bluuebunny/crossref_metadata_2025 huggingface dataset:
A Leaky False Pouch: Left Ventricle Pseudoaneurysm with Active Hemopericardium Detected on Cardiac Computed Tomography Angiography
Authors: Barforoshi Shiva , Shekar Chandana , Yu Zoe , Liu Eugene , Manubolu Venkat , Budoff Matthew J , Roy Sion K
Published: April 2024

Pseudoaneurysm is a rare but fatal complication of myocardial infarction (MI). With the advances in cardiovascular disease detection and treatments, fatal structural complications post-MI are now rare. When they occur, advanced diagnostic modalities can be used for early diagnosis, aiding surgical planning, and improving prognosis. In our case, post-MI left ventricle pseudoaneurysm complicated by hemopericardium was diagnosed using cardiac computed tomography angiography (CCTA). Use of attenuation measurement on CCTA helped diagnose active extravasation into the hemopericardium. This case highlights the high index of suspicion needed for rare but fatal complications post-MI and the utility of CCTA in their management.
The contribution of written corrective feedback and its association with working memory on the development of EFL learners’ English plurals
Authors: Chingchit Ornuma
Published: April 2024

Although numerous studies have attested to the effectiveness of written corrective feedback (WCF) in promoting second language (L2) accuracy, the extent to which WCF contributes to acquisition is still debatable. This study thus aimed to investigate the effects of WCF on the development of Thai EFL (English as a foreign language) learners’ implicit and explicit knowledge of English plurals, and the extent to which learner differences in working memory capacity (WMC) moderated the efficacy of WCF. This experimental study adopted a pre–post–delayed-posttest design and was carried out over the course of a 9-month period. Seventy-five low intermediate learners were randomly assigned to the direct focused, direct unfocused and the control group. All groups completed a metalinguistic knowledge, untimed grammatical judgement, timed writing, timed oral elicited imitation, and two working memory tests. Questionnaires and interviews were also administered to explore potential variables that may moderate the effect of WCF. During treatment, participants wrote a timed essay and received feedback. After the 6-week treatment period, the immediate posttest was completed and the delayed posttest was administered three months after the posttest. The results revealed that WCF was effective in assisting learners’ plural acquisition, suggesting that WCF is beneficial especially to the development of linguistic features influenced by learners’ first language (L1). However, WMC was not found to moderate the efficacy of WCF. The explicitness of WCF, instructional context and proficiency level may have contributed to the absence of working memory effect.
Variations of European climate solidarity: From intergovernmental to social solidarity relations
Authors: Bartenstein Aline
Published: April 2024

The EU has developed the narrative of a green and just transition with solidarity and fairness as core principles of the Green Deal. Given the EU’s transformative agenda, this article examines the meaning of climate solidarity in the EU’s political sphere. Because solidarity among EU member states remains a fuzzy concept that lacks political and legal clarity, this article begins by reflecting on the conceptual implications of European solidarity. Next, it examines how climate solidarity has evolved in the post-Paris discourse and also explores, via in-depth document analysis, the sense and purpose of solidarity in the Green Deal. In addition, this article illustrates how solidarity is discussed within two distinct contexts: the green transition (which is about decarbonizing the economy) and the Just Transition (which focuses on aspects of social change in relation to the green transition). Particular attention is paid to the coupling of solidarity with the ‘leave no one behind’ (LNOB) principle. I conclude that solidarity refers primarily to the relationship among member states in order to regulate their modes of intergovernmental cooperation; only recently has it begun to encompass social cohesion and intergenerational justice at the EU level.
Is culture essential to race?
Authors: Hardimon Michael O.
Published: April 2024

I argue that culture is not essential to race by considering the strongest and most persuasive contemporary articulation of the view that culture is essential to race—that provided by Chike Jeffers I then argue for the possibility of conceiving of race without adverting to culture by presenting the minimalist conception of race I developed in Rethinking Race as an example of a conception of race that makes no reference to culture. I next show how the ancestry-related features of culture that might be thought to be racial but fall outside of the minimalist race can be captured in a minimalist conception of ethnicity. I finally explain why we are better off conceiving of race in a way that does not advert to culture and conclude.
Bolt loosening angle detection through arrangement shape-independent perspective transformation and corner point extraction based on semantic segmentation results
Authors: Li Shengyuan , Le Yushan , Li Xian , Zhao Xuefeng
Published: April 2024

The identification of loosened bolts is crucial for the early warning of structural damage and maintaining the overall stability of the structure. Most existing two-dimensional computer vision-based bolt loosening detection methods need to rely on the bolt arrangement shape for perspective transformation, to overcome this limitation, this study proposes a bolt loosening angle detection method through arrangement shape-independent perspective transformation and corner point extraction based on semantic segmentation results. First, a dataset of 1748 images containing bolts is collected. Second, a bolt region of interest (RoI) detection is developed to extract the sub-image of the bolt. The results show that the training and validation accuracy of bolt RoI detector are 99.5%, and 99.4%, respectively. Then, the contour corner points are extracted, the automatic and arrangement shape-independent perspective transformation of the image is completed using the planar homography-based image processing algorithm and the regular hexagonal characteristics of the bolt. Finally, automatic estimation of the bolt angle is performed on the corrected bolt image. The proposed method is used to detect bolt images obtained from different shooting distances, perspective angles, and lighting conditions. The results demonstrate that the method can accurately detect the looseness of bolts in bolt connections, and the quantification error is mostly less than 3°, it has the potential for real-time bolt loosening monitoring of multi-type bolted connections.
Validation of the Youth Internalizing Problem Screener in Singapore
Authors: Yong Minglee
Published: April 2024

