bluuebunny/crossref_metadata_2025 huggingface dataset:
Investigation of the Exam Question Types Attitude Scale for Secondary School Students: Development, Validity, and Reliability
Authors: KURBANOGLU İzzet , OLCAYTÜRK Mevlüde
Published: August 2023

Developing students' positive attitudes toward a situation is extremely important. Many attitude scales aim to measure students' general attitudes toward a situation, but there is a scarcity of tools that can be easily employed to determine the type of questions students prefer in an exam. This paper reports the development and testing of an instrument like this for secondary school students, and 781 secondary school students participated in this study. The Exam Question Types Attitude Scale (EQTA-S) consisting of 10 items was developed in this study, and its validity and reliability were analyzed. Exploratory factor analysis was performed for the construct validity of the EQTA-S and an EQTA-S consisting of 10 items was obtained. The result of the confirmatory factor analysis showed that the scale is a good fit for the proposed one-factor structure. Additionally, the reliability of the scale was established by acceptable Cronbach alpha values that indicated reliability coefficients (Cronbach's alpha) of .81, .85, .84, and .82, respectively. Therefore, the findings of the study revealed that secondary school students' attitude scale toward exam question types provides valid and reliable results. As a result, this scale can be used to measure students' attitudes towards five different types of exam questions.
Thematic Content Analysis of Studies Concerning Misconceptions in Science Education in Turkey
Authors: ÖZCAN Fatmana , BAKIR Selda
Published: August 2023

The current study aims to contribute to closing this gap in the literature by making a thematic content analysis. In this study, which was conducted to examine the studies on misconceptions in science education in Turkey by thematic content analysis according to their type, year, method, sample, sampling method, data collection tools, and topics, a total of 346 studies published between 2000–2022 and accessed through the YÖK Thesis Center, ERIC, and Google Scholar were analyzed. As a result of the research, it was determined that most of the studies on misconceptions in science education in Turkey were published in 2011 in the forms of articles, they mainly used the survey method, they were conducted generally at the primary education level, the most frequently used sampling method was convenience sampling, and they often utilized concept tests as data collection tools. In terms of the preferred topics, it was found that most studies aimed to detect misconceptions. It is a well-known fact that misconceptions prevent science learning. Although it is favorable that a substantial number of studies on misconceptions are conducted in Turkey, the fact that the vast majority of these studies are about detecting misconceptions is thought-provoking since it is equally important to determine the causes of misconceptions and to try to eliminate them. In addition, based on the conclusion that quantitative methods are mostly used in the studies analyzed, it is essential to increase the number of qualitative studies to gain in-depth information about misconceptions.
Existing models of organizing high-speed public transport routes and their impact on passenger travel time
Authors:   Ural state university of railway transport (USURT), Nevolin D. G. , Tsarikov A. A. ,   Ural state university of railway transport (USURT), Bondarenko V. G. ,   Ural state university of railway transport (USURT)
Published: August 2023

Currently, there are no studies in the Russian scientific literature devoted to models of the organization of high-speed passenger transport routes. At the same time, as practice proves, the time of movement of passengers significantly depends on the accepted system of organization of routes. For example, non-stop routes, on the one hand, increase the required volume of rolling stock used for passenger transportation, but, on the other hand, reduce the total transshipment time. The article analyzes approaches to the organization of routes on the high-speed passenger transport network and presents the calculation of the overhead travel time of passengers for different network options. Calculations of the passenger’s traffic speed are given separately, depending on the distance of a trip and the type of transport used. It is pointed out that the optimal choice of the model of the route network of urban passenger transport makes it possible to reduce the cost of infrastructure construction and improve the quality of public services.
Keeping a Solar Sail near the Triangular Libration Point of a Dumbbell-Shaped or Binary Asteroid
Authors:   Moscow Aviation Institute (National Research University), Rodnikov A. V.
Published: August 2023

The possibility of keeping a spacecraft with a solar sail near an unstable triangular libration point of a minor planet or a binary asteroid is studied under the assumption that only the gravitation and the solar radiation influence the spacecraft motion. The case where the solar sail orientation remains unchanged with respect to the frame of reference of the heliocentric orbit of the asteroid mass center is considered. This means that the angle between the solar sail normal and ecliptic, as well as the angle between this normal and the solar rays at the current point, does not change during the motion. The spacecraft equations of motion are deduced under assumptions of V.V.Beletsky’s generalized restricted circular problem of three bodies, but taking into account the Sun radiation. The existence of a manifold of initial conditions for which it is possible to choose the normal direction that guarantees the spacecraft bounded motion near the libration point is established. Moreover, the dimension of this manifold coincides with that of the phase space of the problem at which the libration point belongs to the manifold boundary. In addition, some proposals for stabilization of the spacecraft motions are formulated for trajectories beginning in the manifold.
Entre clin d’œil et risque juridique, le « petit cru pas classé »
Authors: VINCENT DUPERREY
Published: August 2023

Antoine Armanet, producteur d’olives et vigneron, s’est vu recevoir une lettre de mise en demeure de la part du Conseil des grands crus classés de 1855 pour faire cesser l’utilisation de la dénomination « Petit Cru Pas Classé » au motif d’une utilisation non autorisée de la mention traditionnelle « cru classé »
Juridiquement se pose la question de savoir si le vigneron a fait une utilisation fautive de la mention « cru classé », sur le terrain des pratiques commerciales et de la concurrence déloyale.
Factor analysis of young academician consumption behaviors toward organic food and it’s obstacles
Authors: Hidayat Anas , Wijaya Tony
Published: August 2023

