bluuebunny/crossref_metadata_2025_split huggingface dataset:
In-person and virtual multidisciplinary intensive lifestyle interventions are equally effective in patients with type 2 diabetes and obesity
Authors: Al-Badri Marwa , Kilroy Cara L. , Shahar Jacqueline Ifat , Tomah Shaheen , Gardner Hannah , Sin Mallory , Votta Jennie , Phillips-Stoll Aliza , Price Aaron , Beaton Joan , Davis Chandra , Rizzotto Jo-Anne , Dhaver Shilton , Hamdy Osama 
Published: April 2022

Background: Intensive lifestyle intervention (ILI) is essential for diabetes management. The Weight Achievement and Intensive Treatment (Why WAIT) program is a 12-week multidisciplinary weight management program that has been implemented in real-world clinical practice since 2005 and has shown long-term maintenance of weight reduction for 5 and 10 years. During the COVID-19 pandemic, the program went virtual using telemedicine and mobile health applications. Aims: This retrospective pilot study aims to evaluate the effectiveness of a virtual model of an already established and successful in-person program for diabetes and weight management since 2005. Methods: We evaluated 38 patients with diabetes and obesity enrolled in the Why WAIT program between February 2019 and December 2020. Sixteen participants were enrolled in virtual program (VP) and were compared with 22 participants who completed the latest two physical programs (PPs) before COVID-19. We evaluated changes in body weight, A1C, blood pressure (BP), and lipid profile after 12 weeks of ILI. Results: Body weight decreased by −7.4 ± 3.6 kg from baseline in VP compared with −6.8 ± 3.5 kg in PP ( p = 0.6 between groups). A1C decreased by −1.03% ± 1.1% from baseline in VP, and by −1.0% ± 1.2% in PP ( p = 0.9 between groups). BP, lipid profile, and all other parameters improved in both groups with no significant difference between them. Conclusion: Virtual multidisciplinary ILI is as effective as the in-person intervention program in improving body weight, A1C, BP, and lipid profile, and in reducing the number of anti-hyperglycemic medications. Results from our study suggest that scaling the Why WAIT program in a virtual format to a larger population of patients with diabetes and obesity is feasible and is potentially as successful as the in-person program.
Nurse-led safer opioid supply and HIV pre-exposure prophylaxis: a novel pilot project
Authors: Haines Marlene , O’Byrne Patrick 
Published: April 2022

Introduction: HIV pre-exposure prophylaxis (PrEP) is an effective intervention for preventing HIV infections yet is largely unknown to and underutilized among people who use drugs. Methods: To better provide services to this group, we present a prospective, single-group interventional study involving the creation of a partnership between a safer opioid supply program and an HIV PrEP program, both of which were nurse-led. Results: Overall, HIV PrEP was offered to 42 individuals within the safer opioid supply program, resulting in 55% ( n = 23) acceptance. Almost half of the group that accepted PrEP identified as female, and nearly all participants were homeless and did not have a primary care provider. While it was challenging to obtain routine PrEP follow-up labs per guideline recommendations due to poor venous access, most participants were able to successfully stay on PrEP and maintained good medication adherence. There were no PrEP discontinuations due to renal impairment and no participants tested positive for HIV. Conclusion: This novel integration of programs appeared to be a highly effective way to expand access to HIV prevention among people who use drugs. Given the historical and current mistreatment of people who use drugs within the healthcare system, rapport and trust were essential to the uptake of HIV PrEP services. Further, the importance of infectious disease screening among people who use drugs is underscored, and built-in program flexibility and low barrier access is essential.
Prevalence of chronic kidney disease and associated factors among patients with chronic illness in Ethiopia: A systematic review and meta-analysis
Authors: Animaw Zelalem , Walle Ayehu Gashaw , Abdu Hussen 
Published: April 2022

