bluuebunny/crossref_metadata_2025 huggingface dataset:
Validation of The Turkish Version of The Obstetric Quality-of-Recovery Score 11 (ObsQoR-11T) After Cesarean Delivery
Authors: OZKAN Gökhan , KARA Umut , INCE Mehmet Emin , Ozdemir Ozhan , Ulubay Mustafa , SENKAL Serkan
Published: November 2022

Background: To translate and validate the psychometric characteristics of a Turkish version of the Obstetric Quality-of-Recovery score 11 tool used to measure post-cesarean delivery recovery in Turkish-speaking patients.
Methods: After the original English version of the Obstetric Quality-of-Recovery score 11 tool was translated into Turkish, it was psychometrically validated to assess the post-cesarean delivery quality of recovery. Validity, reliability, and feasibility were investigated. The Obstetric Quality-of-Recovery score 11 tool was administered to Turkish-speaking patients on postoperative day 1. On postoperative day 1, a global health visual analog scale was used to assess the patient's perceived global recovery.
Results: One hundred and eighty-six patients completed their questionnaires, providing a completion rate of 97.35%. The Spearman rho (ρ) correlation coefficient between the Obstetric Quality-of-Recovery score and global health visual analog scale (0-100 points) was 0.850 at postoperative day 1 following surgery (P<0.001). Internal consistency, measured using Cronbach’s alpha, was 0.822. The split-half coefficient was 0.708. The Obstetric Quality-of-Recovery score differed significantly between the emergency and elective cesarean delivery groups (74.54±13.25 vs. 82.50±12.75; P<0.05). The test-retest reliability of the Obstetric Quality-of-Recovery score items was more than 0.6 in 82% of cases, indicating good repeatability and reliability.
Conclusion: The Obstetric Quality-of-Recovery score 11 is a valid and reliable tool to measure the post-cesarean quality of recovery in Turkish-speaking patients. The psychometric properties of the Turkish version of the scale to measure the post-cesarean quality of recovery were similar to those of the seminal English version.
Improved DEA model by quantifying the extreme degree of weight schemes
Authors: Wu Meiqin , Chen Ruixin , Fan Jianping
Published: November 2022

Data Envelopment Analysis (DEA) is a kind of nonparametric methodology used to evaluate different DMUs. DEA allows different DMUs to choose a set of weights that can maximize their efficiency score. Unfortunately, the flexibility in choosing weights is not only an advantage but also a source of disadvantages of DEA. To overcome the shortfalls of the traditional DEA model, a new DEA model based on quantifying the extreme degree of weights is proposed in this paper. The new model uses a pair of parameters and a set of inequalities to limit the selection range of weights. In order to get evaluation results independent of parameters, a novel method based on calculating the area under curve is proposed. Furthermore, the reasonableness of the new model is illustrated by comparing the results of a numerical example between the proposed model and the popular models. Finally, some conclusive remarks and suggestions are proposed for future research.
Comparative effectiveness of interventions for managing urological postoperative catheter-related bladder discomfort: a systematic review and network meta-analysis
Authors: Ren Jingwen , Ting YU , Tian Ye , Luo Guangheng
Published: November 2022

Background
Catheter-related bladder discomfort (CRBD) is a common postoperative bladder pain syndrome. Many drugs and interventions for managing CRBD have been studied, but their comparative effectiveness remains controversial. We made a study to assess the comparative effectiveness of interventions included Ketorolac, Lidocaine, Chlorpheniramine, Gabapentin, Magnesium, Nefopam, Oxycodone, Parecoxib, Solifenacin, Tolterodine, Bupivancaine, Dexmedetomidine, Hyoscine N-butyl bromide Ketamine, Penile nerve block on urological postoperative CRBD.
Methods
We performed a network meta-analysis (NMA) via ADDIS software included 18 studies with 1816 patients and assessed the risk of bias by Cochrane Collaboration tool. The incidence of moderate to severe CRBD at 0, 1, and 6 h after surgery and the incidence severe CRBD at 1h after surgery were compared. We ranked these interventions according outcomes.
Result
The number of best rank is 0.48(Nefopam) and 0.22(Nefopam) in the incidence of moderate to severe CRBD at 1h and incidence severe CRBD at 1h. More than half of studies at unclear or high risk of bias.
Conclusion
Nefopam ranked first in reducing incidence and severity of CRBD but with heterogeneity in study settings and outcome measures.
Estimating Medication Adherence from Electronic Health Records: Comparing Methods for Mining and Processing Asthma Treatment Prescriptions
Authors: Tibble Holly , Sheikh Aziz , Tsanas Athanasios
Published: November 2022

