bluuebunny/crossref_metadata_2025_split huggingface dataset:
Fertility decision and its associated factors in Sub-Saharan Africa: a multilevel multinomial logistic regression analysis
Authors: Teshale Achamyeleh Birhanu , Worku Misganaw Gebrie , Tesema Getayeneh Antehunegn 
Published: August 2022

Abstract
Background
Fertility desire is one of the predictors of contraceptive behavior and fertility-related outcomes. However, information is scarce on individual and community-level factors of women’s fertility decisions in sub-Saharan Africa.

Objective
To assess fertility decisions and their associated factors in Sub-Saharan Africa.

Methods
The 35 Sub-Saharan African country’s most recent demographic and health surveys (DHS) data conducted from 2008 to 2020 was used. A total of 284,744 (weighted) married women were used for analysis. The proportion of fertility decisions with their 95%CI was estimated. To assess the factors associated with fertility decisions, both random effect and fixed effect analyses were conducted. In the fixed analysis, particularly in the multivariable analysis, adjusted relative risk ratio (aRRR) with its 95% confidence interval (CI) was reported and variables with a p-value < 0.05 were considered significant predictors of fertility decisions.

Results
In this study, 64.35% (95%CI: 64.2%, 64.5%) of the study participants had fertility desire. However, 5.4% (95%CI: 5.3, 5.5) of the study participants had undecided fertility behavior. In the multivariable analysis, desire for more children and undecided fertility desire were relatively lower among older women, women with primary, secondary, and higher education, working women, women who currently use contraceptives, women with a higher number of living children, women with higher parity, women from eastern and southern Africa, and women from wealthy households. While, the ideal number of children, women who had decision-making autonomy, and women from the rural residence were all associated with a relatively higher desire for more children and undecided fertility desire. Furthermore, respondents' education and sex of household head were associated with the desire for more children while media exposure was associated with undecided fertility desire.

Conclusion
In this study, around two-thirds of women had a desire for more children and only 5.4% of women had undecided fertility desires. Both individual and community-level factors were associated with both desires for more children and undecided fertility desires. As a result, the aforementioned factors should be considered while developing reproductive health programs.
Continuing chronic care services during a pandemic: results of a mixed-method study
Authors: Sumner Jennifer , Bundele Anjali , Chong Lin Siew , Teng Gim Gee , Kowitlawakul Yanika , Mukhopadhyay Amartya 
Published: August 2022

AbstractBackgroundPatients with chronic diseases have seen unprecedented changes to healthcare practices since the emergence of COVID-19. Traditional ‘on-site’ clinics have had to innovate to continue services. Whether these changes are acceptable to patients and are effective for care continuation are largely unreported.MethodsWe evaluated the effectiveness of care provision at a re-structured chronic care clinic and elicited the patient experiences of care and self-management. We conducted a convergent, parallel, mixed-methods study. Adult patients attending a chronic care clinic were included. We extracted data from 4,849 clinic visits before and during the COVID-19 pandemic, including operational metrics and attendee profile. We also conducted fifteen interviews with patients from the same clinic using a semi-structured interview guide.ResultsRe-structuring the chronic clinic, including the introduction of teleconsultations, home-delivery of prescriptions and use of community-based phlebotomy services, served to maintain continuity of care while adhering to COVID-19 containment measures. Qualitatively, five themes emerged. Patients were able to adjust to healthcare practice changes and adapt their own lifestyles, although poor self-management practices were adopted. While most were apprehensive about attending the clinic, they valued ongoing care access and were reassured by the on-site containment measures.ConclusionsContinuation of routine services is desired by patients and can be achieved through the adoption of containment measures, by greater collaboration with community partners, and the use of technology. Patients adapted to service changes, but poor self-management was evident. To prevent chronic disease relapse, services must strive to innovate rather than suspend services during pandemics.
Long-haul COVID: healthcare utilization and medical expenditures 6 months post-diagnosis
Authors: Koumpias Antonios M. , Schwartzman David , Fleming Owen 
Published: August 2022

Abstract
Background
Despite extensive evidence that COVID-19 symptoms may persist for up to a year, their long-term implications for healthcare utilization and costs 6 months post-diagnosis remain relatively unexplored. We examine patient-level association of COVID-19 diagnosis association of COVID-19 diagnosis with average monthly healthcare utilization and medical expenditures for up to 6 months, explore heterogeneity across age groups and determine for how many months post-diagnosis healthcare utilization and costs of COVID-19 patients persist above pre-diagnosis levels.