Objective: The main aim of this systematic review and meta-analysis is to provide summarized evidence on the prevalence of chronic kidney disease and associated factors among patients with chronic illness in Ethiopia. Method: Databases of MEDLINE/PubMed, Embase, Google Scholar, CINAHL, Cochrane library, and ScienceDirect were searched. In addition, gray literatures were searched manually from university repositories. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses checklist was used to select potential studies. Microsoft Excel 2013 sheet template was used to extract data. The quality of included studies was assessed by utilizing the Newcastle-Ottawa Scale. STATA software version 14.0 is used to compute the estimated pooled prevalence and associated factors of chronic kidney disease. Result: Twelve articles that fulfilled the inclusion criteria were included. The pooled estimate of chronic kidney disease among patients with chronic illnesses in Ethiopia is 21.71% (95% confidence interval: 17.67, 25.74). The highest prevalence of chronic kidney disease among patients with chronic illnesses is from Oromia (32.55% (confidence interval: 19.91, 45.19)). Glomerular filtration rate showed a comparable pooled prevalence from Cockroft-Gault and MDRD methods; 22.38% (confidence interval: 15.83, 28.92), 22.18 (confidence interval: 18.01, 26.34), respectively. Hypertensives become more likely to have chronic kidney disease compared with normotensive patients, (odds ratio = 3.01, 95% confidence interval: 1.33, 6.81). Conclusion: Prevalence of chronic kidney disease among chronic illness patients was significantly high. Hypertension is significantly associated with chronic kidney disease. Hence, we recommend that continuous screening of possible risk factors and proper follow-up and management strategies should be designed.
Patient satisfaction with referral service and associated factors among public hospitals in and around Addis Ababa, Central Ethiopia
Authors: Guddu Dessalegn Keney , Demissie Dereje Bayissa 
Published: April 2022

Objective: Studies in sub-Saharan Africa have shown that patient satisfaction with referral procedures and systems is low due to multiple factors. Despite the challenges on patient satisfaction with referral service in Ethiopia, there are only limited studies on overall satisfaction and associated factors with referral services of the hospitals. The purpose of this study was to determine patient satisfaction with referral services and related characteristics among patients referred to referral hospitals in Central Ethiopia, in the year 2021. Methods: A facility-based multi-center cross-sectional study was conducted at public hospitals in and around Addis Ababa using both quantitative and qualitative data collection methods. The hospitals were selected using a simple random sampling method from the list. Data were collected from 317 referral forms and chart reviews, 310 patient interviews, 27 focused group discussions, and 16 insider observations. The collected data were coded and entered into EPI INFO version 7 and transferred to SPSS version 25 for further analysis. Both binary and multivariable logistic regression models were computed to see the association between independent versus outcome variables. The findings were taken as significant with a p value of <0.05 at 95% confidence interval and results were presented with text, graphs, figures, and tables. Result: Overall level of patients’ satisfaction of referral services in Central Ethiopia was 73.5%, confidence interval (67.9%–81.1 %,) and near 85% of the participants had got an examination by the respective health care worker on arrival. This study identified that factors that increase odds of patient satisfaction toward referral services were status of communication (adjusted odd ratio 44.09 (95% confidence interval, 5.47, 355.68), perceived level of experience of health providers who handle the referral process (adjusted odd ratio 6.42 (95% confidence interval, 1.20, 34.42) and coordination status of the hospitals during referral acceptance (adjusted odd ratio 35.50 (95% confidence interval, 4.87, 258.60) and these were significantly associated with patient’s satisfaction toward referral services. Referral without communication among hospitals was stated as the leading challenge by focused group discussants and very limited practice on referral feedback was reported by insider observers. Conclusion: This study determined that the overall level of patient satisfaction toward referral services in Central Ethiopia was moderate with identified factors that increase odds of patient satisfaction toward referral system being the way of communication, health provider’s experience, and coordination status of the hospitals on referral acceptance. Hence, policymakers and the ministry of health would better consider the aforementioned factors during referral program development and training for improvement of patients’ satisfaction with referral services.
Dysmenorrhea and associated symptoms in Ethiopia: A systematic review and meta-analysis
Authors: Gedefaw Getnet , Wondmieneh Adam , Getie Addisu , Waltengus Fikadu , Demis Asmamaw , Wang Chi Chiu 
Published: April 2022