Purpose – This research aimed to explore environmentally friendly behaviors toward organic food consumption among the young academicians dominant in the higher education environment. This study also aims to explore the obstacles in consuming organic food qualitatively.
Design/methodology/approach – This research uses mix methods by combining two analytical methods. The population was academicians consuming organic food in Indonesia. This research employed the purposive sampling technique. The criteria used in this study determine the sample as young academicians who are still active in higher education, care about a health issue, and regularly buy products for daily consumption, or are called regular consumers. Primary data were collected through surveys using closed and open questionnaires. The study uses mix methods consisting of descriptive qualitative and factor analysis were used in the data analysis.
Findings – The results show that the factors influencing academicians' organic food consumption are responsibility for the environment, subjective norms, information or knowledge, the impact of consumption, behavioral control, and the values oriented towards nature. However, still aspects may become obstacles in consuming organic food, namely organic product price, availability, information or knowledge, and trust.
Originality/value – This research offers a study of consumption from young academics, which is not widely studied, even though young academics have an important role in environmentally-friendly behavior. This research also investigated several reasons that became obstacles to the young academician behavior of consuming organic food.
Research limitation – This research has several limitations, such as the variation of the sample. Cultural differences bring consequences for differences in environmentally friendly behavior because of the values that are different. Future research can compare the consumption behavior of young academicians based on the country and cultural differences.
Practical implication – Based on the findings, some practical recom­men­dations for increasing environmentally friendly consumption are made through promoting organic consumption behavior's benefits and environ­mental impacts. Environmentally friendly teaching material needs to be considered part of the learning process to improve academic knowledge. Young academician can become promotional agents to shape environ­mentally friendly consumption behavior, especially organic products. Another contribution as an agent of change in behavior in the world of education is also acting as a segmentation pattern for academic groups.
Meta-Analysis of Flipped Classroom on Students' Mathematics Abilities: Effectiveness and Heterogeneity Analysis
Authors: Endang Sulistyowati  , Jul Julham Hukom , Ali Muhtadi
Published: August 2023

Despite numerous studies investigating whether the Flipped Classroom method is more effective in enhancing students' mathematical abilities compared to conventional teaching methods, previous research has shown inconsistent results. This study aims to examine the effectiveness of the Flipped Classroom method on students' mathematical abilities compared to conventional methods and to investigate the factors that can influence the effectiveness of using the Flipped Classroom method on students' mathematical abilities. The research design used in this study is a meta-analysis, analyzing 42 effect sizes from 31 primary studies that meet inclusion criteria. The results of the analysis, using a random-effects approach, yielded a combined effect size of (g = 1.05; p < 0.01). It can be concluded that the use of the Flipped Classroom method significantly contributes to students' mathematical abilities and is more effective compared to conventional teaching methods. Furthermore, the analysis of heterogeneity found that the effectiveness of using the flipped classroom method on mathematical abilities is influenced by moderator variables such as the type of measured abilities, platform, type of experimental group, country, and publication type. However, it was not influenced by variables such as educational level and publication year. The findings of this meta-analysis provide more accurate results regarding the inconsistent effect size variations and enrich the knowledge insights about the effectiveness of using the Flipped Classroom method in enhancing students' mathematical abilities.
Impact of COVID-19 Vaccine on Hearing Status of Young Ages (Medical College Students as a Sample)
Authors: Hamid Mazin Kamil
Published: August 2023

Many studies dealt with the consequences of  SARS CoV-2  (which cause COVID-19 infection) on the nervous system especially sensory nerves where the virus causes loss of taste and smell as it’s known, and may affect auditory nerves and be the expected cause of some hearing problems. A case-control analytic study was performed on a connivance sample of society of university students from a medical faculty. Each participant filled out a questionnaire contains demographic data and general, auditory and respiratory health condition, in addition to vaccination status. In the other side, the audio- examinations were performed on the study sample including Pure Tone Audiometry (PTA) and tympanometry. Two statistical methods; chi-square and t-test were used to interpret the correlation.  It is noticeable that there is no clear link between the thresholds and the vaccination status. This is contrary to some studies that found that the vaccine may have a very slight influence on hearing thresholds. This can be explained by the fact that is the small (significant) p values ​​in both methods was spread in a various and random manner, and it can be said that there is a possible effect, but it is not clear nor regular. A more comprehensive studies are required to establish this relationship between the hearing threshold and the COVID-19 vaccine.
Post COVID-19 Effect on Medical Staff and Doctors' Productivity Analysed by Machine Learning
Authors: Yousif Maitham G. , Hashim Khalid , Rawaf Salman
Published: August 2023