The use of a screening tool for school-wide screening of internalizing symptoms is an important strategy for early identification and prevention of more serious and impairing emotional and behavioral health problems in adolescents. However, threshold cut-off scores determined for screening tools may not be suitable for all populations. Using a sample of 237 Singaporean secondary school students, this study validated the Youth Internalizing Problems Screener (YIPS) for local use. Results of confirmatory factor analyses supported a one-factor solution for the construct. A threshold cut-off score of 27 was found to show good classification accuracy based on receiver operating characteristics (ROC) analyses. Correlational and path analyses provided evidence of convergent and predictive validity for using YIPS to indicate at-risk status. The YIPS status was uniquely associated with girls’ sense of school well-being over and above the nature of their interpersonal relationships and their sense of inadequacy. Overall, YIPS demonstrated comparable sensitivity and specificity rates even though a different cut-off score was used for this study sample. The use of YIPS as a screening tool in a multitier system of support and directions for future development were discussed.
Investigating the influence of risk perception on females’ public service motivation during public health emergencies
Authors: Liu Fei , Zhang Shuang , Tong Yijing , Hsieh Chih Wei
Published: April 2024

Since the inception of Public Service Motivation (PSM) by Perry and Wise, substantial research has been conducted in this domain. However, there is a dearth of scholarly investigation into the impact of changing public service environments, specifically the perception of workplace risk, on public service motivation. Recent public health crises, such as the COVID-19 pandemic, have necessitated significant changes in frontline public employees’ work environments. As they frequently engage in epidemic prevention and control activities, which entail direct exposure to the virus, their motivation may fluctuate based on their perceived risks. Female employees, in particular, facing the dual pressures of work and family responsibilities, are more prone to being affected. Drawing upon the human behavioral motivation and Stress-Strain-Outcome framework, this study examines the influence mechanism of risk perception on public service motivation among 214 female employees who participated in epidemic control during the 2022 lockdown period in Shanghai. As the findings indicate, risk perception detrimentally affects their public service motivation both directly and indirectly through emotional exhaustion or anxiety-emotional exhaustion dual mediation, whereas anxiety does not mediate such a relationship. The study’s theoretical significance lies in its potential to broaden the scope of antecedent research on public service motivation and address the research gap about the mechanisms through which risk perception influences public service motivation during public health emergencies. Practically, these insights may assist public organizations in mitigating the adverse effects of risk perception, thereby enhancing their employees’ well-being and service effectiveness.
Technology and geopolitics: The social construction of Huawei’s 5G controversy in Europe
Authors: Zhang Zhan
Published: April 2024

This article examines the Huawei 5G controversy in Europe through the lens of social group dynamics and power shifts. It traces Huawei’s European journey from the deregulation of telecommunications in the 1980s to the company’s recent challenges following the US ban. Utilizing theories of the social construction of technology, the study investigates four meta-categories of social actors defining the 5G technology disruption in the Huawei situation, showcasing the evolving roles of various social groups and the impact of geopolitical rivalry.
The pandemic crisis narrated by the populist radical right parties. The cases of the Lega per Salvini and the Rassemblement National
Authors: Campolongo Francesco , Scanni Francesco Maria , Tarditi Valeria
Published: April 2024

One of the characteristics of populist communication is the staging of crises. In particular, populist radical right parties (PRRPs) often communicate a sense of looming crisis by naming real or imagined threats. In light of the recent pandemic crisis, an event that disrupted the ordinary and opened a space for discursive competition, we aim to answer the following questions: what crisis narrative did PRRPs offer? Is it possible to identify a populist articulation in their crisis narratives? Were there differences from their own previous political discourses and the narratives of other similar PRRPs? We propose a qualitative analysis of Facebook posts made in 2020 by the leaders of the Lega per Salvini in Italy and the Rassemblement National in France, Matteo Salvini and Marine Le Pen. We show that the two leaders used a combination of two main strategies: distraction from the crisis by politicizing other issues and maximization of the crisis by identifying enemies and victims. Their crisis narratives had many similarities due to their shared membership of the PRR family and their competitive position as challenger parties but they also had differences that depend on their identity specific characteristics.
Impression life with pulmonary hypertension: clinically relevant characteristics and quality of life among patients in Gansu, China
Authors: Zhang Juxia , Wen Yujie , Yin Yuhuan , Zhang Yiyin , Zhang Rong , Zhang Xiaoli , Ye Jianying , Feng Yuping , Meng Hongyan
Published: April 2024

Background:

The adverse effects of pulmonary arterial hypertension (PAH) on physical, emotional, and health-related quality of life (HRQoL) remain primarily unrecognized, especially in resource-limited settings.

