bluuebunny/crossref_metadata_2025 huggingface dataset:
Impact of Optimal Fenestration Size on Outcomes of High-Risk Fontan Patients
Authors: Miwa Koji , Iwai Shigemitsu , Kanaya Tomomitsu , Kawai Shota
Published: October 2023

Background

We aimed to analyze mid-term outcomes of the fenestrated Fontan procedure, focusing on the fenestration size.

Methods

We retrospectively reviewed the outcomes of the fenestrated Fontan procedure. Among 165 patients who underwent the Fontan procedure from 2011 to 2021, fenestration was created in 27 patients with the highest risks, including those with hypoplastic left heart syndrome, hypoplastic pulmonary arteries, heterotaxy syndrome with high pulmonary vascular resistance, and pulmonary arterial pressure >15 mm Hg. The patients underwent the procedure at a median age of three years (body weight, 11.4 kg; body surface area, 0.54 m2). Fenestration sizes were 3.5 to 5 mm.

Results

Spontaneous fenestration closure occurred within one year postoperatively in nine patients. Among them, three experienced Fontan failure, necessitating refenestration. Although fenestration size did not differ, the size corrected by body surface area at the time of surgery was smaller in patients with fenestration closure (6.4 mm/m2 vs 8.3 mm/m2, P < .05). Patients with a fenestration <7 mm/m2 were more likely to have fenestration closure within one year postoperatively, and those with a fenestration >9 mm/m2 were more likely to have severe desaturation and require home oxygen therapy following discharge.

Conclusions

Spontaneous fenestration closure affected the frequency of Fontan complications. A very small fenestration size corrected by body surface area was a significant risk factor for spontaneous closure. Conversely, a very large fenestration size corrected by body surface area resulted in severe desaturation. The optimal fenestration size to prevent early spontaneous closure and severe desaturation is approximately 8 mm/m2.
Factors of Women Entrepreneurship in Egypt: A Qualitative Perspective
Authors: Borham Ashraf , Taib Rosfizah Binti Md , Sisodia Gyanendra Singh , Fadahunsi Akinola
Published: October 2023

Extensive studies related to women’s entrepreneurial motivation are available in the western context, however, only a few studies are found focused on factors that motivate Egyptian women to engage in entrepreneurial activities. The study explores in-depth the motivations behind female entrepreneurs’ efforts to establish business ventures in Egypt. It analyses the influence of macrosocial realities and cultural values on the motivation for entrepreneurship. The finding demonstrates how post materialism factors motivate Egyptian women to embrace entrepreneurial activity as a way to maintaining “personal freedom”. The results demonstrate the impact of the Arab patriarchal culture on shaping the Egyptian women motivation. The qualitative research approach is adopted in this study to explore the entrepreneurial motivations of Egyptian women entrepreneurs. Through purposeful sampling, 20 women entrepreneurs were selected from five Egyptian governorates to administer a semi structured interview for the collection of primary data. The findings indicated that the motivation of Egyptian women entrepreneurs cover a variety of intrinsic and extrinsic motivations. Intrinsic motivations include maintaining personal freedom, satisfying their creative impulses, utilizing their knowledge derived from education training courses and work experiences, exploiting business opportunities, achieving a sense of self -actualization, improving social motivation. On the other hand, extrinsic factors include the inability to find a suitable job, death or illness of a family member, the need to supplement the family income, unfavorable job routine. The research on female entrepreneurs in the context of Egypt is essential as this study responded to calls for a thorough understanding of women’s entrepreneurial motivations. By studying these factors, the study would be able to show that motivations are unique and differentiate from other contexts.
Relationship Between Passion Pathways and Religious Activism: Why the Threat to Religious Identity Predicts Peaceful Activism or Extremism?
Authors: Shahid Rabbiya , Anjum Gulnaz , Aziz Mudassar
Published: October 2023

Identities of religious believers can motivate believers’ passions, emotions, and action tendencies. Religious identity-based passion can, therefore, lead people to identify with certain kinds of movements, both peaceful and extremist. Around the globe, identities of religious minorities provide a compelling context for studying peaceful and extremist activism driven by passion. Building on previous literature on social identity theory, passion, and religious identity, it was hypothesized that religious identity predicts passion of both types: Harmonious Passion (HP) and Obsessive Passion (OP). It was proposed that people who were harmoniously passionate about their religious identity would promote peaceful activism whereas people who were obsessively passionate would promote hatred and extremism. A sample of 221 devout Shias (a religious minority) from Pakistan participated in the survey-based experiment of this study (males = 108, females = 113; ages ranging from 19 to 38 years, Mage = 22, SD = 2.13; experimental condition = 111, control condition = 110). The results supported the key hypotheses of the study: identification with a minority (Shia Identity) leads to both Harmonious Passion (HP) and Obsessive Passion (OP); when the Shia Identity was threatened, HP and OP scores were lower. Furthermore, HP predicted peaceful activism whereas, under a threat to identify, OP increased and showed a significantly higher violent stance, predicting religious extremism. These findings support the assumption that HP leads to Peaceful Activism, whereas OP is associated with increased support for Extremism and Hatred. The results of this study replicated existing theoretical and empirical predictions about passion pathways and threats to religious identity. The implications of the findings are discussed in the context of contemporary identity threats and activism strategies among Muslim minorities in Pakistan.
Alternative Work Scheme: The Relationship to the Personal and Professional Life
Authors: Barlis Jose M. , Fajardo Josefin D. , Generales Leonila J. , Vicente Joy Anne
Published: October 2023