أثرت جائحة كوفيد-19 بشكل عميق على قطاع الرعاية الصحية وإنتاجية الكادر الطبي والأطباء. تهدف هذه الدراسة إلى استخدام تقنية التعلم الآلي لتحليل الأثر الذي خلفته جائحة كوفيد-19 على إنتاجية الكادر الطبي والأطباء في مختلف التخصصات. أُجريت دراسة عرضية شملت ٩٦٠ مشاركًا من مختلف التخصصات في الفترة بين ١ يونيو ٢٠٢٢ و٥ أبريل ٢٠٢٣. جمعت الدراسة البيانات الديموغرافية، بما في ذلك العمر والجنس والوضع الاقتصادي، بالإضافة إلى معلومات حول عادات النوم للمشاركين وأية مضاعفات ناجمة عن كوفيد-١٩ قد تعرضوا لها. تشير النتائج إلى انخفاض كبير في إنتاجية الطبي والأطباء، حيث بلغت النسبة المتوسطة للانخفاض ٢٣٪ خلال فترة ما بعد كوفيد-١٩. تعكس هذه النتائج الأثر العام الذي لحق بالمجتمع بعد مرور الجائحة بالكامل وليست محصورة بموجة معينة. كما كشف التحليل أن المشاركين الأكبر سناً تأثروا بانخفاض أكبر في الإنتاجية، حيث بلغ متوسط الانخفاض لديهم ٣٥٪ مقارنة بالمشاركين الأصغر سناً. وكان للمشاركات الإناث انخفاض متوسط في الإنتاجية بنسبة ٢٨٪ مقارنة بنظرائهن الذكور. وبالإضافة إلى ذلك، أظهرت الأفراد ذوو الوضع الاقتصادي المنخفض انخفاضًا كبيرًا في الإنتاجية، حيث بلغ المتوسط الانخفاض ٤٠٪ مقارنة بأولئك ذوي الوضع الاقتصادي الأعلى. وبالمثل، لديهم المشاركون الذين ناموا لساعات أقل في الليل انخفاضًا ملحوظًا في الإنتاجية، حيث بلغ المتوسط الانخفاض ٣٣٪ مقارنة بأولئك الذين كان لديهم نوم كافٍ. كشف تحليل التعلم الآلي عن العمر والتخصص ومضاعفات كوفيد-١٩ والوضع الاقتصادي ووقت النوم كعوامل تنبؤية حاسمة للنتيجة الإنتاجية. تسلط الدراسة الضوء على الأثر الكبير الذي تركه ما بعد جائحة كوفيد-١٩ على إنتاجية الكادر الطبي والأطباء في العراق، ويمكن أن تساعد النتائج المؤسسات الصحية في وضع استراتيجيات للتخفيف من الآثار السلبية لجائحة كوفيد-١٩ على إنتاجية الكادر الطبي والأطباء.
Single and coupled cavity mode sensing schemes using a diagnostic field
Authors: Goodwin-Jones Aaron W. , Zhu Haochen , Blair Carl , Brown Daniel D. , vanHeijningen Joris V. , Ju Li , Zhao Chunnong
Published: August 2023

Precise optical mode matching is of critical importance in experiments using squeezed-vacuum states. Automatic spatial-mode matching schemes have the potential to reduce losses and improve loss stability. However, in quantum-enhanced coupled-cavity experiments, such as gravitational-wave detectors, one must also ensure that the sub-cavities are also mode matched. We propose a new mode sensing scheme, which works for simple and coupled cavities. The scheme requires no moving parts, nor tuning of Gouy phases. Instead a diagnostic field tuned to the HG20/LG10 mode frequency is used. The error signals are derived to be proportional to the difference in waist position, and difference in Rayleigh ranges, between the sub-cavity eigenmodes. The two error signals are separable by 90 degrees of demodulation phase. We demonstrate reasonable error signals for a simplified Einstein Telescope optical design. This work will facilitate routine use of extremely high levels of squeezing in current and future gravitational-wave detectors.
Intelli-OVI: A new-generation clinical tool for monitoring emerging viral infections
Authors: Satou Yorifumi , Hossain Md Belal , Uchiyama Yoshikazu , Rajib Samiul Alam , Rahman Akhinur , Takatori Mitsuyoshi , Tan Benjy Jek Yang , Sugata Kenji , Nagashima Mami , Kawakami Mamiyo , Ito Hitoshi , Sadamasu Kenji , Ogi Yasuhiro , Kawaguchi Tatsuya , Tamura Tomokazu , Fukuhara Takasuke , Ono Masahiro , Yoshimura Kazuhisa
Published: August 2023

High transmissible viruses including SARS-CoV-2 frequently accumulate novel mutations that are detected via high-throughput sequencing. However, there is a need to develop an alternative rapid and non-expensive approach. Here we developed a novel multiplex DNA detection method Intelli-OVI for analysing existing and novel mutations of SARS-CoV-2. Intelli-OVI uses the micro-disc-based method IntelliPlex and computational algorithms of objective variant identification (OVI). IntelliPlex uses micro-discs printed with a unique pictorial pattern as a labelling conjugate for DNA probes, and OVI allows simultaneous identification of several variants using multidimensional data obtained by the IntelliPlex method. Importantly, de novo mutations can be identified by decreased signals, which prompts the need to design additional primers and probes. Thus, Intelli-OVI can be upgraded to keep up with rapidly evolving viruses. We believe that Intelli-OVI will be useful in establishing a world better equipped to tackle emerging novel pathogens.
A Qualitative Study of the Barriers and Facilitators Impacting the Implementation of a Quality Improvement Program for Emergency Departments
Authors: Anaraki Nahid Rahimipour , Mukhopadhyay Meghraj , Jewer Jennifer , Patey Christopher , Norman Paul , Hurley Oliver , Etchegary Holly , Asghari Shabnam
Published: August 2023