Methods
This population-based retrospective cohort study followed COVID-19 patients’ healthcare utilization and costs from January 2019 through March 2021 using claims data provided by the COVID-19 Research Database. The patient population includes 250,514 individuals infected with COVID-19 during March-September 2020 and whose last recorded claim was not hospitalization with severe symptoms. We measure the monthly number and costs of total visits and by telemedicine, preventive, urgent care, emergency, immunization, cardiology, inpatient or surgical services and established patient or new patient visits.

Results
The mean (SD) total number of monthly visits and costs pre-diagnosis were .4783 (4.0839) and 128.06 (1182.78) dollars compared with 1.2078 (8.4962) visits and 351.67 (2473.63) dollars post-diagnosis. COVID-19 diagnosis associated with .7269 (95% CI, 0.7088 to 0.7449 visits; P < .001) more total healthcare visits and an additional $223.60 (95% CI, 218.34 to 228.85; P < .001) in monthly costs. Excess monthly utilization and costs for individuals 17 years old and under subside after 5 months to .070 visits and $2.77, persist at substantial levels for all other groups and most pronounced among individuals age 45–64 (.207 visits and $73.43) and 65 years or older (.133 visits and $60.49).

Conclusions
This study found that COVID-19 diagnosis was associated with increased healthcare utilization and costs over a six-month post-diagnosis period. These findings imply a prolonged burden to the US healthcare system from medical encounters of COVID-19 patients and increased spending.
Elucidating the picocyanobacteria salinity divide through ecogenomics of new freshwater isolates
Authors: Cabello-Yeves Pedro J. , Callieri Cristiana , Picazo Antonio , Schallenberg Lena , Huber Paula , Roda-Garcia Juan J. , Bartosiewicz Maciej , Belykh Olga I. , Tikhonova Irina V. , Torcello-Requena Alberto , De Prado Paula Martin , Puxty Richard J. , Millard Andrew D. , Camacho Antonio , Rodriguez-Valera Francisco , Scanlan David J. 
Published: August 2022

AbstractBackgroundCyanobacteria are the major prokaryotic primary producers occupying a range of aquatic habitats worldwide that differ in levels of salinity, making them a group of interest to study one of the major unresolved conundrums in aquatic microbiology which is what distinguishes a marine microbe from a freshwater one? We address this question using ecogenomics of a group of picocyanobacteria (cluster 5) that have recently evolved to inhabit geographically disparate salinity niches. Our analysis is made possible by the sequencing of 58 new genomes from freshwater representatives of this group that are presented here, representing a 6-fold increase in the available genomic data.ResultsOverall, freshwater strains had larger genomes (≈2.9 Mb) and %GC content (≈64%) compared to brackish (2.69 Mb and 64%) and marine (2.5 Mb and 58.5%) isolates. Genomic novelties/differences across the salinity divide highlighted acidic proteomes and specific salt adaptation pathways in marine isolates (e.g., osmolytes/compatible solutes - glycine betaine/ggp/gpg/gmgclusters and glycerolipidsglpK/glpA), while freshwater strains possessed distinct ion/potassium channels, permeases (aquaporin Z), fatty acid desaturases, and more neutral/basic proteomes. Sulfur, nitrogen, phosphorus, carbon (photosynthesis), or stress tolerance metabolism while showing distinct genomic footprints between habitats, e.g., different types of transporters, did not obviously translate into major functionality differences between environments. Brackish microbes show a mixture of marine (salt adaptation pathways) and freshwater features, highlighting their transitional nature.ConclusionsThe plethora of freshwater isolates provided here, in terms of trophic status preference and genetic diversity, exemplifies their ability to colonize ecologically diverse waters across the globe. Moreover, a trend towards larger and more flexible/adaptive genomes in freshwater picocyanobacteria may hint at a wider number of ecological niches in this environment compared to the relatively homogeneous marine system.
Cellular crosstalk during liver regeneration: unity in diversity
Authors: Shu Wenzhi , Yang Mengfan , Yang Jiayin , Lin Shengda , Wei Xuyong , Xu Xiao 
Published: August 2022