Background
Medication adherence is usually defined as the extent of the agreement between the medication regimen agreed to by patients with their healthcare provider and the real-world implementation. Proactive identification of those with poor adherence may be useful to identify those with poor disease control and offers the opportunity for ameliorative action. Adherence can be estimated from Electronic Health Records (EHRs) by comparing medication dispensing records to the prescribed regimen. Several methods have been developed in the literature to infer adherence from EHRs, however there is no clear consensus on what should be considered the gold standard in each use case.
Our objectives were to critically evaluate different measures of medication adherence in a large longitudinal Scottish EHR dataset. We used asthma, a chronic condition with high prevalence and high rates of non-adherence, as a case study.
Methods
Over 1.6 million asthma controllers were prescribed for our cohort of 91,334 individuals, between January 2009 and March 2017. Eight adherence measures were calculated, and different approaches to estimating the amount of medication supply available at any time were compared.
Results
Estimates from different measures of adherence varied substantially. Three of the main drivers of the differences between adherence measures were the expected duration (if taken as in accordance with the dose directions), whether there was overlapping supply between prescriptions, and whether treatment had been discontinued. However, there are also wider, study-related, factors which are crucial to consider when comparing the adherence measures.
Conclusions
We evaluated the limitations of various medication adherence measures, and highlight key considerations about the underlying data, condition, and population to guide researchers choose appropriate adherence measures. This guidance will enable researchers to make more informed decisions about the methodology they employ, ensuring that adherence is captured in the most meaningful way for their particular application needs.
Development and Validation of the Knowledge, Attitude, and Practice Questionnaire for Community Pharmacy Personnel in Tuberculosis Case Detection, Drug Monitoring, and Education
Authors: Kausar Mersa , Fitriana Efi , Khairunnisa Khairunnisa , Bahar Muh. Akbar , Alfian Sofa , pradipta Ivan , Faruque Md. Omar
Published: November 2022

Background
Validated and standardized structured questionnaires based on psychometric analysis are extremely limited, particularly for assessing community pharmacy personnel's knowledge, attitude, and practice (KAP) in tuberculosis (TB) case detection, drug monitoring, and education. We, therefore, developed and validated a questionnaire to assess the KAP of community pharmacy personnel in TB case detection, drug monitoring, and community education.
Methods
This study was conducted in two phases. First, we developed the questionnaire, which included framework development, item generation, item screening, and pre-testing. Second, we validated the questionnaire with 400 participants using various analyses, including participant analysis, individual item content validity index (I-CVI), confirmatory factor analysis (CFA), adjusted goodness-of-fit index (AGFI), comparative fit index (CFI), non-normed fit index (NNFI), root mean square error of approximation (RMSEA), and standardized root mean square residual (SRMR). We determined the reliability test using Cronbach’s alpha and test-retest reliability using Pearson’s correlation.
Results
In the development phase, we defined 63 items that comprised 18 sociodemographic, 18 knowledge, 18 attitude, and 9 practice items. Across the 63 items, the I-CVI scores of sociodemographic and KAP items were one each. The CFA model parameter values were X2 /df= 2.28; AGFI = 0.95; CFI = 0.99; NNFI = 0.98; RMSEA = 0.06; and SRMR = 0.03 (p < 0.05 for all). Cronbach’s alpha coefficients of KAP items were 0.75, 0.91, and 0.95, respectively. The test-retest reliability coefficients of KAP were 0.84, 0.55, and 0.91, respectively (p < 0.01).
Conclusion
This study indicates that the developed questionnaire is a valid and reliable instrument for assessing the KAP of community pharmacy personnel for TB case detection, drug monitoring, and community education. The questionnaire can identify further strategies to engage community pharmacies in TB prevention and care.
An Online Biased Signaling Atlas
Authors: Caroli Jimmy , Mamyrbekov Alibek , Harpsøe Kasper , Gardizi Sahar , Dörries Linda , Ghosh Eshan , Hauser Alexander , Kooistra Albert , Gloriam David
Published: November 2022

Biased signaling is a paradigm in signal transduction whereby hormones, probes, or drugs bind the same receptor but engage different intracellular signaling pathways leading to distinct functional outcomes. Whereas there is a wealth of knowledge of bias signaling, it is scattered throughout literature and the vast majority of signaling pathways still lack a biased tool compound and functional annotation. Here, we provide an online Biased Signaling Atlas (https://BiasedSignalingAtlas.org) letting any researcher swiftly navigate 9,000 ligand bias datapoints and 640 functional/therapeutic annotations of signaling pathways, analyze ligand-bias relationships, download machine learning-ready data, select tool compounds, and calculate consistent bias values. We invite the global community to together advance biased signaling by depositing its data into the shared repository. This provides a common hub for the global research community to jointly explore the principals of signal transduction and to translate mapped molecular mechanisms to design drugs with better efficacy and safety.
In situ synthesis of g-C3N4/TiO2 heterojunction by a concentrated absorption process for efficient photocatalytic degradation of tetracycline hydrochloride
Authors: Bi Renke , Liu Jialong , Zhou Chutong , Shen Yijie , Liu Zhe , Wang Zhiyu
Published: November 2022