Personal life and professional life are two significant grounds that may affect one another. A profession can distract personal life while personal life can hinder professional life. Both conflicts may lead to unfavorable outcomes in personal and professional life. The study focused on the experiences of the faculty from Polytechnic University of the Philippines Bataan Branch during the implementation of an alternative work scheme because of quarantine implementation and a series of lockdowns. Forty-six (46) or 70% faculty members participated in the study regardless of their status. It was conducted during the Academic Year 2020 to 2021, second Semester. The study revealed that time management was found out to have a positive correlation to availability, preparation, and work environment at a low extent but negatively correlated to the family conflict to a moderate extent. On the other hand, time management has a positive correlation to the overall home-related factors to a moderate extent. Instructional materials were found out to have a positive correlation to availability, work environment, internet connection, and overall home-related factors to a moderate extent. Class monitoring was positively correlated to availability, work environment, and to the internet connection to a low extent but negatively correlated to a low extent with family conflict. On the contrary, class monitoring has a positive correlation to a moderate extent to overall home-related factors. Overall work-related factors were found out to be positively correlated to availability, preparation, work environment, internet connection, and overall home-related factors to a moderate extent.
The Incorporation of Facebook-Based Peer Comments Into Writing Revisions: A Framework for Social-Network Peer Commentaries
Authors: Pham Vu Phi Ho , Luong Thi Kim Phung
Published: October 2023

This study determined the degree to which students used peer feedback from Facebook to revise their writing papers and explored the students’ perspectives on a framework of using a social network for peer commentaries. The study enrolled two intact groups, 40 students in the control group and 32 students in the experimental group, at a university in Ho Chi Minh City, Vietnam. The student’s initial and final drafts, peer reviews, and semi-structured interviews were used to collect data. The results indicated that 45% of changes were made in response to peer reviews, while 55% were made solely on the basis of the student’s own judgments. Additionally, the overall number of revisions made by students was greater than the number of revisions caused by comments at higher levels such as “Clause,”“Sentence,” and “Paragraph.” Numerous previous studies refuted the current study’s results, raising questions for researchers/instructors considering using Facebook as a forum for their writing classes because the students become more responsible for developing their writing skills.
Safe Destination Choice Among Tourism-Product Consumers in the New Era of Tourism
Authors: Quan Wei , Jang Jichul , Radic Aleksandar , Ariza-Montes Antonio , Han Heesup
Published: October 2023

The current study assessed and demonstrated the impact of perceived knowledge and perceived susceptibility about COVID-19 on travelers’ intentions for safe destination choice in case when the COVID-19 pandemic is being controlled by crowdedness (i.e., human crowdedness and spatial crowdedness) and monetary promotions. The reliability and validity of the proposed research model were tested by using regression analysis and covariance structural equation modeling. The results revealed a significant effect of perceived knowledge and perceived susceptibility on behavioral intention. It was evidenced that increasing knowledge and susceptibility of COVID-19 is necessary. The moderating effects of human crowdedness, spatial crowdedness, and monetary promotions were also examined through SPSS Process Macro v3.5 and invariance test. In addition, differences in demographic variables (gender, age, annual income, marital status, and ethnic background) on the research model were unveiled. Lastly, both theoretical values and practical implications of this study were discussed.
Dissecting Automated News Production From a Transdisciplinary Perspective: Methodology, Linguistic Application, and Narrative Genres
Authors: Zhang Wei , Pérez Tornero José Manuel , Tian Qiusheng
Published: October 2023

There is a need for a conceptual framework and transdisciplinary construction to help understand and instruct automated news production for integrating AI into news routines. Using a conceptual method, this article attempts to explicate the journalistic background of automated news production and proposes a methodology of artificial language philosophy and a therapeutic approach. We argue that the methodology for automated news production should be able to demystify the technological process and clarify the relationship between AI and human journalists. The article introduces linguistics and narratology to decipher the process of automated news production and finally summarizes the typical narratives for automated news production. This article’s ultimate contribution is offering a transdisciplinary perspective to dissect automated news production for further studies.
The Relationship Between Intelligence and Creativity Within the Threshold Theory Among Gifted and Bright Secondary School Students in Turkey
Authors: Çetinkaya Çağlar
Published: October 2023