AbstractThe liver is unique in its ability to regenerate from a wide range of injuries and diseases. Liver regeneration centers around hepatocyte proliferation and requires the coordinated actions of nonparenchymal cells, including biliary epithelial cells, liver sinusoidal endothelial cells, hepatic stellate cells and kupffer cells. Interactions among various hepatocyte and nonparenchymal cells populations constitute a sophisticated regulatory network that restores liver mass and function. In addition, there are two different ways of liver regeneration, self-replication of liver epithelial cells and transdifferentiation between liver epithelial cells. The interactions among cell populations and regenerative microenvironment in the two modes are distinct. Herein, we first review recent advances in the interactions between hepatocytes and surrounding cells and among nonparenchymal cells in the context of liver epithelial cell self-replication. Next, we discuss the crosstalk of several cell types in the context of liver epithelial transdifferentiation, which is also crucial for liver regeneration.
Impact of a conserved N-terminal proline-rich region of the α-subunit of CAAX-prenyltransferases on their enzyme properties
Authors: Hagemann Anna , Tasillo Sandro , Aydin Aykut , Kehrenberg Miriam Caroline Alice , Bachmann Hagen Sjard 
Published: August 2022

Abstract
Background
The CAAX-prenyltransferases farnesyltransferase (FTase) and geranylgeranyltransferase I (GGTase I) are heterodimers with a common α- (FTα) and unique β-subunits. Recently, α-subunits of species (e.g., human) that harbour an N-terminal proline-rich region (PRR) showed different dimerization behaviours than α-subunits without PRR (e.g., yeast). However, the specific function of the PRR has not been elucidated so far.

Methods
To determine whether the PRR is a conserved motif throughout eukaryotes, we performed phylogenetics. Elucidating the impact of the PRR on enzyme properties, we cloned human as well as rat PRR deficient FTα, expressed them heterologously and compared protein–protein interaction by pull-down as well as crosslinking experiments. Substrate binding, enzyme activity and sensitivity towards common FTase inhibitors of full length and PRR-deletion α-subunits and their physiological partners was determined by continuous fluorescence assays.

Results
The PRR is highly conserved in mammals, with an exception for marsupials harbouring a poly-alanine region instead. The PRR shows similarities to canonical SH3-binding domains and to profilin-binding domains. Independent of the PRR, the α-subunits were able to dimerize with the different physiological β-subunits in in vitro as well as in yeast two-hybrid experiments. FTase and GGTase I with truncated FTα were active. The KM values for both substrates are in the single-digit µM range and show no significant differences between enzymes with full length and PRR deficient α-subunits within the species.

Conclusions
Our data demonstrate that an N-terminal PRR of FTα is highly conserved in mammals. We could show that the activity and inhibitability is not influenced by the truncation of the N-terminal region. Nevertheless, this region shows common binding motifs for other proteins involved in cell-signalling, trafficking and phosphorylation, suggesting that this PRR might have other or additional functions in mammals. Our results provide new starting points due to the relevant but only partly understood role of FTα in eukaryotic FTase and GGTase I.
Determining host factors contributing to the reactivation of JC virus in kidney transplant recipients
Authors: Keykhosravi Sajedeh , Khosravi Masoud , Shenagari Mohammad , Hasan-alizadeh Elham , Mosadegh Mehrdad , Noori Goodarzi Narjes , Monfared Ali , Ashrafkhani Babak , Hasandokht Tolou 
Published: August 2022

Abstract
Background and aims
The John Cunningham virus (JCV) is the established etiological agent of the polyomavirus-associated nephropathy among renal transplant recipients. In the present study, we aimed to determine the probable predictive factors leading to JCV replication in renal transplant patients.

Material and methods
Urine and plasma samples were collected from a total of 120 consecutive renal‐transplanted patients without preliminary screening from Jan 2018 to Mar 2019. After DNA extraction, the simultaneous detection and quantification of JCV and BK polyomavirus (BKV) were conducted using a Real-time quantitative PCR method. Moreover, statistical analyses were performed using the statistical software packages, SPSS version 21.

Results
The prevalence of JCV viruria and viremia among renal transplant recipients were 26 (21.67%) and 20 (16.67%), respectively. A significant association was observed between the JCV and two risk factors, diabetes mellitus (P = 0.002) and renal stones (P = 0.015). The prevalence of JCV viremia among recipients who were grafted near time to sampling was significantly higher (P = 0.02). There was a statistically significant coexistence between BK and JC viruses among our patients (P = 0.029). The frequency of JCV viruria in males was reported almost three times more than in females (P = 0.005). The JCV shedding in urine was significantly associated with the tropical steroids like prednisolone acetate, which have been the standard regimen (P = 0.039). Multivariable analysis revealed duration of post-transplantation (OR, 0.89; P = 0.038), diabetes mellitus (OR, 1.85; P = 0.034), and renal stone (OR 1.10; P = 0.04) as independent risk factors associated with JCV viremia post-renal transplantation.