Background: The implementation of intervention programs in Emergency Departments (EDs) is often fraught with complications due to the inherent complexity of the environment. Hence, the exploration and identification of barriers and facilitators prior to an implementation is imperative to formulate context-specific strategies to ensure the tenability of the intervention.
Objectives: In assessing the context of four EDs prior to the implementation of SurgeCon, a quality improvement program for ED efficiency and patient satisfaction, this study identifies and explores the barriers and facilitators to successful implementation from the perspective of the providers, patients, researchers, and decision makers involved in the implementation.
Settings: Two rural and two urban Canadian EDs with 24/7 on-site physician support.
Methods: Data were collected prior to the implementation of SurgeCon, by means of qualitative and quantitative methods consisting of semi-structured interviews with 33 healthcare providers (e.g., physicians, nurses, and managers), patient-reported experience and satisfaction telephone interviews with 341 patients, and structured observations from four EDs. Interpretive description approach was utilized to analyze the data gathered from interviews, open-ended questions of the survey, and structured observations.
Results: A set of five facilitator-barrier pairs were extracted. These key facilitator-barrier pairs were: (1) management and leadership, (2) available resources, (3) communications and network across organization, (4) previous intervention experiences, and (5) need for change.
Conclusion: Knowledge of the barriers and facilitators in the implementation of the quality improvement program was found to be a vital precursor to its successful implementation. Given the dynamic and complex nature of ED environments, such an approach, prior to an implementation, may prove useful for other such interventions.
Trial registration:

Name of the registry: ClinicalTrials.gov
Trial registration number: NCT04789902
Date of registration: 10/03/2021
Contractor selection by using multi-criteria decision making For Egyptian road maintenance
Authors: fawzy mohamed , elsharkawy Ahmed shawky , hassan abbas Atef , khalifa yasser ali
Published: August 2023

Egypt has witnessed a revolution in all fields and the establishment of giant projects, which require the selection of the appropriate contractor for their implementation. The major factor for evaluating contractors is the tenders price of the project. The lowest price is not always a guarantee of the quality or time of a building project. Recently, there has been a shift away from the “lowest-price-wins” concept and a subjective judgment towards multi-criteria decision-making of selecting the project's contractors aiming to help owners in making decisions. The manuscript presents a multi-criteria decision-making strategy to optimize the selection of contractors for construction projects. the calculation of this strategy is divided into two phases. The first phase is designed to identify contractor prequalification criteria and utilize the AHP approach based on current Egyptian practice to calculate their weight. The second phase provides two techniques: (1) technique for order preference by similarity to ideal solution (TOPSIS) and (2) vlsekriterijumska optimization I kompromisno resenje (VIKOR) to optimize the selection of the available contractors for construction projects. A real-life case study improvement and refurbishment project is examined to demonstrate the value and highlight capabilities.
Development of a customized m-Health-based intervention to reduce loss to follow-up among patients undergoing treatment for cervical lesions at a rural Referral Hospital, South Western Uganda
Authors: Ssedyabane Frank , Randall Thomas C , Kajabwangu Rogers , Namuli Alexcer , Tusubira Deusdedit , Kakongi Nathan , Galiwango Martin , Maling Samuel , Turyakira Eleanor , Atukunda Esther Cathyln
Published: August 2023

Background
Loss to follow-up (LTFU) in individuals undergoing cervical cancer treatment is a major challenge in many low resource settings. Mhealth interventions via text messaging have potential to improve health outcomes in such settings. We describe development of a customized and tailored user-centered mHealth intervention for reducing LTFU among patients undergoing cervical cancer treatment at Mbarara Regional Referral Hospital (MRRH).
Methods
We interviewed all health care providers (HCPs) at the cervical cancer clinic of MRRH, and owned a phone for at least one year between April and May 2023 to understand challenges/facilitators of LTFU, identify and develop an appropriate mHealth intervention that can re-engage patients in care. Transcripts were subsequently derived, reviewed and coded to generate themes and categories using inductive content analytic approach. Four medical experts used this data to develop relevant SMS content, which was incorporated into an app designed through partnership with Ucatch Technologies Limited, a local application development company in South Western Uganda.
Results
Interviewed HCPs had owned a phone for 13.8 ≤ years, had worked at the clinic for 5 ≤ years, and used text messages regularly. Qualitative data revealed that the main challenge to re-engagement was absence a reminder mechanism between HCPs and patients. HCPs preferred text and or audio mode of messaging to improve health care responsiveness to LTFUs, awareness, continuity of care, and health service uptake among the majority illiterate population; though with potential constraints of costs and workload. HCPs identified key messaging content to include; the importance of attending scheduled follow-ups, follow up visit date and clinic customization and tailoring the message to the intended recipient. Developed SMS content considering themes was uploaded onto the cc-follow-up app platform and customized according to preferred language, day, frequency and time of delivery.
Conclusion
Tailoring an mHealth messaging intervention could be an important strategy to re-engage and reduce LTFU through improved information sharing, awareness, responsiveness, care engagement and medical compliance. Our app additionally supports improved clinical and behavioural data collection for low resource settings. More work is required to evaluate our intervention’s feasibility and acceptability among individuals undergoing cervical cancer treatment in South Western Uganda.
Identification and analysis of inflammation-related biomarkers in tetralogy of Fallot
Authors: Du Junzhe , Zheng Fengnan , Liu Huaipu , Wu Wenzhi , Wang Pengcheng , Meng Baoying , Wang Yuanxiang
Published: August 2023