This study examines the relationship between the intelligence and creativity scores of gifted and bright students according to the Threshold Theory.1155 students participated in the study. Students are at the secondary school level. There are seven different regions in Turkey. The sample consists of participants from the largest provinces of the regions. The Wisc-R intelligence test and Torrance Creative Thinking Test (TTCT) were used. Data were collected over a decade between 2012 and 2022. The obtained data were tested according to the Threshold Theory. The relationship between intelligence and creativity was studied based on different intelligence score ranges. A significant relationship was found between the intelligence and creativity scores of the bright students. It was determined that there is a positive and significant ( r = .725, p < .001) correlation between intelligence and creativity scores of children ( n = 432) with bright intelligence (120–129). In the findings obtained, no significant correlation was found between giftedness and creativity scores of the gifted and profoundly gifted students. No significant correlation was found between intelligence and creativity scores ( r = .051, p > .05) of gifted children ( n = 581). No significant correlation was found between intelligence and creativity scores ( r = .062, p > .05) of children ( n = 142) with profoundly gifted intelligence (146–160). The result of this study confirmed the Threshold Theory.
What People Talk About Multi-Channel Purchasing Behavior and What They Intend to do: Related Perspective From ESG Evaluation System
Authors: Hou Jiangyuan , Du Mingyue , Zhou Qingjie
Published: October 2023

With the development of the Internet economy, online shopping has become the main way for consumers to obtain goods, especially for organic infant milk. Do millennials who grew up in the era of Internet prefer online purchasing channel? Or are they stickier to online channel than offline channel? To solve these issues, we conduct the regression analysis of a latent class and the model of Quadratic Engel Almost Ideal Demand System aimed at the user stickiness in China. Moreover, we further analyze the environmental social governance effect of multi-channel stickiness, which is able to further explore the impact of environmental social governance investment strategy on consumers’ purchasing behavior. Through these analyses, we confirm the online channel stickiness and platform stickiness of Taobao. Results also indicate that (i) The primary factor influencing the inertia of consumption and trade volume is the channel and platform stickiness, the latter positively affects the former. (ii) The ESG rating index plays a positively moderating role in the consumers’ user stickiness. (iii) Environment and Social Score have a significant positive impact on online platform stickiness.
Is Naga Society Egalitarian and Democratic? The Gender Questions on Customary Law and Its Practices in Nagaland
Authors: Longkoi Khiamniungan T.
Published: October 2023

Customary law and its practices in tribal culture usually reproduce gender bias on almost all fronts. Focusing on Khiamniungan, one of the Naga tribes, this article tries to illustrate the patriarchal aspect of social reality as it is manifested through customary practices, folklore, local sayings and local proverbs. Based on ethnographic research, the study argues that the institution of Morung is the epitome of customary practices and justifies patriarchy, especially in the political sphere. Also, Naga women have to bargain and negotiate on all fronts: property rights, decisions in marriage and divorce, public participation and so on. As a result, such dominance silences the Naga women’s experiential history. The attempt is to critically reflect on the colonial narrative of Nagas as an egalitarian and democratic society and further highlight that the colonial paradigm continues to be reproduced in postcolonial times without an empirical and critical reflection.
Residency Training: A Practical Guide for Medical Students who are Planning a Future in Child Neurology
Authors: Gupta Megan , Nordli Douglas R. , Hur Moon Hee , Phitsanuwong Chalongchai , Sheth Raj , Galan Fernando
Published: October 2023

At the time of graduation from medical school, medical students have been exposed primarily to adult neurology and have limited exposure to child neurology. Child neurology is a unique field that encompasses caring for children with neurological conditions ranging from routine to rare. There are many opportunities for a variety of unique careers in child neurology including both in the inpatient and outpatient setting. This article aims to provide practical advice for the medical student interested in child neurology to best prepare for a successful match and rewarding career.
COVID-19 Lockdown and Vendors’ Business in a Smart City: Some Observations from Bhubaneswar, Odisha, India
Authors: Sahoo Pradeep Kumar , Ray Rashmita , Basantaray Amit Kumar , Pradhan Asutosh
Published: October 2023

The people engaged in street vending are vulnerable to various forms of disruptions. COVID-19-induced lockdown brought a sudden desolation to the business activity of vendors, which bent down the socio-economic condition of their families. This article looks into that aspect and especially tries to analyse the effect of COVID-19 lockdown/shutdown on vending businesses in a smart city in Odisha, Bhubaneswar. Using survey data from six different vending zones in Bhubaneswar Municipal Corporation on a total of 142 vendors, 62 registered (formal) and 80 unregistered (informal) vendors, we observed a significant decline in the income of both formal and informal vendors during COVID-19 lockdown. The decline is more pronounced among informal vendors compared to formal vendors. There is a significant mean difference between monthly income and expenditure during pre- and post-lockdown/shutdown period. This indicates the adverse impact of the COVID-19 lockdown/shutdown on the vending business in Bhubaneswar, Odisha in general, and informal vendors in particular.
Exploring the Impact of Supermarket Store Layout and Atmospheric Elements on Consumer Behavior: A Field Research Study in Greece
Authors: Mantratzis P. , Tsiotras G. , Tsironis Loukas K. , Gotzamani K.
Published: October 2023

The highly competitive retail industry pushes retailers to seek strategies like creating atmospheric in-store experiences to boost consumer satisfaction and encourage return visits. Store atmosphere and layout design influence consumer decision-making, perception, and satisfaction. Factors such as building design, customer patterns, merchandise mix, and proximity requirements impact consumer perception and store layout.