Conclusion
It seems that the discovery of potential risk factors, including immunological and non-immunological elements, may offer a possible preventive or therapeutic approach in the JCV disease episodes. The results of this study may also help clarify the probable clinical risk factors involving in progressive multifocal leukoencephalopathy development.
Seroconversion following the first, second, and third dose of SARS-CoV-2 vaccines in immunocompromised population: a systematic review and meta-analysis
Authors: Mehrabi Nejad Mohammad-Mehdi , Shobeiri Parnian , Dehghanbanadaki Hojat , Tabary Mohammadreza , Aryannejad Armin , Haji Ghadery Abdolkarim , Shabani Mahya , Moosaie Fatemeh , SeyedAlinaghi SeyedAhmad , Rezaei Nima 
Published: August 2022

Abstract
Background
Immunocompromised (IC) patients are at higher risk of more severe COVID-19 infections than the general population. Special considerations should be dedicated to such patients. We aimed to investigate the efficacy of COVID-19 vaccines based on the vaccine type and etiology as well as the necessity of booster dose in this high-risk population.

Materials and methods
We searched PubMed, Web of Science, and Scopus databases for observational studies published between June 1st, 2020, and September 1st, 2021, which investigated the seroconversion after COVID-19 vaccine administration in adult patients with IC conditions. For investigation of sources of heterogeneity, subgroup analysis and sensitivity analysis were conducted. Statistical analysis was performed using R software.

Results
According to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses, we included 81 articles in the meta-analysis. The overall crude prevalence of seroconversion after the first (n: 7460), second (n: 13,181), and third (n: 909, all population were transplant patients with mRNA vaccine administration) dose administration was 26.17% (95% CI 19.01%, 33.99%, I2 = 97.1%), 57.11% (95% CI: 49.22%, 64.83%, I2 = 98.4%), and 48.65% (95% CI: 34.63%, 62.79%, I2 = 94.4%). Despite the relatively same immunogenicity of mRNA and vector-based vaccines after the first dose, the mRNA vaccines induced higher immunity after the second dose. Regarding the etiologic factor, transplant patients were less likely to develop immunity after both first and second dose rather than patients with malignancy (17.0% vs 37.0% after first dose, P = 0.02; 38.3% vs 72.1% after second dose, P < 0.001) or autoimmune disease (17.0% vs 36.4%, P = 0.04; 38.3% vs 80.2%, P < 0.001). To evaluate the efficacy of the third dose, we observed an increasing trend in transplant patients after the first (17.0%), second (38.3%), and third (48.6%) dose.

Conclusion
The rising pattern of seroconversion after boosting tends to be promising. In this case, more attention should be devoted to transplant patients who possess the lowest response rate.
Correlation of short knee and full-length X-rays in evaluating coronal plane alignment in total knee arthroplasty
Authors: Kazemi Seyyed-Morteza , Qoreishi Seyyed-Mohammad , Maleki Arash , Minaei-Noshahr Reza , Hosseininejad Seyyed-Mohsen 
Published: August 2022

Abstract
Background
Coronal alignment after total knee arthroplasty (TKA) would influence the implant survival. Coronal alignment could be measured on short and full-length X-rays. The goal of the current study was to assess the correlation of short and full-length X-rays to accurate prediction of the true Hip-Knee-Ankle alignment after TKA in the Iranian population.

Methods
Lateral distal femoral and medial proximal tibial angles, FTA, HKA, in 180 Iranian patients (243 knees without extra-articular deformities) were measured and compared on short and full-length standing X-rays of primary TKA pre/postoperatively.

Results
The correlation between the preoperative FTA-short and FTA-long, FTA-short and HKA, and FTA-long and HKA values in degrees were fair, good and good (r = 0.64) (r = 0.73), (r = 0.76), respectively. This correlation for postoperative aMPTA and mMPTA (r = 0.73), and FTA-short and HKA (r = 0.76) values were good and significant (P = 0.001). Also, assessing coronal alignment based on short and full-length measurements would result in varying pre/postoperative alignments (varus, neutral and valgus).

Conclusion
Full length X-rays could not be replaced by short knee X-rays to asses true coronal alignment in TKA; considerable portion of our cases were missorted as varus, neutral or valgus based on the FTA versus the HKA. Intraoperative fixed 5° valgus angle cut of distal femur did not result in postoperative favorable neutral alignment in all cases.