A facile and feasible method was innovatively evolved to in-situ prepare g-C3N4/TiO2 heterojunctions through a high concentration absorption process, to satisfy the exigent requirements of an efficient, low-cost and environmental-friendly photocatalyst for massive antibiotic effluent treatment. This synthesis method was much easier and more rapid than the traditional routes, which can be primarily depicted as follows: the nitrogen precursors were uniformly dispersed on the amorphous hydrolysis product of titanium precursors (titanic acid or metatitanic acid) driven by a concentration gradient, and then, affording the heterostructure of granular TiO2 coupled with lamellar g-C3N4 through a calcination process. The effects of the one-step synthesis on the characteristics of g-C3N4/TiO2 nanocomposites were investigated by XRD, HRTEM, XPS, UV-vis DRS and PL, and the results demonstrated that the nanocomposites exhibited a well-defined micromorphology and enhanced photoabsorption capacity. For the degradation of tetracycline hydrochloride, the g-C3N4/TiO2 heterojunction displayed remarkably elevated photocatalytic activity over bare g-C3N4 and commercial TiO2 under simulated sunlight and visible light. The sample with 4 g of urea content was optimal, with photodegradation efficiencies 3.9 and 2 times higher than those of pure g-C3N4 and TiO2 respectively. Besides, photodegradation pathways based on the role of active species •O2− and •OH were identified by the trapping experiments, indicating that the substantial increase in photocatalytic efficiency can be credited to the construction of direct Z-scheme heterojunctions. This work has provided a novel in-situ synthesis approach to the heterostructure, which would open up new horizons for the rational design and the wide-scale application of high-performance photocatalysts for the photodegradation of antibiotic-based pollutants.
Pressure controlled ventilation versus pressure controlled ventilation - volume guaranteed in patients undergoing bariatric surgery: a randomized trial
Authors: Zhou Zhengyu , Wu Pan , Hua Rong , Yu Qiong
Published: November 2022

Background The optimal ventilation mode for patients with obesity undergoing laparoscopic surgery remains unclear. In this prospective randomized controlled study, the effects of two ventilation modes, pressure-controlled ventilation (PCV) and pressure-controlled ventilation - volume guaranteed (PCV-VG), on perioperative oxygenation and respiratory mechanics were compared in patients undergoing laparoscopic bariatric surgey. Methods A total of 110 subjects were randomly divided into PCV-VG group (n = 56) or PCV group (n = 54). The perioperative pulmonary mechanics and arterial blood gas results were compared between the two groups. Postoperative extubation time, the incidences of postoperative pulmonary complications (PPCs) and abnormal radiographic changes (ARCs) were also recorded. Results During intraoperative pneumoperitoneum, the respiratory dynamic compliance (Cdyn) was significantly lower in PCV-VG group than that in PCV group. There were no significant differences in perioperative oxygenation index and respiratory peak pressure (Ppeak) between the two groups. Eighty-six subjects (78.2%) had ARCs on the 1st day after surgery, only ten subjects (9.1%) developed PPCs. There was no significant difference in extubation time, ARCs or PPCs between the two groups. After adjustment, anesthesia duration and oxygenation index before anesthesia induction were significantly associated with extubation time. Anesthesia duration of more than 2 hours was a risk factor for postoperative radiographic abnormalities. Conclusions Compared with PCV-VG mode, PCV mode provides better pulmonary compliance during intraoperative pneumoperitoneum. Further large-sample studies are needed to determine the optimal ventilation mode in subjects with obesity undergoing laparoscopic surgery.
Has land resource misallocation increased air pollution in Chinese cities?
Authors: Xie Wancheng , Gao Wen , Zhang Ming
Published: November 2022

As a fundamental production factor for economic development, rational land allocation is not only relevant to economic development but also an important factor affecting urban air pollution. In this paper, 284 cities in China were selected as samples to analyze the impact of land resource misallocation on air pollution and the underlying mechanisms. The findings are as follows: First, land resources misallocation increases urban air pollution. Second, land resources misallocation inhibits technological innovation, government technology investment and foreign direct investment, thereby increasing local air pollution. Third, the impact of land resources misallocation on air pollution is affected by heterogeneous conditions such as geographic region, city type, and city size. Finally, based on the air pollution caused by land resources misallocation, local governments should not only optimize the land supply structure but also improve the environment for technological innovation and investment.
Persistent organic pollutants in hospitalized individuals in the municipality of Petropolis - Brazil
Authors: de Rezende Louise Moura , Rosa Ana Cristina Simões , Santos Sabrina da Silva , Monteiro Gina Torres Rego
Published: November 2022

Persistent organic pollutants (POPs) are highly lipophilic and can accumulate and biomagnify in food chains. Characterized as a public health problem, exposure to these compounds enables the development of diseases like cancer, cardiovascular disease, diabetes, and obesity. The objective of this study was to estimate the plasma levels of organochlorine pesticides and PCBs in hospitalized individuals in Petropolis, Brazil. Individuals over 18 years of age and residing for at least two years in the mountainous region of the State of Rio de Janeiro, Brazil, participated in a cross-sectional study. Interviews using a structured questionnaire and blood samples to estimate plasma levels of persistent organic pollutants provided data. Gas chromatography coupled with triple quadrupole mass spectrometry provided the levels of organochlorine pesticides and PCBs. Compared to data present in the literature, the concentration of POPs was lower, and individuals from 55 to 64 years of age (3.28 ng mL− 1) and women (2.52 ng mL− 1) presented a higher average concentration of organochlorine pesticides; men (0.05 ng mL− 1) also presented a high concentration of PCBs. This is the first Brazilian study to estimate the concentration of several POPs in a hospital-based sample that includes men and women, thus contributing to the characterization of our population regarding environmental exposures relevant to health.
Ionic Liquids: Environmentally Sustainable Materials for Energy Conversion and Storage Applications
Authors: Choudhary Gaurav , Dhariwal Jyoti , Saha Moumita , Trivedi Shruti , Banjare Manoj K. , Kanaoujiya Rahul , Behera Kamalakanta
Published: November 2022