This article investigates the effect of supermarket chains’ layouts on consumer behavior, focusing on atmospheric elements. A Greek field study involving 205 participants assessed perceptions and attitudes toward supermarket layouts and design elements. Results suggest that retail environment characteristics impact emotional reactions, which in turn influence impulse buying behavior.

Emphasizing the importance of a superior customer experience throughout the purchasing process, the study identifies key atmospheric elements affecting consumer behavior in supermarkets. The article concludes by discussing implications for retail marketers and suggesting future research directions.
Validation and Psychometric Evaluation of Diabetes Literacy, Numeracy, and Knowledge Tools in the Arabic Context
Authors: Hasan Sanah , Alzubaidi Hamzah , Samorinha Catarina , Al Radhaideh Ahmed
Published: October 2023

Purpose:

The purpose of this study was to validate the Literacy Assessment for Diabetes (LAD), the Diabetes Numeracy Test (DNT), and the Simplified Diabetes Knowledge Test (DKT) in the Arabic language and context.

Methods:

Three hundred eighty four, ≥18-year-old patients with type 1, type 2, or gestational diabetes mellitus were recruited from 3 endocrinology clinics in the United Arab Emirates. Exploratory factor analysis using principal component was performed. Achieved scores were compared using Pearson bivariate correlation.

Results:

All 60 LAD items loaded on 1 factor accounting for 66.7% of the variance, with internal consistency α = .991. Average score = 68.7%. Nineteen out of 26 items were retained on the DNT and grouped into 4 factors, prescription reading and directions, proper dose coverage, nutrition, and insulin, with good internal consistency (α = .721). Average score = 73.2%. All 20 DKT items loaded on 3 factors accounting for 41.2% of the variance, causes and consequences of the high blood sugar level, prevention of the disease, and misconceptions about diabetes self-management, with good internal consistency (α = .799). Average score = 71.9%. A moderate and significant correlation between the DKT and DNT ( r = .56, P < .001) was observed.

Conclusions:

Three tools to assess diabetes literacy, numeracy, and knowledge were psychometrically tested to establish their validity and reliability in the Arabic language and context. The tools could be used to assess patient skills and competence in navigating the health care system and managing their diabetes.
Revisiting the emerging lopsided city
Authors: DeVerteuil Geoffrey
Published: October 2023

In the context of an ongoing conversation about cities and inequality, I offer a critical but not contrarian set of responses to the very generous commentaries provided by the five peer reviewers. I hope to use this space to both clarify and nuance some of my original provocations around the emerging lopsided city and the value of revisiting insights on inequality generated in the 1990s.
Displacement and affective economies in gentrification research
Authors: Bloch Stefano , Meyer Dugan
Published: October 2023

In our initial paper calling for a more affective understanding of displacement in gentrification studies, we argued that displacement is a process that functions through diverse rearticulations of people's embodied capacity to make place, only some of which take the form of physical or social dislocation. Our intervention was intended to reignite this already existing argument by drawing attention to the embodied, affective, and emotional dimensions of displacement with a critical consideration of the role race/racism plays within this process today. We argue that such a perspective offers gentrification researchers a more critically incisive methodological and theoretical toolkit for grasping how power operates in urban space, particularly in dimensions commonly overlooked by traditional critical scholarship. We are excited and grateful to the editors of Dialogues in Urban Research for making space for this conversation, and to the scholars – Prince K. Guma, John Lennon, Joy White, Brandi T. Summers, Prentiss Dantzler, and Maria-Aminata Peron – who offered insightful responses to our paper. These responses both clarified and extended our own perspective, particularly in terms of demonstrating how the agential, creative, and collaborative efforts of urban residents to make and remake place can both bring into focus the affective dimensions of urban space and open up possibilities for imagining new urban imaginaries.
Fie, foh, and fum, smelling the work of other urban scholars
Authors: Cousin Bruno
Published: October 2023

Comments on Bas van Heur’s bibliometric article about urban studies as a global field of research, and how to improve their inclusivity and decentralization.
Case Series: Multiple Soft Tissue Lesions Demonstrated by Sonography and MRI Correlation
Authors: Nanni Garth S.
Published: October 2023

Varied diagnostic imaging techniques may often be used in tandem, to enhance and complement each other, when an initial imaging diagnosis appears equivocal. Diagnostic medical sonography and magnetic resonance imaging (MRI) are imaging techniques that often complement each another. Sonography is an excellent diagnostic technique to determine the consistency of a soft tissue mass (e.g., solid vs cystic), and its relationship to adjacent structures, size, and shape. Sonography is especially useful for evaluating palpable lumps and allows sonographers to perform targeted examinations around the area of interest. In addition, color and pulsed-wave Doppler enable further characterization of a lesion’s presence or lack of vascularity. Sonography can also guide core-needle biopsy of superficial lesions. However, sonography is less reliable for deep masses in large anatomical regions. The American College of Radiology recommends MRI for deeper lesions of this type. Magnetic resonance imaging is also recommended for soft tissue masses suspected to be localized to the peripheral nervous system.
Hydrogen sulfide priming enhanced salinity tolerance in sunflower by modulating ion hemostasis, cellular redox balance, and gene expression
Authors: Younis Abeer Abdelrazk , Mansour Mohamed Magdy F.
Published: October 2023