Introduction: Dysmenorrhea is the most common gynecologic compliant and reproductive health problem among adolescents, young, and reproductive age group. Dysmenorrhea has psychological, physical, and behavioral impact on adolescent girls in different regions. Objective: This systematic review and meta-analysis aimed to assess the overall prevalence of dysmenorrhea, its pain intensity and associated symptoms in Ethiopia and compare with other countries. Methods: Literatures from PubMed, MEDLINE, EMABSE, CINHAL, SCOPUS, Hinari, Africa journals, and Google scholar were retrieved. Eligible cross-sectional studies were included for meta-analysis. I2 statistics was calculated to check heterogeneity. Subgroup analysis based on outcome of interest was performed. Sensitivity analysis was undertaken to examine the level of heterogeneity. Results: The prevalence of overall and primary dysmenorrhea in Ethiopia was 72% (95%CI 68–77) and 72.27% (95%CI 69.8–75.33) respectively. Back pain 56.62% (95%CI 46.68–66.57) and fatigue 51.51% (95%CI 40.08–62.94) were more common than headache 29.15% (95%CI 18.16–40.14) whereas moderate pain 41.03% (95%CI 33.98–48.07) was more common than mild 31.83% (95%CI 21.61–42.05) and severe pain intensity 21.57% (95%CI 14.24–28.89). The prevalence between small and large samples, Northern and South/West Ethiopia, and school girls and university students were nearly similar. Positive family history (OR = 4.05; 95%CI 3.15–5.20), early menarche (OR = 2.91; 95%CI 2.00–4.24) and irregular monthly menstrual cycle (OR = 1.87, 95%CI 1.23–2.84) were the predictors of dysmenorrhea. Conclusion: Compared with other countries, the prevalence of dysmenorrhea in Ethiopia is moderate, presenting as mainly back pain and fatigue with moderate pain intensity. Positive family history, early menarche, and irregular menstrual cycle are the positive contributing factors.
Patterns of Intervertebral Disk Alteration in Asymptomatic Elite Rowers: A T2* MRI Mapping Study
Authors: Benedikter Chiara , Abrar Daniel Benjamin , Konieczny Markus , Schleich Christoph , Bittersohl Bernd 
Published: April 2022

Background: Repetitive loading of the back puts elite rowers at risk for acute and chronic back injuries. Hypothesis: That asymptomatic elite rowers would demonstrate characteristic intervertebral disk (IVD) alterations on T2* magnetic resonance imaging (MRI) mapping compared with asymptomatic nonrowers. Study Design: Cross-sectional study; Level of evidence, 3. Methods: This study included 20 asymptomatic elite rowers (mean age, 23.4 ± 3.03 years; 9 women, 11 men) studied at 2 different times, once before ( t 1) and once after ( t 2) the competition phase. MRI including T2* mapping was performed on a 3-T scanner. The authors derived normative T2* data from a previous study on 40 asymptomatic volunteers (20 men, 20 women) who were not competitive rowers; based on complete T2* data sets, 37 controls were included. T2* values were compared between groups in 4 lumbar IVDs, and midsagittal T2* values were compared in 5 zones: anterior annulus fibrosus (AF), anterior nucleus pulposus (NP), central NP, posterior NP, and posterior AF. The Pfirrmann grade was used for morphological assessment of disk degeneration. Statistical analysis was conducted using the Mann-Whitney U test, Wilcoxon matched-pairs test, and Spearman rank correlation coefficient. Results: Lower T2* values were noted in the rower group compared with the controls (37.08 ± 33.63 vs 45.59 ± 35.73 ms, respectively; P < .001). The intersegmental comparison revealed lower mean T2* values among rowers ( P ≤ .027 for all). The interzonal comparison indicated significantly lower mean T2* values for the rowers in all zones except for the anterior NP ( P ≤ .008 for all). Lower mean T2* values were observed for the rowers at t 1 versus t 2 (39.25 ± 36.19 vs 43.97 ± 38.67 ms, respectively; P = .008). The authors noted a higher level of IVD damage according to Pfirrmann assessment in the rower cohort ( P < .001); the Pfirrmann grade distributions of rowers versus controls, respectively, were as follows: 51.3% versus 73.7% (grade 1), 20.5% versus 19.5% (grade 2), 21.8% versus 6.8% (grade 3), 5.1% versus 0% (grade 4), and 1.3% versus 0% (grade 5). The authors also noted a correlation between low T2* and high Pfirrmann grade at t 1 ( r =–0.48; P < .001) and t 2 ( r =–0.71; P < .001). Conclusion: The cohort of elite rowers revealed more degenerative IVD changes compared with controls. The T2* values suggest that repetitive loading of the spine has demonstrable short-term and possibly permanent effects on the lumbar IVD.
Elongation Patterns of Posterolateral Corner Reconstruction Techniques: Results Using 3-Dimensional Weightbearing Computed Tomography Simulation
Authors: Hodel Sandro , Hasler Julian , Fürnstahl Philipp , Fucentese Sandro F. , Vlachopoulos Lazaros 
Published: April 2022