Objectives:

This study aims to characterize the HRQoL of patients with PAH in this area and also identify the potential role of clinically relevant characteristics, including the 6-min walk distance test (6MWD), WHO-Functional Classification (WHO-FC), and mental health in the occurrence of lowering quality of life.

Design:

This was a cross-sectional observational study.

Methods:

Inpatients with PAH were chosen from a tertiary hospital located in Gansu province, China. All participants were interviewed face-by-face by using questionnaires, including items from the 36-Item Short Form Health Survey (SF-36), the self-rating anxiety scale, and the self-rating depression scale. Data on demographic and clinically relevant characteristics, including WHO-FC and 6MWD, were also collected by tracing medical recorders. Multiple linear regression analysis was used to determine the association between demographic, clinically relevant characteristics data, and physical component summary (PCS) or mental component summary (MCS) in SF-36.

Results:

Of the 152 participants, SF-36 differed significantly from Chinese norms in all eight domains, with role-physical (21.55 ± 9.87) less than one-third of the norm (88.79 ± 28.49). Multiple linear regression results showed that the factors with the greatest impact on PCS were anxiety scores (β = −0.22, p = 0.001), followed by WHO-FC (β = −0.16, p = 0.014) and 6MWD (β = 0.15, p = 0.036). The factors with the greatest impact on MCS were WHO-FC (β = −0.30, p < 0.001), followed by anxiety (β = −0.23, p = 0.001) and depression scores (β = −0.16, p = 0.013).

Conclusion:

HRQoL was substantially reduced among PAH patients in the resource-limited area, mainly the physiological functions. WHO-FC and anxiety scores were independently associated with both PCS and MCS in SF-36. Clinicians should make reasonable rehabilitation programs and plans for patients according to their cardiac function grade and the severity of clinical symptoms. In addition, psychological interventions should also be taken, especially for those with anxiety symptoms, so as to improve their HRQoL.
Computer-Assisted Drug Discovery of Potential African Anti-SARS-CoV-2 Natural Products Targeting the Helicase Protein
Authors: Metwaly Ahmed M. , Alesawy Mohamed S. , Alsfouk Bshra A. , Ibrahim Ibrahim M. , Elkaeed Eslam B. , Eissa Ibrahim H.
Published: April 2024

Objectives: In our continuous efforts to combat COVID-19, our objective was to conduct a comprehensive computer-aided drug design study utilizing 4924 African natural metabolites sourced from diverse databases across various African regions from 1962 to 2019. The primary goal was to target the SARS-CoV-2 helicase, a crucial enzyme in viral replication. Methods: We employed structural fingerprint and molecular similarity studies with VXG, the co-crystallized ligand, as a reference. Subsequently, docking and absorption, distribution, metabolism, excretion, and toxicity (ADMET) studies were conducted. Results: The structural fingerprint analysis identified 200 structurally similar compounds, then the molecular similarity studies selected 40 compounds. Among them, 15 metabolites with low free energies, favorable binding modes, and promising ADMET properties were identified. Four compounds were excluded according to the toxicity studies. Compound 1552, 1-(( S)-2,3-dihydro-2-(( R)-1-hydroxypropan-2-yl)benzofuran-5-yl)ethenone, exhibited the most favorable docking results. Molecular dynamics simulations conclusively demonstrated its stable binding to the SARS-CoV-2 helicase, characterized by low energy and optimal dynamics. Conclusion: The findings suggest promising avenues for potential COVID-19 cures, encouraging further exploration through in vitro and in vivo studies of the identified compounds, particularly compound 1552.
Transgender behind bars. The transgender pains of imprisonment in the light of the emerging and advancement of human rights protection for transgender prisoners within the Council of Europe context
Authors: Jacobs Pauline
Published: April 2024

Prison systems are traditionally binary systems, as prisoners are either placed in a male or a female prison facility. In the literature, transgender prisoners are identified as a vulnerable group, due to the heightened risk of human rights violations such as violence, abuse, sexual exploitation, stigma and discrimination. Maycock, building upon the theory on the ‘pains of imprisonment’ by Sykes, has identified specific pains of imprisonment to consider the particular deprivations or frustrations that transgender people experience within prison settings. In this article, the central question is whether the human rights framework as developed within the Council of Europe has put forward human rights norms for the placement and treatment of transgender prisoners to deal with these specific pains of imprisonment and to provide protection to transgender prisoners against additional suffering in prison. To ensure safe and humane prison conditions for the vulnerable group of transgender prisoners adequate human rights protection is of the utmost importance. Combining the criminological theory of the transgender pains of imprisonment with the human rights based approach this article makes a novel contribution to the study of transgender people in custody within the Council of Europe context. This approach will shed light on this often overlooked group of vulnerable persons in European prisons. The findings are not only based on theory, but also illuminate current practices in the Council of Europe Member States, as Maycock’s theory of the transgender pains of imprisonment is based on interviews with 13 transgender people in custody in the Scottish penal context and the country reports by the CPT provide evidence of penal policies and practices on the placement and treatment of transgender prisoners in 10 different Council of Europe Member States.
Spontaneous intrauterine pregnancy after tubal sterilization: A case report
Authors: Lim Lauren , Fuentes Heather
Published: April 2024