Background

The salinity threat represents an environmental challenge that drastically affects plant growth and yield. Besides salinity stress, the escalating world population will greatly influence the world’s food security in the future. Therefore, searching for effective strategies to improve crop salinity resilience and sustain agricultural productivity under high salinity is a must. Seed priming is a reliable, simple, low-risk, and low-cost technique. Therefore, this work aimed to evaluate the impact of seed priming with 0.5 mM NaHS, as a donor of H2S, in mitigating salinity effects on sunflower seedlings. Primed and nonprime seeds were established in nonsaline soil irrigated with tape water for 14 d, and then exposed to 150 mM NaCl for 7 d.

Results

Salinity stress significantly reduced the seedling growth, biomass accumulation, K+, Ca2+, and salinity tolerance index while elevating Na+ uptake and translocation. Salinity-induced adverse effects were significantly alleviated by H2S priming. Upregulation in gene expression (HaSOS2, HaGST) under NaCl stress was further enhanced by H2S priming. Also, H2S reduced lipid peroxidation, electrolyte leakage, and H2O2 content, but elevated the antioxidant defense system. NaCl-induced levels of ascorbate, glutathione, and α tocopherol, as well as the activities of AsA-GSH cycle enzymes: ascorbate peroxidase, monodehydroascorbate reductase, dehydroascorbate reductase, glutathione reductase, and glutathione S-transferase, were further enhanced by H2S priming. Increased level of H2S and total thiol by NaCl was also further stimulated by H2S priming.

Conclusion

H2S priming has proved to be an efficient strategy to improve sunflower seedlings’ salinity tolerance by retaining ion homeostasis, detoxifying oxidative damage, modulating gene expression involved in ion homeostasis and ROS scavenging, and boosting endogenous H2S. These findings suggested that H2S acts as a regulatory molecule activating the functional processes responsible for sunflower adaptive mechanisms and could be adopted as a crucial crop management strategy to combat saline conditions. However, it would be of great interest to conduct further studies in the natural saline field to broaden our understanding of crop adaptive mechanisms and to support our claims.
Prevalence and predictors of acute respiratory infection among children under-five years in Tigray regional state, northern Ethiopia: a cross sectional study
Authors: Gebrerufael Gebru Gebremeskel , Hagos Bsrat Tesfay
Published: October 2023

Background

Acute respiratory infection is still one of the leading causes of child morbidity and mortality worldwide. Developing countries, especially in Sub-Saharan Africa including Ethiopia continue to share an overburden of this infection. Studies showed that different predictor factors were associated with the occurrence of childhood acute respiratory infection. Therefore, the main aim of this study was to assess the prevalence and associated predictor factors of acute respiratory infection among children under-five years in the Tigray Regional State, northern Ethiopia.

Methods

A retrospective cross-sectional study design was done from January 18, 2016, to June 27, 2016. A total of 986 children under-five years were selected for this study. The logistic regression model analysis was employed to examine the predictor factors of childhood acute respiratory infection. Both bi-variable and multivariable data analysis was performed using STATA version 14.0.

Results

Overall, the study showed that the two weeks prevalence of acute respiratory infection among children under-five years was 16.10% [95%CI: 13.80–18.40]. According to the multivariable logistic regression model analysis, children aged (24–60) months (AOR: 0.59, 95%CI: 0.352–0.98), rich wealth index of households (AOR: 0.60, 95%CI: 0.378–0.959), diarrhea status of children (AOR: 3, 95%CI: 1.97–4.73), and mothers smoking cigarettes (AOR: 4, 95%CI: 1.15–16.50), were significant predictors of acute respiratory infection.

Conclusion

The prevalence of ARI displays that Tigray regional state was experiencing a higher ARI rate than the national level. The current study identified the low wealth index of households, children aged (24–60 months), mothers smoking cigarettes, and diarrhea status of the children as crucial predictor factors for ARI. Interventions should be improved to these modifiable major predictor factors that significantly decrease the ARI problem among under-five children.
Trends in sexually transmitted and blood-borne infections in China from 2005 to 2021: a joinpoint regression model
Authors: Wang Shuyuan , Chen Jialu , Li Yuansheng , Zhang Beibei , Li Xiang , Han Ying , Zhang Junhui
Published: October 2023

Background

Sexually transmitted and blood-borne infections (STBBIs) is a major public health concern in China. This study assessed the overall trends in STBBIs to improve the comprehensive understanding of the burden of STBBIs and provide evidence for their prevention and control.

Methods

Data for the period from 2005 to 2021 were analyzed across China on infections with hepatitis B or C; syphilis; gonorrhea; and HIV infection. Trends, annual percent change (APC), and average annual percent change (AAPC) in diagnosis rate was analyzed using joinpoint regression models for the five STBBIs together or individually.

