bluuebunny/crossref_metadata_2025 huggingface dataset:
A Best Linear Empirical Bayes Method for High-Dimensional Covariance Matrix Estimation
Authors: Yuan Jin , Yuan Xianghui
Published: June 2023

Covariance matrix estimation plays a significant role in both in the theory and practice of portfolio analysis and risk management. This paper deals with the available data prior to developing a factor model to enhance covariance matrix estimation. Our work has two main outcomes. First, for a general linear model with unknown prior parameters, a class of best linear empirical Bayes estimators is established through two kinds of architectures to improve the estimation accuracy by utilizing additional data prior. The theoretical results indicate two key points: the proposed estimators are equivalent to the linear minimum mean-square error estimator when complete or sufficient partial data prior are provided; and the proposed estimators perform better than the optimal weighted least squares method, which ignores the data prior in each situation. Second, the proposed estimators are used for calculating a high-dimensional covariance matrix through factor models. The numerical example and the simulation results verify the effectiveness of our methods.
Transport-Environmental Kuznets Curve Hypothesis: Evidence From Belt and Road
Authors: Zhang Liguo , Jiang Cuiting , Cai Xiang , Huang Xin , Wu Jun , Chen Ping
Published: June 2023

The conundrum of how to balance economic growth with transportation carbon abatement has never been more vital for the Belt and Road countries. This study analyzes the Transport-Environmental Kuznets Curve nexus and explores the heterogeneity using fixed-effect estimation and panel data from 1981 to 2020 in 64 Belt and Road countries. The findings indicate that there is an N-shaped nexus between transport carbon emissions and economic growth. The environmental rebound effects in some Belt and Road countries are solidified from different perspectives and show a diamond-shaped lock-in feature. Moreover, most Belt and Road countries are still in the “climbing” stage and are struggling to reconcile economic growth with reducing transport carbon emissions. These conclusions have constructive policy implications for the Belt and Road countries at the various stages of “climbing,”“nearing or crossing the top,”“heading downhill,” and “rebounding” to advance the green transportation transformation strategy.
Separation Operation Followed by Stereotactic Radiotherapy in the Treatment of Spinal Metastasis From Hepatocellular Carcinoma: A Retrospective Cohort Study
Authors: Liu Bin , Chen Haoliang , Liu Xiangyang , Wang Guoping , Shen Xiongjie
Published: June 2023

Study Design

Retrospective cohort study.

Objective

Spinal metastasis from hepatocellular carcinoma is rapidly progressive and predisposes to spinal disability, cord compression and further neural injury, leading to poor prognosis. Currently, it is still challenging to look for a treatment strategy that can improve the quality of life of patients and even directly prolong the survival time. This study attempts to evaluate the clinical efficacy of separation operation combined with postoperative stereotactic radiotherapy (SRT/SRS) in the treatment of hepatocellular carcinoma patients developing spinal metastasis and epidural spinal cord compression.

Methods

Patients with metastases spinal cord compression from hepatocellular carcinoma were studied retrospectively and divided into two groups, the SO group (who undergo separation operations combined with postoperative SRS, n = 32) and RT group (who received only SRS, n = 28). The visual Analogue Scale (VAS) pain score, Frankel grade, Karnofsky performance score, and Quality of Life (SF-36) score were comparatively analyzed between the two groups.

Results

Significantly higher VAS pain scores, Frankel grades, Karnofsky performance scores and Quality of Life (SF-36) scores were demonstrated in patients with combination treatment than in patients with SRS alone.

Conclusion

Separation operations are effective surgical procedure for the treatment of spinal metastatic tumor from hepatocellular carcinoma with spinal cord compression. The combination with postoperative SRS can significantly improve the quality of life in this patient population via spinal canal decompression and spinal stability reconstruction.
Asymmetric two-dimensional ferroelectric transistor with anti-ambipolar transport characteristics
Authors: Zhao Yilin , Chi Mengshuang , Liu Jitao , Zhai Junyi
Published: June 2023

Two-dimensional (2D) ferroelectric transistors hold unique properties and positions, especially talking about low-power memories, in-memory computing, and multifunctional logic devices. To achieve better functions, appropriate design of new device structures and material combinations is necessary. We present an asymmetric 2D heterostructure integrating MoTe2, h-BN, and CuInP2S6 as a ferroelectric transistor, which exhibits an unusual property of anti-ambipolar transport characteristic under both positive and negative drain biases. Our results demonstrate that the anti-ambipolar behavior can be modulated by external electric field, achieving a peak-to-valley ratio up to 103. We also provide a comprehensive explanation for the occurrence and modulation of the anti-ambipolar peak based on a model describing linked lateral-and-vertical charge behaviors. Our findings provide insights for designing and constructing anti-ambipolar transistors and other 2D devices with significant potential for future applications.
Barriers and facilitators to participation in exercise prehabilitation before cancer surgery for older adults with frailty: a qualitative study
Authors: Barnes Keely , Hladkowicz Emily , Dorrance Kristin , Bryson Gregory L. , Forster Alan J. , Gagné Sylvain , Huang Allen , Lalu Manoj M. , Lavallée Luke T. , Saunders Chelsey , Moloo Hussein , Nantel Julie , Power Barbara , Scheede-Bergdahl Celena , Taljaard Monica , van Walraven Carl , McCartney Colin J. L. , McIsaac Daniel I.
Published: June 2023

Background

Older adults with frailty are at an increased risk of adverse outcomes after surgery. Exercise before surgery (exercise prehabilitation) may reduce adverse events and improve recovery after surgery. However, adherence with exercise therapy is often low, especially in older populations. The purpose of this study was to qualitatively assess the barriers and facilitators to participating in exercise prehabilitation from the perspective of older people with frailty participating in the intervention arm of a randomized trial.