Ionic liquids (ILs), known as green designer solvents, have shown tremendous application potential in various fields of science and technology. Their unusual and unique physicochemical properties have attracted researchers worldwide from interdisciplinary research areas. ILs possess high boiling point and low volatility, that makes them suitable environmentally benign candidates for many potential applications. The more important aspect associated with ILs is their physicochemical properties can be effectively changed for desired applications just by tuning the structure of the cationic and/or anionic part of ILs. Furthermore, these environmentally benign designer materials can be used as both electrolytes as well as solvents depending on the requirement. Owing to thedistinctive properties such as low volatility, high thermal and electrochemical stability, better ionic conductivity, ILs are nowadays immensely used in variety of energy applications, particularly in the development of green and sustainable energy storage and conversion devices. Suitable ILs are designed for specific purposesto be used as electrolytes and/or solvents for fuel cells, lithium-ion batteries, supercapacitors(SCs) and solar cells. Herein, we have highlighted the utilization of ILs as unique green designer materials in Li-batteries, fuel cells,SCs and solar cells. This review will enlighten the promising prospects of these unique environmentally sustainable materials for next-generation green energy conversion and storage devices.
Prediction and Early Warning Model of Mixed Exposure of Air Pollution and Meteorological Factors on Death of Respiratory Diseases Based on Machine Learning
Authors: Sun Hongying , Chen Siyi , Li Xinyi , Cheng Liping , Luo Yipei , Xie Lingli
Published: November 2022

In recent years, with the repeated occurrence of extreme weather and the continuous increase of air pollution, the incidence of weather-related diseases is increasing year by year. Air pollution and extreme temperature bring serious threats to the lives of sensitive groups, among which air pollution is most closely related to respiratory diseases. Owing to the skewed attention, timely intervention is necessary to better predict and warn the occurrence of death from respiratory diseases.In this paper, according to the existing research, based on a number of environmental monitoring data, the regression model is established by integrating the machine learning methods XGBoost, SVM and GAM model. The distributed lag nonlinear model (DLNM) is used to set the warning threshold to transform the data and establish the warning model. According to the DLNM model, the cumulative lag effect of meteorological factors is explored. There is a cumulative lag effect between air temperature and PM2.5, which reaches the maximum when the lag is 3 days and 5 days respectively. If the low temperature and high environmental pollutants (PM2.5) continue to influence for a long time, the death risk of respiratory diseases will continue to rise, and the early warning model based on DLNM has better performance.
Examination of one-dimensional S-wave velocity structure using strong-motion data for high-seismic-intensity area during 2018 Hokkaido Eastern Iburi earthquake
Authors: Nakagawa Naofumi , Takai Nobuo , Shigefuji Michiko
Published: November 2022

The Yufutsu Plain, a sedimentary basin surrounded by mountains, is located in the southern part of the Ishikari-Yufutsu Lowlands, Hokkaido, Japan. The Hidaka arc-arc collision zone, located in the eastern part of the Yufutsu Plain, forms the Hidaka Mountain range in central Hokkaido, with the Ishikari-Teichi-Toen Fault Zone of the Ishikari-Yufutsu Lowlands on the west side, which forms part of a major geological boundary that extends in the north-south direction. The 2018 Hokkaido Eastern Iburi earthquake (Mw 6.6) occurred at 03:08 JST on September 6, 2018, in this arc-arc collision zone. The K-NET HKD126 station in Mukawa Town, which is close to the severely damaged basin margin area, recorded strong-motion data with strong power for a period of 1–2 s during the main shock. The site amplification characteristics of the shallow S-wave velocity structure, which was estimated from microtremor array observations and surface wave explorations, were one of the causes of this strong ground motion. It is essential to accurately estimate the depth of the seismic bedrock and basin margin to evaluate the long period of large earthquakes. In this study, we used strong-motion data recorded at HKD126 and three temporary strong-motion stations near the basin margin area to tune the deep S-wave velocity structure. First, we performed microtremor array observations and surface wave explorations to estimate the S-wave velocity structure to a depth of 1 km beneath the station at the hill site because a detailed shallow structure is not available for this site. Then, with a combination of the estimated S-wave velocity structure and the existing structure, we tuned the deep structures based on an autocorrelation function analysis using strong-motion data. The validity of the estimated structures from the shallowest depth to the seismic bedrock was verified based on the observed arrival time and theoretical travel time differences for the S-wave initial motion. We estimated the seismic bedrock of the four stations to be at a depth of 7–10 km. In addition, an autocorrelation function analysis suggests topological basement irregularity.
Effects and mechanism of Kudingcha on obesity
Authors: Sui Xiaohui , Liu Jia , Gong Li , Zhang Lei
Published: November 2022