The sterilization failure rate of a total bilateral salpingectomy is unknown. After a total bilateral salpingectomy, spontaneous intrauterine pregnancy is extremely rare; only four cases have been documented. This case report describes a 34-year-old G4P1213 with a history of bilateral salpingectomy who was found to have a viable intrauterine pregnancy. The pregnancy was continued and ended in a repeat cesarean section. At the time of surgery, a left tubal remnant was noted. While the patient was originally reported to have a complete salpingectomy, the evidence of a tubal stump makes this an unintended partial salpingectomy. It is theorized that dense pelvic adhesions at the time of the left salpingectomy increased the likelihood of sterilization failure. This is the first case report to evaluate the pelvic cavity after an intrauterine pregnancy following a reported complete bilateral salpingectomy. Patients should be counseled on the risk of ectopic and intrauterine pregnancy following a bilateral salpingectomy.
Immersive virtual reality in the promotion of health and well-being for people in residential aged care without cognitive impairment: A scoping review
Authors: Holloway Helen , Conroy Brenda , Isbel Stephen , D’Cunha Nathan M
Published: April 2024

Objective

Sustaining the health and well-being of older people living in residential aged care (RAC) requires new means of providing safe and stimulating recreational and therapeutic programs such as using virtual reality (VR). The aim of the scoping review was to investigate the utility of immersive VR interventions using head-mounted display technology to promote the health and well-being of people without cognitive impairment living in RAC.

Method

The following databases were searched from inception until January 2024: PubMed, PsycINFO, Scopus, Cochrane and CINAHL. The eligibility criteria were quantitative, qualitative or mixed methods studies published in English, conducted in RAC, using VR with head-mounted display with people without cognitive impairment.

Results

Of the 274 articles identified, 9 articles with a total of 310 residents and 50 staff met the inclusion criteria. Seven factors to either impede or enable the use of VR with head-mounted displays in RAC were: residents’ agency; the nature of the VR experience; the content of the experience; the ease of use and comfort of the technology; the role of RAC staff; and the role of residents’ family members.

Conclusion

Immersive VR has potential as a tool to promote the health and well-being of people without cognitive impairment living in RAC. Small sample sizes, variations in study design, and selection bias mean that generalisability of the results is limited. Further research is recommended to inform the design and implementation of immersive VR programs tailored specifically for this population.
An Unusual Presentation of Double-Outlet Right Atrium
Authors: Al Kindi Hamood , Abolwafa Amr , Al Hashmi Halima , Al-Maskari Salim , Maddali Madan Mohan , Anderson Robert Henry
Published: April 2024

We describe an unusual example of double-outlet right atrium with separate atrioventricular junctions. The straddling and overriding tricuspid valve had two orifices, and the mitral valve was morphologically normal. An appropriate understanding of the morphology of the atrioventricular junctions, the valves, and the subvalvar apparatus, along with the location of the atrioventricular conduction axis, allowed for successful biventricular repair.
The Impact of Financing Constraints on the Efficiency of Investment and Construction: Evidence from Municipal Infrastructure in China
Authors: Li Xiaojie , Li Hao , Qiu Fei
Published: April 2024

Imperfect external capital market and internal soft budget constraints are important reasons for the issue of enterprise financing constraints. This paper studies the impact of financing constraints and influencing factors of financing constraints in municipal infrastructure investment and construction for local governments by using the panel data from 2003 to 2018 in China. The results show that, first, there are great financing constraints in municipal infrastructure investment and construction for local government in China. Second, the increase of self-financing capacity and external financing capacity can reduce the level and uncertainty of financing constraints, thus improving the efficiency of municipal infrastructure investment and construction. Third, the expansion of the city scale may reduce the uncertainty of financing constraints, but improve the level of financing constraints thus reducing the efficiency of municipal infrastructure investment and construction.
Effects of different antiviral mouthwashes on the surface roughness, hardness, and color stability of composite CAD/CAM materials
Authors: Hazar Ahmet , Hazar Ecehan
Published: April 2024

Objective:

To evaluate the effect of COVID-19 preventive mouthwashes on the surface hardness, surface roughness (Ra), and color change (ΔE) of three different polymer-based composite CAD/CAM materials (Vita Enamic (ENA), Grandio Block (GB), Lava Ultimate (LU)).

Methods:

A total of 100 rectangular-shaped specimens with dimensions of 2 mm × 7 mm × 12 mm were obtained by sectioning three different CAD/CAM blocks and randomly divided into five subgroups according to the 30 days of mouthwash immersion protocol as follows: Control: artificial saliva, PVP-I: 1% povidone-iodine, HP: 1.5% hydrogen peroxide, CPC: mouthwash containing 0.075% cetylpyridinium chloride, EO: mouthwash containing essential oils. Microhardness, Ra, and ΔE values were measured at baseline and after 30 days of immersion protocols. Data were analyzed using the Wald Chi-square, two-way ANOVA, and post hoc Tukey tests.