Background
Studies have revealed that inflammatory response is relevant to the tetralogy of fallot (TOF). However, there are no studies to systematically explore the role of the inflammation related genes (IRGs) in diagnosis of TOF.
Materials and methods
TOF-related datasets (GSE36761 and GSE35776) were downloaded from the Gene Expression Omnibus (GEO) database. The differentially expressed genes (DEGs) between TOF and control groups were identified in GSE36761. And DEGs between TOF and control groups were intersected with IRGs to obtain differentially expressed IRGs (DE-IRGs). Afterwards, the least absolute shrinkage and selection operator (LASSO) and random forest (RF) were utilized to identify the biomarkers. Next, immune analysis was carried out. The TF-mRNA, lncRNA-miRNA-mRNA, and miRNA-SNP-mRNA networks were created. Finally, the potential drugs targeting the biomarkers were predicted.
Results
There were 971 DEGs between TOF and control groups, and 29 DE-IRGs were gained through the intersection between DEGs and IRGs. Next, a total of five biomarkers (MARCO, CXCL6, F3, SLC7A2, and SLC7A1) were acquired via two machine learning algorithms. Infiltrating abundance of 18 immune cells was significantly different between TOF and control groups, such as activated B cells, neutrophil, CD56dim natural killer cells, etc. The TF-mRNA network contained 4 mRNAs, 31 TFs, and 33 edges, for instance, ELF1-CXCL6, CBX8-SLC7A2, ZNF423-SLC7A1, ZNF71-F3. The lncRNA-miRNA-mRNA network was created, containing 4 mRNAs, 4 miRNAs, and 228 lncRNAs. Afterwards, nine SNP locations were identified in the miRNA-SNP-mRNA network. A total of 21 drugs were predicted, such as ornithine, lysine, arginine, etc..
Conclusion
Our findings detected five inflammation related biomarkers (MARCO, CXCL6, F3, SLC7A2, and SLC7A1) for TOF, providing a scientific reference for further studies of TOF.
Numerical Evaluation of the Directed Oil Cooling System of a Mobile Power Transformer
Authors: Moura Luciene Martins , Huebner RUDOLF Huebner , Trevizoli Paulo Vinicius
Published: August 2023

Power transformers represent an important part of the capital investment in transmission and distribution substations. The cooling of the windings (electrical coil) depends on the convection of heat, enhanced by the forced circulation of oil through the windings and heat exchangers. The forced circulation of oil combined with the forced circulation of air in the heat exchangers is usually found in mobile transformers, whose compact structure is a challenge in terms of heat transfer rates. An improper design or fabrication problem associated with the assembling of the cooling system may result in an inefficient exchange of heat, which may lead to transformer failure from overheating or a reduction of the life span. In this context, the present work proposes a 2D mathematical model to simulate the winding cooling system of a 138x69-34x13.8 kV 25 MVA Mobile Power Transformer with the objective of investigating the causes of overheating. The model is implemented in CFD Ansys-Fluent® version 17.0 and validated with experimental data. It is evaluated the velocity and temperature distribution, and the identification of the hot spots on the transformer operating considering the nominal conditions for oil flow rate, inlet temperature, and power dissipated. The hot spot temperatures are compared with the current Brazilian Association of Technical Standards - NBR 5356-2: 2007 Power Transformers Part 2: Heating, 2007. After, some geometric and/or operational constraints are artificially imposed to the transformer. Their impact on the velocity and temperature fields, as well as the hot spot temperatures, are mapped in order to verify if they still respect the standard´s temperature limits and if imposed constraints may lead to the transformer failure. The numerical results demonstrated that the geometric imperfections of the disks, guides, or axial cooling ducts dimensions directly affect the oil flow and the temperature distributions, as well modify the position and greatly increase the temperature of the hottest spot in the winding, even extrapolating the ABNT NBR 5356:2 standard in some situations. This way, the proposed mathematical model can be used as a consistent tool for understanding the thermal behavior and, to investigate and map the occurrence of failures in mobile transformers.
Diet quality and its relationship with iodine status in pregnant women living in a Brazilian region where table salt is iodine-fortified according to Public Health Policies
Authors: Schtscherbyna Annie , Saraiva Débora Ayres , de Morais Nathalie Silva , Corcino Carolina Martins , Berbara Tatiana Martins Benvenuto Louro , Horta Paula Martins , Vaisman Mario , Teixeira Patricia de Fátima dos Santos
Published: August 2023

Background
Conditions related to iodine status (IS) in pregnancy should be addressed to help public health strategies. In the present study, we evaluated diet quality (DQ) and its relationship with IS in pregnant women from a coastal Brazilian state where table salt is iodine fortified.
Methods
In a cross-sectional study, 199 women were evaluated on three different days of their first trimester of pregnancy. In every visit, a urinary spot sample was requested to assess urinary iodine concentration (UIC); and a 24-hour dietary recall related to the time that they collected the urine was also applied by a nutritionist. Total and component scores were estimated for the Healthy Eating Index-2015 (HEI-2015). The association between DQ and IS was evaluated, considering adequate UIC as the reference group (RG).
Results
The median total score for HEI-2015 was 45.8 points, being higher in the insufficient UIC than in RG (48.1 vs. 41.3 in the RG; p = 0.04). Insufficiency of iodine was related to higher scores in “whole fruit” (B = 0.712 [CI: +0.421/+1.002]), “total fruit” (B = 0.744[-0.002/+0.006]), “total vegetables” (B = 0.678([+ 0.444/+0.913]) and “refined grains” (B = 0.685 [+ 0.406/+0.964]). On opposite, excessive IS was related to lower scores in the same components.
Conclusions
pregnant women with insufficient IS had better diet quality, with higher consumption of fruits and vegetables, as also lower intake of refined grains. In contrast, poor DQ was associated with excessive UIC during pregnancy. The necessity of iodine supplementation for pregnant women should be better explored even in a region adopting iodine fortified table salt as public health policy.
Association between the Geriatric Nutritional Risk Index and osteoporosis in patients with fragility fractures in eastern China
Authors: Wang Peng , Xu Zhujie , Wang Xiaokun , Cui Hao , Wang Zhenting , Liu Yi
Published: August 2023