Obesity is the world's most high-profile public health problem. Kudingcha has been used in traditional medicine because of its antioxidant, anti-inflammatory and weight loss properties. Quercetin and kaempferol are the main components rich in Kudingcha that are effective against obesity. Therefore, we used the method of network pharmacology to study the effects of quercetin and kaempferol to HepG2 cells on obesity. We obtained 20 hub genes through PPI results and the Cytoscape plug-in cytoHubba. The top 10 genes were found eventrully by GO and KEGG enrichment analysis. The results showed that the insulin resistance, PI3K-Akt signaling pathways and adipocytokine signaling pathway might be the central pathways associated with the treatment of obesity by kudingcha. Next, we used Real-Time PCR to detect the expression levels of ISNR, SLc2a4 and APOE genes to study its mechanism. The results showed that compared with the blank group, the expression of ISNR and SLc2a4 increased and the expression of APOE decreased. Our experiments confirmed that Kudingcha contains compounds that can improve insulin resistance and obesity. This can provide a reference for further research and application of Kudingcha in the treatment of obesity.
On potential challenges of V2X sidelink relaying: Link-level and system-level simulation with neural network assisted
Authors: Zhao Chonghao , Wu Gang
Published: November 2022

The ever-increasing demand for high data rates and high connection densities in the vehicle communication network, along with the widespread adoption of radio access over the Third Generation Partnership Project (3GPP) standard, has been a major driver of a large amount of research on cellular vehicle-to-everything (C-V2X) communication. Additionally, Wi-Fi and other wireless communication technology work on the unlicensed band has undergone booming development due to the proliferation of handheld devices over the years. It is, therefore, likely that C-V2X users dedicated band on the 5.9 GHz spectrum may suffer from both co-channel and adjacent channel interference, which cannot be negligible, especially in urban scenarios. To this end, 3GPP has standardized relay technology in New Radio (NR) V2X sidelink to confront such engineering concerns. Placing relay nodes on vehicles is a promising approach to save power and energy, as well as extend the transmission range under interference. In this paper, through a link-level and system-level simulation study, we implement parameter optimization and performance evaluation in relaying scenarios. Motivated by the recent success of deep learning, a novel neural network is further introduced to detect and classify interference signals of different protocols so that the sidelink transceiver can adopt specific schemes to mitigate interference respectively. Simulation results provide direct insight into the system performance in relay-assisted cases and reveal that the interference incurred by NR on unlicensed spectrum (NR-U) signal is the most intractable which may bring potential challenges in future works.
In vitro effects of the combination of serotonin, selenium, zinc, vitamin D and E supplementation on human sperm motility
Authors: Yılmazer Yasemin , Moshfeghi Elnaz , Cetin Fadime , Findikli Necati
Published: November 2022

Background Infertility affects 15% of all couples worldwide. According to recent research, 50% of cases of infertility are solely due to male factors. A decrease in motility is directly related to infertility. The purpose of this study was to see how sperm motility was affected by the combination of serotonin (5-HT), selenium (Se), zinc (Zn), vitamin D, and vitamin E supplementation. Methods and results Semen samples were incubated for 75 minutes at 37°C in media containing varying concentrations of 5-HT, Se, Zn, vitamin D, and E. Sperm concentration and motility were assessed at the end of the incubation. Calculations were made for each supplement to determine the proportions of fast progressive (+ 4), slow progressive (+ 3), non-progressive (+ 2), and immotile (+ 1) sperm cells. There was a significant improvement in fast progressive motility when compared to the control groups. 5-HT (200 µM), Se (2 µg), Zn (10 µg), vitamin D (100 nM), and vitamin E (2 mmol) concentrations have also been shown to increase fast progressive sperm motility. Three different mixtures were tested for their effects on sperm motility, and the one with the highest serotonin content was also found to have higher sperm motility than the others. While the mean + 4 sperm motility in the control group was 5.26%, it increased to 16.45% in the first mixture. Conclusion Sperm motility is improved by incubating with 5-HT, Se, Zn, Vitamin D, and E. These molecules may enhance the success of assisted reproduction techniques when present in sperm preparation media.
A Discrete Choice Experiment to Elicit Preferences for a Liver Screening Programme in Queensland, Australia: A Mixed Methods Study to Select Attributes and Levels
Authors: Allen Michelle , Doran Rachael , Brain David , Powell Elizabeth E , O’Beirne James , Valery Patricia C , Barnett Adrian , Hettiarachchi Ruvini , Hickman Ingrid J , Kularatna Sanjeewa
Published: November 2022

Background
In Australia, the overall prevalence of liver disease is increasing. Maximising uptake of community screening programmes by understanding patient preferences is integral to developing consumer-centred care models for liver disease. Discrete choice experiments (DCEs) are widely used to elicit preferences for various healthcare services. Attribute development is a vital component of a well-designed DCE and should be described in sufficient detail for others to assess the validity of outcomes. Hence, this study aimed to create a list of potential attributes and levels which can be used in a DCE study to elicit preferences for chronic liver disease screening programmes.
Methods
Key attributes were developed through a multi-stage, mixed methods design. Focus groups were held with consumers and health care providers on attributes of community screening programmes for liver disease. Stakeholders then prioritised attributes generated from the focus group in order of importance via an online prioritisation survey. The outcomes of the prioritisation exercise were then reviewed and refined by an expert panel to ensure clinically meaningful levels and relevance for a DCE survey.
Results
Fifteen attributes were generated during the focus group sessions deemed necessary to design liver disease screening services. Outcomes of the prioritisation exercise and expert panel stages recognised five attributes, with three levels each, for inclusion in a DCE survey to elicit consumer preferences for community screening for liver disease. This study also highlights broader social issues such as the stigma around liver disease that require careful consideration by policy makers when designing or implementing a liver screening programme.
Conclusions
The attributes and levels identified will inform future DCE surveys to understand consumer preferences for community screening programmes for liver disease. In addition, the outcomes will help inform the implementation of the LOCATE-NAFLD programme in real-world practice, and could be relevant for other liver and non-liver related chronic disease screening programmes.
A ResNet-LSTM Hybrid Model for Predicting Epileptic Seizures using a Pretrained Model with Supervised Contrastive Learning
Authors: LEE DOHYUN , KIM BYUNGHYUN , MIN KYEONGYUK , CHONG JONGWHA , KIM TAEJOON , JUNG KIYOUNG , JOE INWHEE
Published: November 2022