Results:

The independent factors (materials and solutions) significantly influenced the microhardness and color ( p < 0.001). Ra of the materials was not affected by any of the mouthwashes ( p > 0.05). The microhardness and color of each material varied significantly after immersion in PvP-I and HP ( p < 0.05). The highest percentage change in microhardness, Ra, and ΔE was found in LU immersed in PvP-I and HP mouthwashes, while the lowest change was found in ENA groups ( p < 0.05).

Conclusion:

Within the limitations of this study, it was found that the surface hardness and color of tested polymer-based composite CAD/CAM materials are susceptible to degradation and change after 30 days of immersion in 1% PvP-I and 1.5% HP mouthwashes.
Conscious and non-conscious responses to branded narrative advertising: Investigating narrativity level and device type
Authors: Simonetti Aline , Dini Hossein , Bruni Luis Emilio , Bigne Enrique
Published: April 2024

Narrative advertising enhances advertisement (ad) and brand evaluations from consumers. However, how the narrativity level of the ad impacts these evaluations is less clear. This study investigates affective and cognitive conscious and non-conscious responses to branded advertising in the form of two-dimensional videos that differ in narrativity level. In addition, it explores the effects of delivery modality (computer screen vs virtual reality). We collected self-reported, electroencephalography, and galvanic skin response data from participants watching real video ads with low and high narrativity levels. While self-reported data showed higher positive perceptions toward ads with a high (vs low) narrativity level, the neurophysiological metrics revealed no differences in arousal levels, cognitive load, and approach–avoidance behavior. Delivery modality had little to no effect on self-reported ad and brand metrics, but ads viewed through virtual reality evoked negatively valenced arousal. The findings suggest that narrativity level differently modulates conscious and unconscious cognitive and affective responses to video ads.

JEL CLASSIFICATION: M31; M37
Does Freedom of Domestic Movement Impact Forest Loss? A Cross-National Analysis
Authors: Georgiev Georgi , Alasaly Shahd , Fatima Shumaila , Sommer Jamie M.
Published: April 2024

On the one hand, previous research argues that growth in rural populations leads to forest loss from clearing trees to make room for the growing population and their farming needs. On the other hand, research is also concerned with how deforestation drives people out of rural areas, leading to overurbanization. From this work, it is clear that the movement of people has an important relationship to forest loss, but it is less clear what the autonomy of people is in this process. Put differently, more focus has been put on state-level economic and environmental factors than political factors when considering the impact of domestic migration on forest loss. Although there has been substantial work on how political factors, like democracy, impact forest loss, there is less research on how political rights, like freedom of domestic movement, may impact forest loss. To build on this research, we test the impact of freedom of domestic movement and democracy on forest loss from 2001 to 2014 for a sample of 107 low- and middle-income nations. We find support for the idea that having more freedom of movement decreases forest loss in more democratic nations compared to less democratic nations. We also find that both rural and urban population growth, among others, is associated with higher levels of forest loss. Together, our findings suggest that the freedom of domestic movement should be taken into consideration in addition to population growth from actual domestic movement when researching forest loss.
Caring neighbourhoods in Belgium: lessons learned on the development, implementation and evaluation of 35 caring neighbourhood projects
Authors: De Donder Liesbeth , Stegen Hannelore , Hoens Sylvia
Published: April 2024

Background:

In recent years, there has been a rise in international (care) movements that prioritise community-centred initiatives such as age-friendly communities, compassionate communities or integrated community care. Although these movements have different focal points, they share common features: seeking to address systemic failures in (care) services, value the participation of end-users, focus on unmet (care) needs, through a local, neighbourhood-oriented approach. In the Flemish and Brussels regions notably the concept of Caring Neighbourhoods is experiencing rapid growth.

Objectives:

The objective of the present study is to examine the development and implementation of 35 Caring Neighbourhood initiatives in Flanders and Brussels (Belgium) to explore the added value of such projects, as well as the crucial elements for creating Caring Neighbourhoods.

Design:

Thirty-five caring neighbourhood projects were examined by means of five focus group interviews with project coordinators ( n = 34) and five focus group interviews with neighbourhood residents ( n = 27), using participant-generated photo elicitation.

Methods:

The focus group sessions were recorded, transcribed and data were labelled using an inductive analytical framework, following the steps of reflexive thematic analysis.

Results:

The analysis of the 35 Caring Neighbourhoods showed that fostering connections was key in building Caring Neighbourhoods: connections among residents, connections between residents and care and support services and among care services themselves. The three primary ways to connect people were through activities, places and people. Also, the role of the Caring Neighbourhood coordinator is highlighted as key, which should focus on weaving existing resources, facilitating and coaching instead of organising. Altogether, the projects brought meaning and value to participants’ lives, enhancing overall life satisfaction and well-being, with an emphasis on physical and psychosocial care and support.