Results

From 2005 to 2021, the overall diagnosis rate of all five STBBIs increased, with an AAPC of 1.3% [95% confidence interval (CI) -0.5% to 3.1%]. Diagnosis rates of HIV, syphilis and hepatitis C increased individually, but it decreased for infections of hepatitis B and gonorrhea. Joinpoint analysis identified four phases in diagnosis rate of hepatitis C; three phases in diagnosis rate of hepatitis B, HIV infection, and syphilis; two in diagnosis rate of gonorrhea infection.

Conclusion

Despite national efforts to prevent and control STBBIs, their overall diagnosis rate has continued to rise in China, and they remain an important public health challenge. Further efforts should be made to educate the general population about STBBIs, particularly HIV. Interventions targeting vulnerable groups should be adopted and their efficacy monitored through regular analysis of trends.
Brain tumor image segmentation based on improved FPN
Authors: Sun Haitao , Yang Shuai , Chen Lijuan , Liao Pingyan , Liu Xiangping , Liu Ying , Wang Ning
Published: October 2023

Purpose

Automatic segmentation of brain tumors by deep learning algorithm is one of the research hotspots in the field of medical image segmentation. An improved FPN network for brain tumor segmentation is proposed to improve the segmentation effect of brain tumor.

Materials and methods

Aiming at the problem that the traditional full convolutional neural network (FCN) has weak processing ability, which leads to the loss of details in tumor segmentation, this paper proposes a brain tumor image segmentation method based on the improved feature pyramid networks (FPN) convolutional neural network. In order to improve the segmentation effect of brain tumors, we improved the model, introduced the FPN structure into the U-Net structure, captured the context multi-scale information by using the different scale information in the U-Net model and the multi receptive field high-level features in the FPN convolutional neural network, and improved the adaptability of the model to different scale features.

Results

Performance evaluation indicators show that the proposed improved FPN model has 99.1% accuracy, 92% DICE rating and 86% Jaccard index. The performance of the proposed method outperforms other segmentation models in each metric. In addition, the schematic diagram of the segmentation results shows that the segmentation results of our algorithm are closer to the ground truth, showing more brain tumour details, while the segmentation results of other algorithms are smoother.

Conclusions

The experimental results show that this method can effectively segment brain tumor regions and has certain generalization, and the segmentation effect is better than other networks. It has positive significance for clinical diagnosis of brain tumors.
Functional and structural MRI based obsessive-compulsive disorder diagnosis using machine learning methods
Authors: Huang Fang-Fang , Yang Xiang-Yun , Luo Jia , Yang Xiao-Jie , Meng Fan-Qiang , Wang Peng-Chong , Li Zhan-Jiang
Published: October 2023

Background

The success of neuroimaging in revealing neural correlates of obsessive-compulsive disorder (OCD) has raised hopes of using magnetic resonance imaging (MRI) indices to discriminate patients with OCD and the healthy. The aim of this study was to explore MRI based OCD diagnosis using machine learning methods.

Methods

Fifty patients with OCD and fifty healthy subjects were allocated into training and testing set by eight to two. Functional MRI (fMRI) indices, including amplitude of low-frequency fluctuation (ALFF), fractional ALFF (fALFF), regional homogeneity (ReHo), degree of centrality (DC), and structural MRI (sMRI) indices, including volume of gray matter, cortical thickness and sulcal depth, were extracted in each brain region as features. The features were reduced using least absolute shrinkage and selection operator regression on training set. Diagnosis models based on single MRI index / combined MRI indices were established on training set using support vector machine (SVM), logistic regression and random forest, and validated on testing set.

Results

SVM model based on combined fMRI indices, including ALFF, fALFF, ReHo and DC, achieved the optimal performance, with a cross-validation accuracy of 94%; on testing set, the area under the receiver operating characteristic curve was 0.90 and the validation accuracy was 85%. The selected features were located both within and outside the cortico-striato-thalamo-cortical (CSTC) circuit of OCD. Models based on single MRI index / combined fMRI and sMRI indices underperformed on the classification, with a largest validation accuracy of 75% from SVM model of ALFF on testing set.

Conclusion

SVM model of combined fMRI indices has the greatest potential to discriminate patients with OCD and the healthy, suggesting a complementary effect of fMRI indices on the classification; the features were located within and outside the CSTC circuit, indicating an importance of including various brain regions in the model.
Age at job initiation and risk of coronary heart disease: findings from the UK biobank cohort study
Authors: Zhang Zenghui , Zeng Chuanrui , Chen Zhiteng , Liu Pinming , Gao Jingwei , Guo Qi , Wu Maoxiong , He Wanbing , Gao Qingyuan , Guo Dachuan , Liang Xiaotian , Huang Zegui , Wang Jingfeng , Zhang Haifeng , Chen Yangxin
Published: October 2023

Background

Commencing work at an early age has been linked to various risk factors for coronary heart disease (CHD), such as shift work and intensive job strain. However, the relationship between starting work too early and CHD risk remains largely unclear. We examined the association between age at job initiation and the risk of CHD.

Methods

UK Biobank participants aged 38 to 70 years without cardiovascular disease who provided data on their age at job initiation were included. The primary outcome was CHD, which was ascertained using hospital and death records. The hazard ratios (HRs) and 95% confidence interval (CIs) for the association between age at job initiation and CHD were calculated using multivariable Cox regression.