Background Osteoporosis is a very common bone disease in older people. Malnutrition can lead to osteoporosis. The Geriatric Nutritional Risk Index (GNRI) is a tool used to assess nutritional status and is an important predictor of many diseases. Therefore, this study investigated the association between the GNRI and the presence of osteoporosis and assessed the value of this index for predicting osteoporosis in patients with fragility fractures. Methods A total of 1172 inpatients with fragility fractures from January 2017 to March 2023 were retrospectively analyzed. This included 806 cases in the osteoporosis group and 366 cases in the non-osteoporosis group. The patients' general and laboratory data were collected, along with their bone mineral density (BMD) measurements. GNRI was calculated based on ideal body weight and serum albumin levels. Correlation analysis was performed to determine the relationship between GNRI and BMD and bone metabolism markers. Descriptive analysis and logistic regression analysis were performed for osteoporosis characteristics and its risk factors. Receiver operating characteristic (ROC) curve was developed to predict the cut-off value. Results Univariate analysis showed significant differences between the osteoporosis group and the non-osteoporosis group in sex, age, height, weight, BMI, history of diabetes and gastrointestinal diseases, hemoglobin concentration, albumin concentration, prealbumin concentration, GNRI, blood glucose concentration, osteocalcin, β-isomerized C-terminal telopeptides (β-CTX), procollagen of type I N-propeptide (PINP), BMD and T-score. Spearman's correlation analysis showed that GNRI was positively associated with BMD and T-score at all bone sites (r = 0.272–0.397, P < 0.05). GNRI was negatively associated with procollagen of type I N-propeptide (r=-0.14, P = 0.025). Further logistic regression showed that sex, age, BMI, GNRI, albumin and diabetes were independent risk factors for osteoporosis. According to the results of the receiver operating characteristic curve, the predictive accuracy of osteoporosis was high, with an area under the curve (AUC) of 0.644, sensitivity of 52.4%, specificity of 71.3% and threshold value of 97.31. Conclusion Gender, age, BMI, GNRI, albumin and diabetes were independent risk factors. GNRI was positively correlated with BMD and inversely correlated with osteoporosis in patients with fragility fractures. In addition, the incidence of osteoporosis increased when GNRI was less than 97.31.
Prevalence and Epidemiology of Group A B-Hemolytic Streptococcus (GABHS) Among Young School-Age Children with Tonsillopharyngitis in Northern Palestine: A Cross- Sectional Study
Authors: Sawafta Reem , Basha Walid , Faid Amjad , Alameh Waleed , Afaneh Afnan , Alawneh Montaser
Published: August 2023

Introduction: Tonsillopharyngitis is a common diagnosis in children, it is mainly caused by viral pathogens. GABHS is the most common bacterial cause, and it is often overestimated as a causative agent because diagnosis often relies on clinical judgment, leading to the overuse of broad-spectrum antibiotics. The study aims to evaluate the prevalence of GABHS in children clinically diagnosed with pharyngitis/tonsillitis. Objectives include determining the prevalence in our area and assessing antibiotic sensitivity. Methods: A non-interventional cross-sectional study on children aged 5–15 who were clinically diagnosed with tonsillopharyngitis. Throat swab samples were collected from patients diagnosed with pharyngitis/tonsillitis at 3 major healthcare centers in north Palestine. The samples were evaluated for the presence of GABHS through a swab culture on blood agar and RADT for Streptococcus. A structured questionnaire was used to collect data from patients, their families, and treating physicians Results: A cohort of 321 patients presenting with clinical symptoms suggestive of tonsillitis/pharyngitis to the enrolled healthcare centers from September 2022 to January 2023, and meeting the inclusion criteria, were evaluated in this study. Of these patients, 30.8% tested positive on a Rapid Antigen Test, and 23.4% were confirmed to have GABHS based on culture results. Penicillin was identified as the most effective antibiotic with a sensitivity rate of 97.3%, followed by Amoxicillin-Clavulanic Acid with a sensitivity rate of 96%, while Azithromycin was the least effective antibiotic. These results provide guidance for the selection of appropriate antibiotics for the treatment of GABHS-induced tonsillitis/pharyngitis. Conclusion Among patients with tonsillitis infections, the prevalence of GABHS was determined to be 23.4%. If antibiotic therapy is warranted, Amoxicillin/Clavulanic Acid and Penicillin are the recommended drugs of choice.
Shifting Cryptocurrency Influence: A High-Resolution Network Analysis of Market Leaders
Authors: Hiray Arnav , Shah Agam , Chava Sudheer
Published: August 2023

