; the calf with the highest IgG1/IgG2 ratio had the fewest ticks. Ticks on vaccinated cattle had significantly greater replete weights compared to ticks on controls, mirroring results seen with RNA silencing of RmAQP2. However, protein data could not confirm that vaccination had any impact on the ability of the tick to concentrate its blood meal by removing water.

Conclusions
A reduced number of ticks feed successfully on cattle vaccinated to produce antibodies against the extracellular domains of RmAQP2. However, our predicted mechanism, that antibody binding blocks the ability of RmAQP2 to move water out of the blood meal, could not be confirmed. Further study will be required to define the mechanism of action and to determine whether these vaccine targets will be useful components of an anti-tick vaccine cocktail.

Graphical Abstract
The impact of environmental factors on human echinococcosis epidemics: spatial modelling and risk prediction
Authors: Yin Jie , Wu Xiaoxu , Li Chenlu , Han Jiatong , Xiang Hongxu 
Published: February 2022

Abstract
Background
Human echinococcosis is affected by natural environmental factors, and its prevalence shows a distinct geographical distribution. Western China has the highest endemicity of human echinococcosis worldwide, but the spatial pattern and environmental determinants of echinococcosis are still unclear.

Methods
Hot/cold spot analysis was used to investigate the spatial distribution of human echinococcosis prevalence. Geodetector was used to identify key natural factors, and a structured additive regression model was used to analyse the relationship between natural factors and human echinococcosis prevalence and spatially predict echinococcosis epidemics.

Results
Hot spots for human echinococcosis prevalence include western and southeastern parts of Tibet Autonomous Region (henceforth Tibet) and the border areas between Tibet and the provinces of Qinghai and Sichuan. Spatial effects are crucial when modelling epidemics, and relative humidity, altitude and grassland area ratio were found to have the most evident effects on echinococcosis epidemics. The relationship between these three factors and echinococcosis prevalence was non-linear, and echinococcosis risk was higher in areas with high relative humidity, high altitude, and a high ratio of grassland to other land use types. The prevalence that was predicted from the investigated environmental factors was generally higher than the actual prevalence, and more epidemic hot spots were predicted for the Qinghai-Tibet Plateau, Inner Mongolia Autonomous Region, and the provinces of Yunnan and Sichuan than the rest of western China. These results indicate that prevention and control measures may effectively reduce echinococcosis prevalence.

Conclusions
We suggest that the prevention and control of human echinococcosis should be prioritized in the hot spots identified here, through the rational allocation of limited medical resources to where they are most needed. Furthermore, the spatial epidemiological modelling methods used in this study can be employed in future studies on echinococcosis and similar diseases.

Graphical abstract
Development of a convolutional neural network for the identification and the measurement of the median nerve on ultrasound images acquired at carpal tunnel level
Authors: Smerilli Gianluca , Cipolletta Edoardo , Sartini Gianmarco , Moscioni Erica , Di Cosmo Mariachiara , Fiorentino Maria Chiara , Moccia Sara , Frontoni Emanuele , Grassi Walter , Filippucci Emilio 
Published: February 2022

AbstractBackgroundDeep learning applied to ultrasound (US) can provide a feedback to the sonographer about the correct identification of scanned tissues and allows for faster and standardized measurements. The most frequently adopted parameter for US diagnosis of carpal tunnel syndrome is the increasing of the cross-sectional area (CSA) of the median nerve. Our aim was to develop a deep learning algorithm, relying on convolutional neural networks (CNNs), for the localization and segmentation of the median nerve and the automatic measurement of its CSA on US images acquired at the proximal inlet of the carpal tunnel.MethodsConsecutive patients with rheumatic and musculoskeletal disorders were recruited. Transverse US images were acquired at the carpal tunnel inlet, and the CSA was manually measured. Anatomical variants were registered. The dataset consisted of 246 images (157 for training, 40 for validation, and 49 for testing) from 103 patients each associated with manual annotations of the nerve boundary. A Mask R-CNN, state-of-the-art CNN for image semantic segmentation, was trained on this dataset to accurately localize and segment the median nerve section. To evaluate the performances on the testing set, precision (Prec), recall (Rec), mean average precision (mAP), and Dice similarity coefficient (DSC) were computed. A sub-analysis excluding anatomical variants was performed. The CSA was automatically measured by the algorithm.ResultsThe algorithm correctly identified the median nerve in 41/49 images (83.7%) and in 41/43 images (95.3%) excluding anatomical variants. The following metrics were obtained (with and without anatomical variants, respectively): Prec 0.86 ± 0.33 and 0.96 ± 0.18, Rec 0.88 ± 0.33 and 0.98 ± 0.15, mAP 0.88 ± 0.33 and 0.98 ± 0.15, and DSC 0.86 ± 0.19 and 0.88 ± 0.19. The agreement between the algorithm and the sonographer CSA measurements was excellent [ICC 0.97 (0.94–0.98)].ConclusionsThe developed algorithm has shown excellent performances, especially if excluding anatomical variants. Future research should aim at expanding the US image dataset including a wider spectrum of normal anatomy and pathology. This deep learning approach has shown very high potentiality for a fully automatic support for US assessment of carpal tunnel syndrome.
Role of point-of-care ultrasonography (POCUS) in the diagnosing of acute medial meniscus injury of knee joint
Authors: Ahmadi Omid , Motififard Mehdi , Heydari Farhad , Golshani Keihan , Azimi Meibody Azita , Hatami Saeed 
Published: February 2022

Abstract
Background
In recent years, musculoskeletal ultrasound has increasingly become the common method for diagnosis for many medical specialties. Therefore, the present study was performed to evaluate the diagnostic value of point-of-care ultrasonography (POCUS) as a primary triage tool in the diagnosis of the acute medial meniscus injury of the knee.

Materials and methods
The present cross-sectional study was performed on patients with a suspected medial meniscus injury of the knee in the emergency department (ED). After history taking and primary physical examination, radiographic imaging of the knee was done. If there was no fracture in the knee X-ray, the POCUS examination on the knee was carried out. All the patients were asked to refer to an orthopedic clinic 2 weeks after discharge from ED for the Magnetic Resonance Imaging (MRI) evaluation. Finally, the POCUS findings were compared with the MRI findings in diagnosing medial meniscus injury.

Results
Fifty-five patients with a mean age of 35.48 ± 11.58 years were analyzed in the study (69.1% male). In comparison with MRI scan, the sensitivity and specificity of POCUS in the detection of medial meniscus injury were 85.0 [95% confidence interval (CI), 54.0 to 98.9] and 65.7% [95% CI 42.2 to 85.7], respectively. Its positive and negative predictive values were 58.6% [95% CI 33.8 to 81.5] and 88.5% [95% CI 62.1 to 99.3], respectively. (Area under the ROC curve = 0.726, P value = 0.003).

Conclusion
The present study demonstrated that POCUS can reasonably be applied in comparison with MRI to evaluate medial meniscus injury. POCUS is an effective initial diagnostic modality in patients with suspected medial meniscus injuries.