In this paper, we propose a method for predicting epileptic seizures using a pre-trained model utilizing supervised contrastive learning and a hybrid model combining Residual Networks (ResNet) and Long Short-Term Memory (LSTM). The proposed training method includes three phases: pre-processing, pre-training as a pretext task, and training as a downstream task. In the pre-processing phase, Short Time Fourier Transform (STFT) was used to convert the data into a spectrogram image with time and frequency information to compensate for the complexity and irregularity of the Electroencephalography (EEG) data, which made data analysis difficult. In the pre-training phase, band-stop filter and temporal cutout were applied to the original data to create augmented data, which were then pre-trained with a ResNet and supervised contrastive loss model to train the representation of the spectrogram image. During the training phase, image features and time information were extracted from a hybrid model consisting of ResNet initialized as weight values of a pre-trained model and LSTM. CHB-MIT and Seoul National University Hospital (SNUH) were used to validate the proposed method, and generalization performance was confirmed using Leave-one-out cross-validation. From the experimental results measuring accuracy, sensitivity, and False Positive Rate (FPR), CHB-MIT was 91.90%, 89.64%, 0.058 and SNUH was 83.37%, 79.89%, and 0.131. The experimental results demonstrate that the proposed method outperforms the conventional methods.
Effect of levothyroxine on gestational hypertension and pre-eclampsia in subclinical hypothyroidism, hypothyroidism, and thyroid autoimmunity: a systematic review and meta-analysis
Authors: Goodarzi-Khoigani Masoomeh , Aminorroaya Ashraf , Mohammadi Raziyeh
Published: November 2022

Background We assessed the effect of levothyroxine (LT4) therapy on gestational hypertension (GH) and preeclampsia (PE) in subclinical hypothyroidism (SCH), overt hypothyroidism (OH), or thyroperoxidase antibody (TPOAb) positivity. Methods Scopus, Medline, Science Direct, ProQuest, Google Scholar, and Cochrane library were scientifically searched for randomized controlled trials (RCTs), cohorts, and case-control studies assessing the effect of levothyroxine on incidences of GH or/and PE compared to control or placebo up to November 2022. Results After LT4 therapy in women with SCH, the ORs of GH and PE were not significantly different from compared groups; also, in OH, and studies recruited both SCH or OH subjects. LT4 reduced GH in TPOAb + women compared with a non-treated group, while after treatment in TPOAb + versus TPOAb- women, the ORs of GH and PE did not change significantly. Conclusion After LT4 therapy, the ORs of GH and PE did not significantly change in SCH, OH, SCH or OH participants compared to controls; also, in TPOAb + compared to TPOAb- equivalents. Reduction of GH in treated TPOAb + versus non-treated TPOAb + women refers to the importance of TPOAb determination. Insignificant changes of both ORs in treated SCH compared to untreated indicates whether SCH increases the incidence of GH and PE.
Influence of Joint Volume on Range of Motion after Arthroscopic Rotator Cuff Repair
Authors: Kim Jung-Han , Min Young-Kyoung , Kim Dae-Yoo , Park Jun-Ho , Seo Young-Chae , Seo Won-Seok
Published: November 2022