Results

Of the 501,971 participants, 114,418 eligible participants were included in the final analysis. The median age at job initiation was 19.0 years. During the mean follow-up of 12.6 years, 6,130 (5.4%) first CHD events occurred. We observed that age at job initiation was inversely associated with CHD (HR 0.98, 95% CI 0.97–0.99), and the association was potentially J-shaped. The HRs for the < 17-year, 17–18-year, and 19–21-year age groups were 1.29 (95%CI 1.18–1.41), 1.12 (95% CI 1.03–1.22) and 1.05 (95% CI 0.97–1.14), respectively, compared with those of the ≥ 22-year group.

Conclusions

Age at job initiation was associated with incident CHD, which was independent of socioeconomic status. Participants who commenced employment before the age of 19 years exhibited a higher risk of developing CHD later in adulthood.
Healthcare-seeking of medical students: the effect of socio-demographic factors, health behaviour and health status – a cross-sectional study in Hungary
Authors: Umami Afriza , Zsiros Viktória , Maróti-Nagy Ágnes , Máté Zsuzsanna , Sudalhar Sudalhar , Molnár Regina , Paulik Edit
Published: October 2023

Background

Medical students are more likely to have various physical and psychological issues, but less information is available about the healthcare-seeking behaviour for physical and mental health issues. The aim of this study is to determine the factors affecting medical students’ healthcare-seeking when visiting a general practitioner (GP) and/or psychologist.

Methods

688 medical students (326 International and 362 Hungarian,) participated in a cross-sectional study. The information was gathered using a self-administered online questionnaire and covered socio-demographic background, health behaviour, general and mental health status and healthcare-seeking. For analysing adjusted associations, multivariable logistic regression models were used.

Results

Overall, 56.8% of medical students visit the GP; and 17.2%, the psychologist. Hungarian medical students visited the GP with chronic diseases, International medical students were more likely to visit a GP when they encountered sexual activity and had chronic diseases. Moreover, there was a significant correlation between sex, alcohol consumption, and perceived stress in the total sample of psychologist visits. When Hungarian medical students were in their clinical years and had a poor self-rated mental health, they were more likely to visit a psychologist. Whereas female international medical students and those who had poor self-rated mental health were more likely to seek psychological help.

Conclusion

Students visit a GP and/or psychologist is associated with a variety of factors, including socio-demographic background, health behaviours, and health issues. Medical schools should encourage help-seeking behaviours and early disclosure of medical students. Their ability to grasp healthcare attitudes and designing treatments will be important for both their academic success and future profession.
Evaluation of the nutrition literacy assessment questionnaire for college students and identification of the influencing factors of their nutrition literacy
Authors: Yan Wang , Caihong Hu , Xuefeng Yang , Jiayu Zhang
Published: October 2023

Background

Nutrition health has become a major public health issue in both high and middle-income countries. Nutrition literacy is an important indicator to evaluate the effect of public health intervention and one of the important concepts in health promotion. Thus, this study aimed to verify the reliability and validity of a nutrition literacy assessment questionnaire (NLAQ) and investigate the associated factors of nutrition literacy among college students.

Methods

We conducted a cross-sectional online survey of college students from April to November 2022 in Wuhan (N = 774). We employed the Cronbach’s alpha coefficient, exploratory and confirmatory factor analysis to evaluate the reliability and validity. We used latent profile analysis to classify the nutrition literacy. We conducted Chi-square test and binary logistic regression to identify the influencing factors.

Results

The Cronbach’s alpha coefficient of the NLAQ and its dimension was ranging from 0.837 to 0.909. The common factors were consistent with the original dimensions. All indicators met the requirements (χ2/df = 6.16 < 8, GFI = 0.929, NFI = 0.939, CFI = 0.948, RMSEA = 0.082 < 0.1). College students’ disciplines (χ2 = 7.769, P = 0.021), mothers’ education level (χ2 = 26.599, P < 0.001), and fathers’ occupation type (χ2 = 11.218, P = 0.024) had impacts on nutrition literacy.

Conclusion

The NLAQ has good reliability and validity, and could be used as a measurement tool to evaluate college students’ nutrition literacy. Schools and families should take targeted measures to improve the college students’ nutrition literacy.
Phase transformation and mechanical properties of heat-treated nickel-titanium rotary endodontic instruments at room and body temperatures
Authors: Kasuga Yuka , Kimura Shunsuke , Maki Keiichiro , Unno Hayate , Omori Satoshi , Hirano Keiko , Ebihara Arata , Okiji Takashi
Published: October 2023

Background

The aim of this study was to evaluate the phase composition, phase transformation temperatures, bending property, and cyclic fatigue resistance of different heat-treated nickel-titanium (NiTi) rotary instruments with the same tip diameter and taper at room (RT; 25 ± 1 °C) and body (BT; 37 ± 1 °C) temperatures.