Conclusion:

Through critically reflecting on our results and other research, we call on researchers to pay increased attention in research on community-centred care initiatives to death, dying and grief, equity and social justice and the need for both warm and cold solidarity.
Acupuncture versus tricyclic antidepressants in the prophylactic treatment of tension-type headaches: an indirect treatment comparison meta-analysis
Authors: Tao Qing-Feng , Huang Yan-Bing , Yuan Lu , Shi Yun-Zhou , Qin Di , Ye Kun , Peng Wen-Yan , Xie Chao-Rong , Zheng Hui
Published: April 2024

Background

Acupuncture showed better improvement than sham acupuncture in reducing attack frequency of tension-type headache (TTH), but its effectiveness relative to first-line drugs for TTH is unknown, which impedes the recommendation of acupuncture for patients who are intolerant to drugs for TTH. We aimed to estimate the relative effectiveness between acupuncture and tricyclic antidepressants (TCAs) through indirect treatment comparison (ITC) meta-analysis.

Methods

We searched Ovid Medline, Embase, and Cochrane Library from database inception until April 13, 2023. Randomized controlled trials of TCAs or acupuncture in the prevention of TTH in adults were included. The primary outcome was headache frequency. The secondary outcomes were headache intensity, responder rate, and adverse event rate. Bayesian random-effect models were used to perform ITC meta-analysis, and confidence of evidence was evaluated by using the GRADE approach.

Results

A total of 34 trials involving 4426 participants were included. Acupuncture had similar effect with TCAs in decreasing TTH frequency (amitriptyline: mean difference [MD] -1.29, 95% CI -5.28 to 3.02; amitriptylinoxide: MD -0.05, 95% CI -6.86 to 7.06) and reducing TTH intensity (amitriptyline: MD 2.35, 95% CI -1.20 to 5.78; clomipramine: MD 1.83, 95% CI -4.23 to 8.20). Amitriptyline had a higher rate of adverse events than acupuncture (OR 4.73, 95% CI 1.42 to 14.23).

Conclusion

Acupuncture had similar effect as TCAs in reducing headache frequency of TTH, and acupuncture had a lower adverse events rate than amitriptyline, as shown by very low certainty of evidence.
Ultrasound-based radiomics machine learning models for diagnosing cervical lymph node metastasis in patients with non-small cell lung cancer: a multicentre study
Authors: Deng Zhiqiang , Liu Xiaoling , Wu Renmei , Yan Haoji , Gou Lingyun , Hu Wenlong , Wan Jiaxin , Song Chenwanqiu , Chen Jing , Ma Daiyuan , Zhou Haining , Tian Dong
Published: April 2024

Background

Cervical lymph node metastasis (LNM) is an important prognostic factor for patients with non-small cell lung cancer (NSCLC). We aimed to develop and validate machine learning models that use ultrasound radiomic and descriptive semantic features to diagnose cervical LNM in patients with NSCLC.

Methods

This study included NSCLC patients who underwent neck ultrasound examination followed by cervical lymph node (LN) biopsy between January 2019 and January 2022 from three institutes. Radiomic features were extracted from the ultrasound images at the maximum cross-sectional areas of cervical LNs. Logistic regression (LR) and random forest (RF) models were developed. Model performance was assessed by the area under the curve (AUC) and accuracy, validated internally and externally by fivefold cross-validation and hold-out method, respectively.

Results

In total, 313 patients with a median age of 64 years were included, and 276 (88.18%) had cervical LNM. Three descriptive semantic features, including long diameter, shape, and corticomedullary boundary, were selected by multivariate analysis. Out of the 474 identified radiomic features, 9 were determined to fit the LR model, while 15 fit the RF model. The average AUCs of the semantic and radiomics models were 0.876 (range: 0.781–0.961) and 0.883 (range: 0.798–0.966), respectively. However, the average AUC was higher for the semantic-radiomics combined LR model (0.901; range: 0.862–0.927). When the RF algorithm was applied, the average AUCs of the radiomics and semantic-radiomics combined models were improved to 0.908 (range: 0.837–0.966) and 0.922 (range: 0.872–0.982), respectively. The models tested by the hold-out method had similar results, with the semantic-radiomics combined RF model achieving the highest AUC value of 0.901 (95% CI, 0.886–0.968).

Conclusions

The ultrasound radiomic models showed potential for accurately diagnosing cervical LNM in patients with NSCLC when integrated with descriptive semantic features. The RF model outperformed the conventional LR model in diagnosing cervical LNM in NSCLC patients.
The relationship between changes in peak expiratory flow and asthma exacerbations in asthmatic children
Authors: Chen Xiongbin , Han Peng , Kong Yan , Shen Kunling
Published: April 2024

Background

Asthma is one of the most common chronic airway diseases in children. Preventing asthma exacerbation is one of the objectives of all asthma action plans. In patients with poor perception, it is difficult to identify acute asthma exacerbations by clinical asthma score, asthma control test or asthma control questionnaire. The aim of this study is to analyze whether children with asthma have changes in peak expiratory flow(PEF)before an acute asthma exacerbation and to evaluate the relationship between PEF and asthma exacerbation.

Methods

Basic information (including sex, age, atopy, etc.) and clinical information of asthmatic children who registered in the Electronic China Children’s Asthma Action Plan (e-CCAAP) from 1 September 2017 to 31 August 2021 were collected. Subjects with 14 consecutive days of PEF measurements were eligible. Subjects in this study were divided into an exacerbation group and a control group. We analyzed the relationship between changes in PEF% pred and the presence of asthma symptoms.