Background: The isometric characteristics of nonanatomic and anatomic posterolateral corner (PLC) reconstruction techniques under weightbearing conditions remain unclear. Purpose: To (1) simulate graft elongation patterns during knee flexion for 3 different PLC reconstruction techniques (Larson, Arciero, and LaPrade) and (2) compute the most isometric insertion points of the fibular collateral ligament (FCL) graft strands for each technique and report quantitative radiographic landmarks. Study Design: Descriptive laboratory study. Methods: The authors performed a 3-dimensional simulation of 10 healthy knees from 0° to 120° of flexion using weightbearing computed tomography (CT) scans. The simulation was used to calculate ligament length changes during knee flexion for the PLC reconstruction techniques of Larson (nonanatomic single-bundle fibular sling reconstruction), Arciero (anatomic reconstruction with additional popliteofibular ligament graft strand), and LaPrade (anatomic reconstruction with popliteofibular ligament graft strand and popliteus tendon graft strand). The most isometric femoral insertion points for the FCL graft strands were computed within a 10-mm radius around the lateral epicondyle (LE), using an automatic string generation algorithm (0 indicating perfect isometry). Radiographic landmarks for the most isometric points were reported. Results: Median graft lengthening during knee flexion was similar for the anterior graft strands of all 3 techniques. The posterior graft strands demonstrated significant differences, from lengthening for the Arciero (9.9 mm [range, 6.7 to 15.9 mm]) and LaPrade (10.2 mm [range, 4.1 to 19.7 mm]) techniques to shortening for the Larson technique (−17.1 mm [range, −9.3 to −22.3 mm]; P < .0010). The most isometric point for the FCL graft strands of all techniques was located at a median of 2.2 mm (range, −2.2 to 4.5 mm) posterior and 0.3 mm (range, −1.8 to 3.7 mm) distal to the LE. Conclusion: Overconstraint can be avoided by tensioning the posterior graft strands in the Larson technique in extension, and in the Arciero and LaPrade techniques at a minimum of 60° of knee flexion. The most isometric point was located posterodistal to the LE. Clinical Relevance: The described isometric behavior of nonanatomic and anatomic PLC reconstruction techniques can guide optimal surgical reconstruction and prevent graft lengthening and overconstraint of the lateral compartment in knee flexion. Repetitive graft lengthening has been found to be associated with graft failure, and overconstraint favors lateral compartment pressure and cartilage degeneration.
Is perioperative blood pressure monitoring during intravitreal injections important?
Authors: Debbarma Meri , Kohli Piyush , Banushree R. , Sen Sagnik , Kumar Jayant , Babu Naresh , Ramasamy Kim 
Published: April 2022

Background: Anti-vascular endothelial growth factor intravitreal injections (IVIs) have proved to be a boon for patients suffering from several retinal pathologies. They are one of the most commonly performed procedures in ophthalmology. A perioperative rise in blood pressure (BP) has been noted during cataract surgery. Objectives: To evaluate the perioperative BP changes during IVI, and the associated risk factors. Design: Cross-sectional observational study Methods: The patients undergoing IVI from May 2019 to August 2019 were evaluated. All the patients underwent BP measurement before, during, and 1 h after the IVI. The correlation between the demographics and, the systemic comorbidities of the patients, and the ocular condition for which IVI was given was evaluated. Results: The study included 302 patients (mean age of 59.9 ± 10.7 years). The mean increase in systolic BP (SBP) and diastolic BP (DBP) at the time of injection was 25.7 ± 21.0 and 1.3 ± 13.4 mmHg, respectively. A ⩾ 10, ⩾ 20, ⩾ 30 mmHg increase in SBP at the time of injection was seen in 83.8% ( n = 253), 69.5% ( n = 210) and 49.0% ( n = 148) patients, respectively. Forty-one (13.6%) patients developed intra-procedural hypertensive urgency, out of which six patients (14.6%) did not recover even after 1 h of the procedure. None of the patients experienced any cardiovascular events. The univariate and multivariate linear regression analyses showed that the change in intra-procedural SBP correlated positively with the age of the patient and negatively with the baseline SBP. Conclusion: There is a significant rise of SBP at the time of IVI, especially in patients with advanced age and high baseline SBP. Some of the patients can experience hypertensive urgency at the time of injection and may take more than 1 h to recover. The patients receiving IVI should undergo a detailed physician evaluation before the procedure.
Three-dimensional Modeling and Simulation of Muscle Tissue Puncture Process
Authors: Lv Zongkai , Song Qinghua , Gao Fan , Liu Zhanqiang , Wan Yi , Jiang Yonghang 
Published: April 2022