Methods

Five heat-treated NiTi rotary instruments, HyFlex EDM (EDM), HyFlex CM (CM), Vortex Blue (VB), RE file CT (RE) and JIZAI, and a non-heat-treated NiTi rotary instrument (Mtwo) with a size 40, 0.04 taper were investigated. Temperature-dependent phase transformation was examined with differential scanning calorimetry (DSC). The bending loads of the instruments at RT and BT were evaluated using a cantilever-bending test. Cyclic fatigue resistance at RT and BT was measured using a dynamic test, during which the instruments were rotated in combination with a 2-mm back-and-forth motion in an artificial curved canal, and the number of cycles to failure (NCF) was determined. The results were analyzed using two-way repeated measures analysis of variance, a simple main effect test, and the Bonferroni test (α = 0.05).

Results

DSC results indicated that EDM and Mtwo were primarily composed of martensite/R-phase and austenite, respectively, while the other heat-treated instruments were composed of a mix of martensite/R-phase and austenite at the tested temperatures. Regardless of the temperature setting, the bending loads of heat-treated instruments were significantly lower than those of Mtwo (p < 0.05). EDM showed the lowest bending loads and highest NCF at both temperatures (p < 0.05). CM, VB, and JIZAI showed significantly higher bending loads at BT than at RT (p < 0.05). The NCF of all the heat-treated instruments, except VB, was lower at BT than at RT (p < 0.05). At BT, the NCF of CM, VB, RE, and JIZAI were not significantly higher than that of Mtwo (p > 0.05).

Conclusions

Heat-treated NiTi instruments exhibited lower bending loads and higher NCF values than Mtwo. However, this tendency was less pronounced at BT than at RT, especially in the NCF values of instruments with a mixture of martensite/R-phase and austenite phases at the tested temperatures.
Clinical feasibility evaluation of a digital workflow of prosthetically oriented onlay bone grafting for horizontal alveolar augmentation: a prospective pilot study
Authors: Tang Yiman , Zhai Shuyong , Yu Huajie , Qiu Lixin
Published: October 2023

Background

Onlay bone grafting is considered highly reliable for reconstructing severe horizontal bone defects. A critical problem is how to achieve precise position of the bone block to control alveolar ridge dimensions. This research aims to establish a digital workflow for prosthetically oriented onlay bone grafting and evaluate its accuracy and efficiency.

Methods

This prospective pilot study investigated eight patients who required implant restoration in the esthetic area with horizontal alveolar bone defects. The workflow includes preoperative virtual planning, design and manufacture of patient-specific templates, bone grafting surgery, and implant insertion. Primary outcomes were graft accuracy, defined by root mean square estimate (RMSE) values between preoperatively designed and actual implanted outer contours of bone blocks. Secondary outcomes were bone graft and implant success rates. Besides, the surgeons used the visual analog scale (VAS) to rate the intuitiveness, ease of understanding, and helpfulness of the workflow.

Results

No bone grafts or implants failed in any of the eight patients, resulting in a 100% success rate. The RMSE values between the preoperative design and the implanted outer contour of bone blocks were 0.41 ± 0.15 mm. The digital approach showed advantages in intuitiveness (9.3 ± 0.5), understanding (9.0 ± 0.5), and helpfulness (8.4 ± 1.1) according to surgeons' VAS scores.

Conclusions

A digital workflow provided encouraging results, in terms of accuracy and efficacy, for horizontal bone augmentation.

Trial registration

This study was registered in the National Clinical Trials Registry in 16/02/2023 under the identification number ChiCTR2300068361.
The associations between benevolent leadership, affective commitment, work engagement and helping behavior of nurses: a cross-sectional study
Authors: Shen Xiaolin , Shen Tao , Chen Yanling , Wang Ying , He Xuan , Lv Xinyue , Jin Qiang
Published: October 2023

Background

Benevolent leadership is common in organizations, including hospitals, and is known to have positive effects on employees. Yet, nursing literature lacks sufficient research on its relationships with nurses’ behavior.

Methods

In March to April 2022, a cross-sectional study was carried out involving 320 nurses employed across various hospitals in Sichuan Province, China. Benevolent leadership, affective commitment, work engagement, and helping behavior were evaluated using the Benevolent Leadership Scale, Affective Commitment Scale, Work Engagement Scale, and Helping Behavior Questionnaire, respectively. The study employed structural equation model and the bootstrap method to investigate the proposed relationships.

Results

The SEM analysis results indicated a positive association between benevolent leadership and several outcomes among nurses. Specifically, benevolent leadership was found to be positively associated with nurses’ affective commitment (β = 0.58, p < .001), work engagement (β = 0.02, p < .001), and helping behavior (β = 0.17, p = .001). Additionally, there was a significant indirect effect between benevolent leadership and nurses’ work engagement through affective commitment (β = 0.08, p = .007) as well as between benevolent leadership and helping behavior through affective commitment (β = 0.16, p < .001).

Conclusions

This study’s findings emphasize the crucial role of benevolent leadership in fostering nurses’ positive attitudes and behaviors in the workplace. Hospital administrators could promote the benevolent leadership of head nurses to enhance nurses’ affective commitment, work engagement, and helping behaviors.