Result

A total of 194 children with asthma who met the inclusion criteria were included, including 144 males (74.2%) and 50 females (25.8%), with a male-to-female ratio of 2.88:1. The mean age of the subjects was 9.51 ± 2.5 years. There were no significant differences in sex, age, allergy history or baseline PEF between the two groups. In children with and without a history of allergy, there was no significant difference between the variation in PEF at 14 days. Patients who only had a reduced in PEF but no symptoms of asthma exacerbation had the greatest reduction in PEF compared to the other groups. The most common cause of acute exacerbations of asthma is upper respiratory tract infection. Among the causes of acute exacerbations of asthma, the variation in PEF caused by air pollution was significantly higher than that of other causes (P < 0.05). In acute exacerbations, the decrease in PEF was significantly greater in the exacerbation group than in the control group. In children with asthma symptoms, there was a decrease in PEF approximately 1.34 days before the onset of symptoms.

Conclusion

Children with asthma show a decrease in PEF 1.34 days before the onset of asthma symptoms. We recommend that asthmatic children who show a decrease in PEF should step-up asthma therapy. The most common cause of acute exacerbations of asthma was upper respiratory tract infections, and the variation in PEF caused by air pollution was significantly higher than that caused by other factors.
Understanding facilitators and barriers to COVID-19 vaccination in the Zimbabwean population: a qualitative analysis
Authors: Midzi Nicholas , Mutsaka-Makuvaza Masceline Jenipher , Charimari Lincoln Sunganai , Mangwiro Priscilla , Manengureni Tonderai , Mugadza Gladys
Published: April 2024

Background

Vaccines are effective biological interventions that reduce health burdens. However, during the COVID-19 pandemic, there were concerns about varying levels of COVID-19 vaccination coverage in the Zimbabwean population. This study aimed to understand facilitators and barriers to COVID-19 vaccine uptake in the Zimbabwean population.

Methods

In September–October 2023, key informant interviews (KIIs) and focus group discussions (FGDs) were conducted with a sample comprising health workers, village health workers, church leaders, traditional healers, teachers, youth leaders and the general population selected across the country. At each site, the participant sample was homogeneous. Data were collected using audiotapes, transcribed verbatim, and translated into English. Data were analysed manually using thematic analysis.

Results

Ten FGDs and 30 KIIs were conducted across the country. Among the facilitators of COVID-19 vaccine uptake were the perceived benefits of COVID-19 vaccination, such as protection from infection, severe disease and death. People also complied with COVID-19 vaccination because of the government’s call for mandatory vaccination, travel restrictions, restrictions when entering some premises for services, visiting, working, learning and functions. Barriers to COVID-19 vaccine uptake included low-risk perception, negative attitudes emanating from concerns about the origins of the vaccines, COVID-19 cases or death of vaccinated people, negative peer influence, religious doctrines, cultural beliefs and misconceptions circulating through social media. Other barriers included knowledge gaps on COVID-19 vaccines, safety, effectiveness, side effects, access-related challenges to COVID-19 services and concerns over the changing policy on COVID-19 vaccination.

Conclusions

The study has shown the importance of community engagement and data-driven public health communication strategies to facilitate behaviour change for increased uptake of a vaccine. In future epidemics, public health campaigns should focus on the timely provision of information explaining the benefits of an intervention, addressing safety concerns more effectively. To build trust and hence improve vaccine uptake by the public, there is a need for continuous engagement with people and to provide platforms for dialogue to address issues contributing to low vaccine uptake.
Trends in HIV prevalence and risk factors among men who have sex with men in Mozambique: implications for targeted interventions and public health strategies
Authors: Ribeiro Banze Áuria , Muleia Rachid , Nuvunga Samuel , Boothe Makini , Semá Baltazar Cynthia
Published: April 2024

Background

Men who have sex with Men (MSM) are known to contribute to increased HIV prevalence as an integral part of key populations with high vulnerability to HIV/AIDS due to their sexual behaviours. Mozambique conducted two rounds of bio-behavioral surveys (BBS) in this population with the main objective of estimating HIV prevalence and associated risk behaviors among MSM in Mozambique. The present study aims to estimate the trend of HIV prevalence and determine the correlations of HIV infection among MSM.

Methods

A repeated cross-sectional analytical study was conducted from secondary data from the first and second rounds of BBS in Mozambique conducted in 2011 and 2020–2021 respectively. Each round used a similar methodology which allowed for comparison between the two surveys. Chi-square test and logistic regression was used to compare the HIV prevalence between the BBS rounds, identify factors associated with HIV, and assess changes in HIV prevalence across selected risk factors.

Results

There was a significant increase in HIV prevalence among MSM (7.1–14.9%), living in Maputo (9.3–14.7%), uncircumcised (11.7–25.1%), and those who reported two sexual partners in the last year (5.2–14.4%). In contrast, there was a decrease in prevalence among adult MSM aged between 25 and 29 years (24.7–13.9%), aged 30 years or older (45.7–27.7%), married (29.1–16.8%), with higher education (16.7–5.9%) and moderate perception of HIV risk (10.9–3.4%). Multivariable analysis showed that factors such as age, marital status, religion, sexual identity, circumcision, and the use of lubrication during anal sex are significantly associated with the risk of HIV infection.