Background: Capsular contracture is a well-known etiology in the primary stiff shoulder; thus capsular contracture and resultant decreased joint volume could lead to postoperative stiffness, which is a commonly reported morbidity after arthroscopic rotator cuff repair (ARCR). The purpose of this study was (1) to quantify the joint volume (total joint volume and each half compartmental volume) using computed tomography arthrography (CTA) and (2) to demonstrate the relationship between joint volume and postoperative range of motion (ROM) after ARCR
Materials and Methods: Eighty-three patients (60 ± 5.11 years, men=26, women=57) who had undergone ARCR between January 2015 to December 2020 due to small to medium full-thickness tear and followed by CTA 6 months postoperatively were retrospectively reviewed. An image reconstruction program (3D Slicer, version 4.11.2 software) was used to calculate the joint volume (total joint volume and four half compartment joint volumes; anterior, posterior, superior, and inferior). For shoulder ROM, data including scaption (Sc), external rotation on side (ERs), external rotation at 90° (ER90), and internal rotation on back (IRb) were collected 6 months postoperatively. An evaluation of the correlation between joint volume and each shoulder motion was performed.
Results: There were moderate correlations between the total joint volume and each motion (Sc: Pearson coefficient, 0.32, p=0.0047; ERs: Pearson coefficient, 0.24, p=0.0296; ER90: Pearson coefficient, 0.33, p=0.0023; IRb: Pearson coefficient, 0.23, p=0.0336). Among the half compartments, the posterior half (Sc: Pearson coefficient, 0.34, p=0.0016; ERs: Pearson coefficient, 0.21, p=0.0493; ER90: Pearson coefficient, 0.37, p=0.0006; IRb: Pearson coefficient, 0.25,p=0.0217) and inferior half (Sc: Pearson coefficient, 0.31, p=0.0038; ERs: Pearson coefficient, 0.21, p=0.0483; ER90: Pearson coefficient, 0.31, p=0.0047; IRb: Pearson coefficient, 0.25, p=0.0254) showed moderate correlations with each shoulder motion.
Conclusion: Total joint volume, posterior half compartment joint volume, and inferior half compartment joint volume were related to postoperative ROM after ARCR. Perioperative methods to increase the joint volume, especially the posterior part and inferior part of the capsule may prevent postoperative stiffness after ARCR.
Level of Evidence: Level III; Retrospective Case-Control Study
Successful surgical treatment of post-myomectomy uterine diverticulum: A case report
Authors: Kawatake Rina , Maebayashi Aki , Nishimaki Haruna , Nagaishi Masaji , Kawana Kei
Published: November 2022

Background: Uterine diverticulum is classified into congenital and acquired types. The acquired type is caused by caesarean scar syndrome, which occurs after caesarean section. There are no detailed reports on diverticulum after enucleation of uterine fibroids. Most cases are treated with hysteroscopy or laparoscopy, but a management consensus is lacking. We managed a patient with a uterine diverticulum, which had formed after uterine myoma enucleation, by combining hysteroscopic and laparoscopic treatments.
Case presentation: The patient was a 37-year-old Japanese woman, G1P0. A previous doctor had performed abdominal uterine myomectomy for a pedunculated subserosal uterine myoma on the right side of the posterior wall of the uterus near the internal cervical os. Menstruation had resumed postoperatively, but a small amount of dark-red bleeding persisted. MRI two months after the myomectomy revealed a diverticulum-like structure 3 cm in diameter, communicating with the uterine lumen, on the right side of the posterior wall of the uterus. Under suspicion of uterine diverticulum after uterine myoma enucleation, the patient sought treatment at our hospital approximately four months after the myomectomy. Through a flexible hysteroscope, a hole was observed, hysterosalpingography showed a fistula opening slightly above the internal cervical os in the posterior wall of the uterus and a contrast-enhanced pocket, measuring approximately 3 cm, in front of it. Uterine diverticulum following enucleation of a uterine myoma was diagnosed, and surgery was thus deemed to be necessary. The portion entering the fistula on the external cervical os side was resected employing a hysteroscope. Intra-abdominal findings included a 4-cm mass lesion on the posterior wall on the right side of the uterus. The mass was opened, and the cyst capsule was removed. A 5-mm fistula was detected and was closed with sutures. Re-suturing was not performed after dissection of the right round ligament, due to tension. The postoperative course has been good, to date, with no recurrence.
Conclusion: Even after myomectomy, the occurrence site may develop a pathological condition similar to caesarean scar syndrome. Such lesions can be treated by incorporating a method similar to the that used for caesarean scar syndrome.
Analysis of the sources of inequalities in pregnant women's access to essential medicines in Cameroon: A decomposition approach
Authors: Anya Saturnin Bertrand Nguenda , Nchintouo Yousofou Ndayou , Nzepang Fabrice
Published: November 2022

This article aims to identify the sources of inequalities in pregnant women's access to essential medicines in Cameroon. We mobilize data from the fifth Cameroon Demographic and Health Survey (CDHS) (2018), conducted by the National Institute of Statistics (INS). After measuring the degree of inequality through the concentration index, we used the decomposition method of Wagstaff et al. (2003). The results show that the CI calculations by groups of individuals reveal the existence of important determinants of inequality in access to essential medicines to the disadvantage of pregnant women in poor households and contribute to shares that vary between 24.25% and 69.57%. The factors that contribute most to reducing these inequalities are the level of education, insurance coverage and marital status of pregnant women at 69.57%, 56.81% and 22.33% respectively. In other words, if wealth had been distributed equally, inequalities in pregnant women's access to essential medicines would remain largely due to inequalities related to education, insurance uptake and marital status of pregnant women.
The value of Clinical-and DWI-based Radiomics Nomogram to predict Pathologic Upgrading in Biopsy-Proven Endometrial Cancer
Authors: Yue Xiaoning , Wu Jingjing , Wang Chengwei , He XiaoYu
Published: November 2022