Level of evidence
IV.
Safety and risk factors of TINAVI robot-assisted percutaneous pedicle screw placement in spinal surgery
Authors: Zhang Ren-Jie , Zhou Lu-Ping , Zhang Lai , Zhang Hua-Qing , Zhang Jian-Xiang , Shen Cai-Liang 
Published: August 2022

AbstractObjectiveTo determine the rates and risk factors of pedicle screw placement accuracy and the proximal facet joint violation (FJV) using TINAVI robot-assisted technique.MethodsPatients with thoracolumbar fractures or degenerative diseases were retrospectively recruited from June 2018 and June 2020. The pedicle penetration and proximal FJV were compared in different instrumental levels to identify the safe and risk segments during insertion. Moreover, the factors were also assessed using univariate and multivariate analyses.ResultsA total of 72 patients with 332 pedicle screws were included in the current study. The optimal and clinically acceptable screw positions were 85.8% and 93.4%. Of the 332 screws concerning the intra-pedicular accuracy, 285 screws (85.8%) were evaluated as Grade A according to the Gertzbein and Robbins scale, with the remaining 25 (7.6%), 10 (3.0%), 6 (1.8%), and 6 screws (1.8%) as Grades B, C, D, and E. Moreover, in terms of the proximal FJV, 255 screws (76.8%) screws were assessed as Grade 0 according to the Babu scale, with the remaining 34 (10.3%), 22 (6.6%), and 21 screws (6.3%) as Grades 1, 2, and 3. Furthermore, the univariate analysis showed significantly higher rate of penetration for patients with age < 61 years old, sex of female, thoracolumbar insertion, shorter distance from skin to insertion point, and smaller facet angle. Meanwhile, the patients with the sex of female, BMI < 25.9, grade I spondylolisthesis, lumbosacral insertion, longer distance from skin to insertion point, and larger facet angle had a significantly higher rate of proximal FJV. The outcomes of multivariate analyses showed that sex of male (adjusted OR 0.320, 95% CI 0.140–0.732;p = 0.007), facet angle ≥ 45° (adjusted OR 0.266, 95% CI 0.090–0.786;p = 0.017), distance from skin to insertion point ≥ 4.5 cm (adjusted OR 0.342, 95% CI 0.134–0.868;p = 0.024), and lumbosacral instrumentation (adjusted OR 0.227, 95% CI 0.091–0.566;p = 0.001) were independently associated with intra-pedicular accuracy; the L5 insertion (adjusted OR 2.020, 95% CI 1.084–3.766;p = 0.027) and facet angle ≥ 45° (adjusted OR 1.839, 95% CI 1.026–3.298;p = 0.041) were independently associated with the proximal FJV.ConclusionTINAVI robot-assisted technique was associated with a high rate of pedicle screw placement and a low rate of proximal FJV. This new technique showed a safe and precise performance for pedicle screw placement in spinal surgery. Facet angle ≥ 45° is independently associated with both the intra-pedicular accuracy and proximal FJV.
Ethyl loflazepate as a treatment for patients with idiopathic and psychogenic taste disorder
Authors: Sakata Ken-ichiro , Hato Hiroyuki , Sato Jun , Iori Takashi , Ohga Noritaka , Watanabe Haruhisa , Yamazaki Yutaka , Kitagawa Yoshimasa 
Published: August 2022

Abstract
Background
Ethyl loflazepate (EL) is a benzodiazepine derivative that has been reported to activate the gustatory cortex. Our department routinely uses EL as a first-line treatment for idiopathic and psychogenic taste disorders, although little has been reported in the literature with respect to patient outcomes, so we conducted a retrospective study examining its safety and efficacy.

Methods
Between 2008 and 2020, 49 patients (14 males and 35 females; mean age, 62.1 years) were diagnosed with taste disorders and received EL as their only treatment for > 14 days. Severity of taste disorder was evaluated using the paper disc method by Sakai et al., and treatment efficacy was evaluated using the Visual Analog Scale, wherein patients gave subjective ratings for their symptoms (reductions by > 50% after administration of EL for 4 weeks were defined as improvements).

Results
Results showed that the improvement rates for patients with idiopathic and psychogenic taste disorders were 55 and 70%, respectively. Additionally, the majority (78%) improved within 2 weeks, and side effects were mild (seven cases with drowsiness and one case with dizziness).

Conclusions
We conclude that EL is an appropriate first-line medication for patients with idiopathic and psychogenic taste disorders.