AbstractNeedle biopsy is an essential part of modern clinical medicine. The puncture accuracy and sampling success rate of puncture surgery can be effectively improved through virtual surgery. There are few three-dimensional puncture (3D) models, which have little significance for surgical guidance under complicated conditions and restrict the development of virtual surgery. In this paper, a 3D simulation of the muscle tissue puncture process is studied. Firstly, the mechanical properties of muscle tissue are measured. The Mooney-Rivlin (M-R) model is selected by considering the fitting accuracy and calculation speed. Subsequently, an accurate 3D dynamic puncture model is established. The failure criterion is used to define the breaking characteristics of the muscle, and the bilinear cohesion model defines the breaking process. Experiments with different puncture speeds are carried out through the built in vitro puncture platform. The experimental results are compared with the simulation results. The experimental and simulated reaction force curves are highly consistent, which verifies the accuracy of the model. Finally, the model under different parameters is studied. The simulation results of varying puncture depths and puncture speeds are analyzed. The 3D puncture model can provide more accurate model support for virtual surgery and help improve the success rate of puncture surgery.
Snapback-Free Reverse-Conducting SOI LIGBT with an Integrated Self-Biased MOSFET
Authors: Yang Kemeng , Wei Jie , Dai Kaiwei , Ma Zhen , Li Congcong , Luo Xiaorong 
Published: April 2022

AbstractA novel snapback-free RC-LIGBT with integrated self-biased N-MOSFET is proposed and investigated by simulation. The device features an integrated self-biased N-MOSFET(ISM) on the anode active region. One side of the ISM is shorted to the P + anode electrode of RC-LIGBT and the other side is connected to the N + anode via a floating ohmic contact. The adaptively turn-on/off of the ISM contributes to improve the static and dynamic performance of the ISM RC-LIGBT. In the forward-state, due to the off-state of the ISM, the snapback could be effectively suppressed without requiring extra device area compared to the SSA (separated shorted anode) and STA (segmented trenches in the anode) LIGBTs. In the reverse conduction, the ISM is turned on and the parasitic NPN in the ISM is punched through, which provides a current path for the reverse current. Meanwhile, during the turn-off and reverse recovery states, the ISM turns on, providing a rapid electron extraction path. Thus, a superior tradeoff between the on-state voltage drop (Von) and turnoff loss (Eoff) as well as an improved reverse recovery characteristic can be obtained. Compared to the STA device, the proposed ISM RC-LIGBT reduces Eoff by 21.5% without snapback. Its reverse recovery charge is reduced by 53.7%/58.6% compared to that of the SSA LIGBT with Lb = 40/60 μm at the same Von. Due to the prominent static and dynamic characteristic, the power loss of ISM RC-LIGBT in a completed switching cycle is reduced.
The preference of onboard activities in a new age of automated driving
Authors: Hamadneh Jamil , Esztergár-Kiss Domokos 
Published: April 2022

AbstractAccording to the economic theory assumption, travelers tend to monetize travel time based on factors related to their individual and trip characteristics. In the literature, a limited number of studies evaluating onboard activities on traveler’s utility in the presence of the autonomous vehicle (AV) are found. In the current research, traveler preferences on board of three transport modes: individual-ride autonomous vehicle (IR-AV), shared-ride autonomous vehicle (SAV), and public transport (PT) are studied. The focus of this paper is the examination of travelers in urban areas, where traveling is relatively short, and the study of the travelers’ main trip purposes. The impact of travel time, travel cost, and main onboard activity is estimated based on a discrete choice experiment (DCE). The in-vehicle onboard activities are divided into six onboard activities, where active and passive activities are considered. An experimental design and a stated preference (SP) survey are carried out. The result of the SP survey is analyzed, where a Mixed Logit (ML) model, which includes various explanatory variables, is applied. The developed model contains such variables as trip time, trip cost, main onboard activity, frequent transport mode, job, age, and car ownership. These variables show various effects on the probability of choosing a transport mode. The impact of change in travel time, travel cost, and each of the six onboard activities on traveler preferences is highlighted. As a result, variations on the impact of time, cost, and onboard activities are demonstrated. Furthermore, it is presented that people prefer using IR-AV over SAV and PT, while the probability of choosing SAV is the lowest. Besides, reading and using social media affect the utility of travelers positively (i.e., higher probability) to a greater extent than other activities, while writing alone demonstrates negative utility.