Background: It is important for biopsy formal endometrial cancer patients, especially young patients of childbearing age to determine the preservation of fertility and predict pathological escalation.
Purpose: This study's goal was to determine the viability and effectiveness of a non-invasive quantitative imaging evaluation model built using the Diffusion Weighted Image (DWI) technique and based on Radiomics signatures and clinical parameters Analysis to evaluate Endometrial Cancer (EC) with Biopsy-Proven Pathologic Upgrading.
Method: From January 2018 to December 2021, a total of 76 patients with endometrial cancer who had undergone surgery for the disease were retrospectively recruited (training cohort, n = 53; validation cohort, n = 23). The diffusion-weighted image (DWI) served as the source for the Radiomics features. All images were imported into 3D-slicer for whole tumor Segmentation and were used for radiomics feature extraction. Radiomic features were selected in target tumor volumes to build Radscore using the least absolute shrinkage and selection operator (LASSO) and Cox regression analysis Logistic regression, Next building a combined model incorporating rad-scores and clinical risk factors, compared with Radscore model, the clinical model. The models were evaluated by the receiver operating characteristic curve, and calibration curve as well as verified the model in the verification group.
Results: AUC for identifying non-pathologic upgrading and pathologic upgrading in the training cohort was 0.606 and in the validation cohort was 0.708, Three of the 107 texture feature were retrieved and 3 parameters were preserved to create the Radscore. With the incorporation of clinical risk factors, the nomogram's AUC for the training and validation cohorts were 0.870 and 0.808, respectively. Both values were significantly higher than the AUC of the clinical model in these cohorts (0.830 and 0.815). The nomogram's training cohort and validation cohort's sensitivity and specificity were 0.938, 0.730, 0.900, and 0.769, respectively. The calibration curves for the nomogram had a good agreement.
Conclusions: The Nomogram based on the Radiomics-clinical model in predicting Pathologic Upgrading in Biopsy-Proven Endometrial Cancer with high discriminatory ability.
Factors Influencing the Wearing of Masks Among the Elderly During COVID-19 and Their Root Causes in Remote Rural China: A Qualitative Study
Authors: Liu Yunlai , Huang Chunyan
Published: November 2022

During the COVID-19 pandemic, the criticism of the elderly not wearing masks on Chinese social media has continued to this day, but the research on how to understand the elderly group's use of masks and the factors that affect the response to the epidemic is indeed lacking. This study aimed to address this topic, evaluate the factors that affect the mask-wearing behavior of the elderly in rural areas in the context of the epidemic, and dig out the root causes of these influencing factors from a social structural perspective. Through participant observation and semi-structured interviews with 15 elderly people in a remote village in central China, it was found that factors such as access to epidemic information, perceptions of masks, physical, illnesses and labor habits, and intergenerational social interactions are the main factors affecting the elderly. The key to judging the risk of the epidemic and whether to wear a mask is a significant disconnect from the symbolic meaning of politicizing, moralizing and legalizing masks in China's epidemic prevention and control. The root cause lies in the asymmetry of information channels between the elderly farmers and urban residents who are at the edge of the epidemic prevention and control system, the lack of shared code about the epidemic between the younger generation and the elderly in rural areas, and the dominant prevention and control policies and public health concepts ignore the underlying logic of the rural elderly. Together, they lead to the persistence of dynamic conflicts between the elderly and prevention measures. The analysis of such factors and structural contradictions reminds policymakers and mainstream society to be more tolerant of the rural elderly and take differentiated measures to care for and protect their health.
Promotion of Physical Activity-Related Health Competence and the Influence on Leisure-Time Physical Activity and Health-Related Quality of Life in Office Workers
Authors: Blaschke Simon , Carl Johannes , Pelster Klaus , Mess Filip
Published: November 2022

Background:Office workers (OWs) are at risk of low levels of health-enhancing physical activity (HEPA) and impaired health-related quality of life (HRQOL). Interventions based on physical activity-related health competence (PAHCO) aim to facilitate long-term changes in HEPA and HRQOL. However, these assumptions rely on the changeability and temporal stability of PAHCO and have not been tested empirically. This study therefore aims to test the changeability and temporal stability of PAHCO in OWs within an interventional design and to examine the effect of PAHCO on leisure-time PA and HRQOL.
Methods: 328 OWs (34% female, 50.4 ± 6.4 years) completed an in-person, three-week workplace health promotion program (WHPP) focusing on PAHCO and HEPA. The primary outcome of PAHCO as well as the secondary outcomes of leisure-time PA and HRQOL were examined at four measurement points over the course of 18 months in a pre-post design.
Results: PAHCO displayed a substantial increase from the baseline to the time point after completion of the WHPP (β = 0.44, p < 0.001). Furthermore, there was no decrease in PAHCO at the first (p = 0.14) and the second follow-up measurement (p= 0.56) compared with the level at the end of the WHPP. In addition, the PAHCO subscale of PA-specific self-regulation (PASR) had a small to moderate, positive effect on leisure-time PA (β = 0.18, p < 0.001) and HRQOL (β = 0.26, p < 0.001). The subscale of control competence for physical training (CCPT) also had a positive small to moderate effect on HRQOL (β = 0.22, p < 0.001).
Conclusion: The results substantiate PAHCO’s theoretical characteristics of changeability and temporal stability, and underline the theoretically postulated effects on leisure-time PA and HRQOL. These findings highlight the potential of PAHCO for intervention development, which can be assumed to foster long-term improvements in HEPA and HRQOL in OWs.
Trial Registration: The study was retrospectively registered in the German Clinical Trials Register, which is an approved Primary Register in the WHO network, at the 14/10/2022 (DRKS00030514).