Conclusions

This study underscores the continuing need for HIV prevention and education efforts. The rise in prevalence among specific population segments and the sustained presence of risk factors emphasize the requirement for holistic strategies tailored to the unique requirements of each subgroup. Understanding trends and risk factors is crucial to guiding public health policies and designing efficacious prevention programs that aim to curtail HIV transmission while enhancing the well-being of those impacted by the condition.
Vitamin A supplementation coverage and associated factors for children aged 6 to 59 months in integrated and campaign-based delivery systems in four sub-Saharan African countries
Authors: Janmohamed Amynah , Doledec David , Dissieka Romance , Jalloh Umu H. , Juneja Sugandh , Beye Maguette , Ndiaye Fatou , Jumbe Theresia , Baker Melissa M.
Published: April 2024

Background

Vitamin A deficiency (VAD) is a leading contributor to the poor health and nutrition of young children in sub-Saharan Africa. Funding constraints are compelling many countries to shift from longstanding campaigns to integrating vitamin A supplementation (VAS) into routine health services. We assessed child VAS coverage and associated factors for integrated delivery systems in Mozambique, Senegal, and Sierra Leone and for a campaign-based delivery strategy in Tanzania.

Methods

Data were obtained using representative household surveys administered to primary caregivers of N = 16,343 children aged 6–59 months (Mozambique: N = 1,659; Senegal: N = 7,254; Sierra Leone: N = 4,149; Tanzania: N = 3,281). Single-dose VAS coverage was assessed and bivariate and multivariable associations were examined for child VAS receipt with respect to rural or urban residence; child age and sex; maternal age, education, and VAS program knowledge; and household wealth.

Results

VAS coverage for children aged 6–59 months was 42.8% (95% CI: 40.2, 45.6) in Mozambique, 46.1% (95% CI: 44.9, 47.4) in Senegal, 86.9% (95% CI: 85.8, 87.9) in Sierra Leone, and 42.4% (95% CI: 40.2, 44.6) in Tanzania and was significantly higher for children 6–11 vs. 24–59 months in Mozambique, Senegal, and Tanzania. In Sierra Leone, children aged 12–23 months (aOR = 1.86; 95% CI: 1.20, 2.86) and 24–59 months (aOR = 1.55; 95% CI: 1.07, 2.25) were more likely to receive VAS, compared to those 6–11 months. Maternal awareness of VAS programs was associated with higher uptake in Mozambique (aOR = 4.00; 95% CI: 2.81, 5.68), Senegal (aOR = 2.72; 95% CI: 2.35, 3.15), and Tanzania (aOR = 14.50; 95% CI: 10.98, 19.17). Increased household wealth was associated with a higher likelihood of child VAS in Senegal and Tanzania.

Conclusions

Our findings indicate routine delivery approaches for VAS are not achieving the level of coverage needed for public health impact in these settings. Intensive outreach efforts contributed to the higher coverage in Sierra Leone and highlight the importance of reducing the burdens associated with seeking supplementation at health facilities. As countries move towards incorporating VAS into routine health services, the essentiality of informed communities and potential losses for older children and socio-economically disadvantaged populations are key considerations in the sub-Saharan African context.
Comparison of knowledge, awareness, and behaviors toward oral cancer among dental students and dentists: an online cross-sectional questionnaire in Türkiye
Authors: Tunç Serap Keskin , Toprak Mehmet Emin , Yüce Esra , Efe Nihat , Topbaş Celalettin
Published: April 2024

Objective

This cross-sectional online questionnaire-based study evaluated the knowledge, awareness, and behaviors of dentists and senior dental students regarding oral cancer (OC).

Materials and methods

This study included 168 dentists and senior dental students who had completed all theoretical educations and clinical practices. An online survey was administered to all participants to assess their awareness of the risk factors for OC, clinical knowledge, and behaviors. The participants’ demographic characteristics and knowledge of OC were analyzed.

Results

Of the participants, 48.8% were female and 51.2% were male. Their mean age was 27.04 ± 5.56 years (range: 21–51). In addition, 59.5% were dentists, and 40.5% were senior dental students. The dentists’ mean time since graduation was 6.38 ± 5.64 years (range: 1–27). Routine oral mucosa examination for OC was significantly more frequent among the dentists than the senior dental students (p < 0.05). Among all participants, 33% of dentists and 51.5% of senior dental students had poor knowledge of OC-related or possibly predisposing factors. Routine evaluation of OC-related and predisposing risk factors, including human papillomavirus infection, smoking, alcohol use, trauma-related non-healing oral lesions caused by long-term incompatible prostheses, and poor oral hygiene, was significantly more frequent among the dentists than the senior dental students (p < 0.05).

Conclusion

Educating dental students about a more comprehensive oral examination and early diagnosis of OC would help overcome the current lack of adequate knowledge and attitudes in OC prevention and early detection. A core curriculum compatible with the global standards on OC should be provided to dental students.