Over the last decade, the cryptocurrency market has experienced unprecedented growth, emerging as a prominent financial market. As this market rapidly evolves, it necessitates re-evaluating which cryptocurrencies command the market and steer the direction of blockchain technology. We implement a network-based cryptocurrency market analysis to investigate this changing landscape. We use novel hourly-resolution data and Kendall's Tau correlation to explore the interconnectedness of the cryptocurrency market. We observed critical differences in the hierarchy of cryptocurrencies determined by our method compared to rankings derived from daily data and Pearson's correlation. This divergence emphasizes the potential information loss stemming from daily data aggregation and highlights the limitations of Pearson's correlation. Our findings show that in the early stages of this growth, Bitcoin held a leading role. However, during the 2021 bull run, the landscape changed drastically. We see that while Ethereum has emerged as the overall leader, it was FTT and its associated exchange, FTX, that greatly led to the increase at the beginning of the bull run. We also find that highly-influential cryptocurrencies are increasingly gaining a commanding influence over the market as time progresses, despite the growing number of cryptocurrencies making up the market.
Perceived risk of COVID-19 hurts mental health: the mediating role of fear of COVID-19 and the moderating role of resilience
Authors: Lu Hui , Yang Jialin , Zhao Kejie , Jin Zhou , Wen Xin , Hu Nuonuo , Yang Hongsheng , Sun Zhiyu , Chen Haitao , Huang Yili , Wang Deborah , Wu Yili
Published: August 2023

Background
Depression and anxiety have been found prevalent during all phases of the COVID-19 pandemic. In late December 2022, all COVID-19 control measures were lifted in China, leading to a surge in COVID-19 infections. The public’s perceived risk and fear of COVID-19 would increase. According to Common Sense Model (CSM), emotional illness representation of a disease, i.e., how people feel about the disease (fear of COVID-19), would result in mental distress. This study aimed to examine the prevalence of depression and anxiety in the Chinese general population and explore the mediating role of fear of COVID-19 between COVID-19 perceived risk and depression/anxiety and the moderating role of resilience between fear of COVID-19 and depression/anxiety.
Method
A cross-sectional online survey was conducted in Wenzhou, China, immediately following all COVID-19 control measures lifted. The 9-item Patient Health Questionnaire (PHQ-9), Generalized Anxiety Disorder 7 (GAD-7), the COVID-19 Risk Perception Scale, the Fear of COVID-19 Scale, and the Connor-Davidson Resilience Scale (CD-RISC) were used to evaluate depression, anxiety, COVID-19 perceived risk, fear of COVID-19, and resilience, respectively. Structural Equation Modeling (SEM) with Maximum Likelihood (ML) estimator, with adjustment of the significant background factors was performed to test the moderated mediation. Data obtained from 935 participants were finally analyzed.
Results
The prevalence of moderate to severe depression and anxiety was 23.7% and 9.5%, respectively. The present study revealed positive associations among COVID-19 perceived risk, fear of COVID-19 and depression/anxiety, and negative associations between resilience and fear of COVID-19/depression/anxiety. Fear of COVID-19 partially mediated between COVID-19 perceived risk and depression/anxiety. Furthermore, resilience significantly moderated between fear of COVID-19 and depression/anxiety. Two moderated mediation models were constructed.
Conclusion
Depression and anxiety were prevalent among Chinese adults during the final phase of the pandemic in China. The significant mediation role of fear of COVID-19 implies that reducing fear of COVID-19 may effectively alleviate depression and anxiety symptoms. Moreover, enhancing public resilience during an epidemic crisis is crucial for promoting mental health.
Enhancing the Assessment of Prognosis in Hepatocellular Carcinoma Patients Based on Landmark Analysis
Authors: Ren Qiuping , Yu Jiajie , Wu Menghang , Jiang Xiaolian , Wei Shuangshuang , Xiong Fangli , Yang Yike
Published: August 2023

Background
Accurate estimates of survival after surgical intervention are critical for HCC patients and healthcare providers, and traditional estimates of survival have limitations. The study aims to construct a dynamic prognostic model based on landmark analysis, for HCC individuals undergoing curative-intent resection. This predictive tool may prove useful in enabling patients and healthcare providers to anticipate prognosis accurately and personalize treatment and follow-up strategies for HCC patients.
Method
We enrolled 957 patients who were diagnosed as HCC from West China Hospital. Multivariate Cox proportional hazard models were developed to assess risk factors associated with overall survival (OS) and disease-free survival (DFS) of HCC. Additional landmark analyses were conducted to examine the effects of risk factors at baseline and 1 year after the operation. Harrell’s concordance index and calibration plots using a bootstrap resampling method were applied to evaluate the performance and the robustness of Cox models respectively.
Results
After backward step-wise selection, twelve variables were identified in the OS and DFS models respectively. Landmark analyses show a few risk factors were associated with time. Calibration plots show there was good consistency for both OS and DFS models at year 1, 3 and 5. The performance of both models was good as well (C-index = 0.748 for the OS model and C-index = 0.732 for the DFS model). Based on the selected variables, OS and DFS prediction can be performed on individual HCC patients to estimate their survival probability after operation, which has potential for clinical usage.
Conclusions
A predictive tool was developed by landmark analysis to estimate the probability of OS and DFS at different time points after resection, demonstrating the significance of estimating and adjusting the long-term prognosis of patients undergoing radical surgery for HCC based on follow-up time and intervention events.
Microclimate and the Thermal Comfort During the Implementation of Silvopastoral Systems: the Windbreak Countereffect
Authors: Filho Abdon Luiz Schmitt , Machado Thiago Mombach Pinheiro , Daros Ruan , Farley Joshua , Sinisgalli Paulo A. , Kazama Daniele C.
Published: August 2023

Little has been studied about microclimate and the thermal comfort during the implementation of silvopastoral systems. This study aimed to evaluate the microclimate and thermal comfort during the implementation of High Biodiversity Silvopastoral System with Nuclei (SPSnu). Three treatments were investigated, SPSnu with 5 and 10% of the pasture area with nuclei, (SPSnu5 and SPSnu10, respectively), and treeless pasture (TLP). Each treatment was subdivided into 4 areas: within the nuclei, around the nuclei, around the nuclei with shade and internuclei. The analyzed variables were soil surface temperature, air temperature, wind speed, relative humidity, black globe temperature and the Heat Load Index (HLI) at 20 and 120 cm height. We hypothesized that the wind speed reduction associated with insufficient shade projection typical of the first years of SPSs may interfere in microclimate and thermal comfort during the hot seasons. SPSnu5 and SPSnu10 had a reduction in wind speed of 51.58% and 68.47% respectively when compared to TLP at 20 cm. Soil surface temperature and air temperature at 120 cm were higher for SPSnu than TLP. The same effect was observed for the HLI. At 20 cm, HLI indicated better thermal comfort in TLP than in the SPSnu treatments. The lack of shade projection from young nuclei in conjunction with the decrease of wind speed between the nuclei caused a higher air temperature and HLI in the SPSnu treatments, we called this conditions, windbreak countereffect. Farmers must knowledge this effect when implementing SPSs, and when necessary, mitigate with the proper management decisions.
Association of NT-proBNP and 7-day mortality of patients with acute ischemic stroke in intensive care unit: a retrospective cohort study
Authors: zhang xiangyu , Liu Chao , Liu Jun , Qi Guoqing , Zhao Hongliang , Li Lizhuo , Li Liu , Ding Xiaoyu , Wang Sheng , Han Zongmao , Zhang YanYan , Ji Xiaotong , Zhang Jinhua , Gao Zhichao
Published: August 2023

Acute ischemic stroke (AIS) results in high mortality, especially among patients admitted to the intensive care unit. Previous research has shown the relationship of N-terminal pro-B-type natriuretic peptide (NT-proBNP) with stroke. However, unlike in heart disease, few research has related NT-proBNP with severity and prognosis of patients with AIS in the intensive care unit. This study aimed to investigate the relation between NT-proBNP, which is widely used in heart disease, and the short-term mortality of patients with AIS in critical care unit. This retrospective study was based on Medical Information Mart for Intensive Care (MIMIC)-IV. The main outcome was defined as mortality in seven days and the secondary outcomes were defined as ventricular tachycardia and performance of endotracheal tube. Patients diagnosed with acute ischemic stroke and acute cerebral infarction were extracted based on the 9th and 10th versions of ICD codes. If the patient was treated multiple times in the ICU, only the data of the first admission to the ICU will be taken for research and analysis. The level of NT-proBNP was significantly associated with 7-day all-cause mortality in patients with AIS, the HR was 1.84 ([95% CI, 1.11–3.07], P = 0.019). After excluding patients with heart failure, NT-proBNP showed significant association with 7-day all-cause mortality, the HR was 2.71 ([95% CI, 1.15–6.37], P = 0.022). There was no significant association between NT-proBNP and secondary outcomes. In patients with AIS in intensive care unit, higher levels of NT-proBNP related with a higher mortality. NT-proBNP might serve as a biomarker that help to predict the short-term mortality among the patients with AIS in intensive care unit.
The cost-utility of an intervention for families with a parent having a mental illness: A health economic evaluation of a randomized controlled trial
Authors: Waldmann Tamara , Schaible Jochen , Stiawa Maja , Becker Thomas , Wegscheider Karl , Adema Bonnie , Wiegand-Grefe Silke , Kilian Reinhold
Published: August 2023

Background: Children of families with a parent with a mental illness have an increased risk of developing mental health problems. Therefore, children and adolescents living in families with a parent with mental illness are regarded as a target group for selective prevention. To date, only a few economic evaluation studies for interventions directed at preventing the intergenerational transmission of mental health problems exist. The cost utility of an intervention for the support of families with a parent having a mental illness will be estimated from the perspective of the German health and social care system.
Methods: A total of 214 families with 337 children and adolescents were randomly assigned to the intervention (INT) group (108/170) or the control (TAU) group (106/167). Families in the intervention group received at least eight intervention sessions (50 to 90 minutes) over six months. Total costs of illness were estimated by means of the Children and Adolescent Mental Health Service Receipt Inventory (CAMHSRI) over 24 months. Quality-adjusted live years (QALYs) were estimated on the basis of the KIDSCREEN-10. An incremental cost-utility analysis was performed by means of the net-benefit approach.
Results: The average total annual cost was estimated to be €3,784.59 (SD € 8,581.11) in the TAU group and € 3,264.44 (SD € 9,431.89) in the INT group, the annual cost difference between INT and TAU was € -516.14 (SE 1,124.95) which was not significant at p ≤ 0.05. The average QALY was estimated to be 0.759 (SD 0.073) in the TAU group and 0.763 (SD 0.072). The QALY difference between INT and TAU was 0.0037 (SE 0.0092) which was not significant at p ≤ 0.05. The incremental cost utility ratio (ICUR) indicated that the gain of one additional year in full health by means of the intervention was associated with the saving of €139.49. However, the stochastic insecurity of the ICUR did not allow a unique decision about the cost-utility of the intervention.
Conclusions: More information on the economic value of the intervention for families with a parent with mental illness in comparison to treatment as usual in Germany is needed.
Trial registration: ClinicalTrials.gov, identifier NCT02308462; German Clinical Trials Register: DRKS00006806.