Methods

This was a research ethics approved, nested descriptive qualitative study within a randomized controlled trial of home-based exercise prehabilitation vs. standard care with older patients (≥ 60 years) having elective cancer surgery, and who were living with frailty (Clinical Frailty Scale ≥ 4). The intervention was a home-based prehabilitation program for at least 3 weeks before surgery that involved aerobic activity, strength and stretching, and nutritional advice. After completing the prehabilitation program, participants were asked to partake in a semi-structured interview informed by the Theoretical Domains Framework (TDF). Qualitative analysis was guided by the TDF.

Results

Fifteen qualitative interviews were completed. Facilitators included: 1) the program being manageable and suitable to older adults with frailty, 2) adequate resources to support engagement, 3) support from others, 4) a sense of control, intrinsic value, noticing progress and improving health outcomes and 5) the program was enjoyable and facilitated by previous experience. Barriers included: 1) pre-existing conditions, fatigue and baseline fitness, 2) weather, and 3) guilt and frustration when unable to exercise. A need for individualization and variety was offered as a suggestion by participants and was therefore described as both a barrier and facilitator.

Conclusions

Home-based exercise prehabilitation is feasible and acceptable to older people with frailty preparing for cancer surgery. Participants identified that a home-based program was manageable, easy to follow with helpful resources, included valuable support from the research team, and they reported self-perceived health benefits and a sense of control over their health. Future studies and implementation should consider increased personalization based on health and fitness, psychosocial support and modifications to aerobic exercises in response to adverse weather conditions.
The perks of doing housework: Longitudinal associations with survival and underlying mechanisms
Authors: Chu Li , Gong Xianmin , Lay Jennifer C. , Zhang Fan , Fung Helene H. , Kwok Timothy
Published: June 2023

Background

Although the majority of existing literature has suggested positive effects of housework on older adults’ health and survival rate, the underlying mechanisms of such effects remain unclear. To address potential mechanisms, the present study examined the association between older adults’ housework engagement and days of survival across 14 years and tested three potential mediation pathways in this association.

Methods

Four thousand Hong Kong older adults (50% female; aged between 65 and 98 years) participated in a longitudinal study in which they reported initial housework engagement and health status across three domains (cognitive functioning, physical health, and mental health) at the baseline, and the numbers of days they survived over the subsequent 14-year period were recorded. Linear regression, Cox proportional hazard, and parallel mediation analyses were performed to examine the relationship between housework engagement and days survived, and the mediating effects of these three health factors.

Results

The results showed a positive association between housework engagement and days survived after controlling for demographic variables (age, sex, education, marital status, subjective social status, and living alone). Physical health and mental health, but not cognitive functioning, partially mediated the relationship between housework engagement and days survived. The findings suggest that doing housework may contribute to longer survival by improving older adults’ physical and mental health.

Conclusion

The current study confirms positive relations of housework with health and mortality among Hong Kong older adults. As the first study examining the relationships and mediation pathways between doing housework and survival in later life, the findings advance our understanding of the mechanisms underlying the positive association between housework and mortality and provide insights for future daily-life health-promotion interventions for older adults.
Development of toileting behaviour evaluation for Japanese older patients using wheelchairs in a hospital setting: a validation study
Authors: Higashi Yasuhiro , Kaneda Toshikatsu , Yuri Yoshimi , Horimoto Takumi , Somei Yuta , Hirayama Kimiaki
Published: June 2023

Background

Ageing limits the activities of daily living (ADLs). Among ADLs, a lack of toileting independence causes a decline in the quality of life, mental health, and social participation. Therefore, occupational therapists spend considerable time assessing toileting disability based on various assessment methods for toileting behaviour. However, these assessment methods have issues with the grading levels, number of items, and diseases covered, and they fail to evaluate toileting behaviour accurately and sensitively. Hence, this study developed a Toileting Behaviour Evaluation (TBE) on a 6-point ordinal scale for patients using wheelchairs, with 22 activity components for various diseases.

Methods

This study examined the reliability and validity of the TBE in acute and subacute hospitals in Japan. To this end, two occupational therapists assessed 50 patients for inter-rater reliability at different times and one assessed them twice within 7–10 days for intra-rater reliability using the TBE. Furthermore, occupational therapists assessed 100 patients for internal consistency using the TBE and for concurrent validity using the TBE and Functional Independence Measure (FIM). The patients had been diagnosed with various diseases. This study used the weighted kappa coefficient for statistical analysis of the inter-rater and intra-rater reliability, Cronbach’s alpha coefficient for internal consistency, and Spearman’s rank correlation coefficient for concurrent validity. We performed all statistical analyses using the IBM SPSS Statistics ver. 25 for Windows. All P-values < 0.05 were considered statistically significant.

Results

The minimum weighted kappa coefficients for the inter-rater and intra-rater reliability for each item were 0.67 and 0.79, respectively. Cronbach’s alpha was 0.98 for the 22 items. The Spearman’s rank correlation coefficient between the mean scores on the TBE and FIM for toilet-related items was 0.74 (P < .01).

Conclusions

The TBE demonstrated good reliability and validity. This means that therapists can use it to identify impaired toileting behaviour. However, the relationship between impairments and each item of toileting behaviour should be explored in future studies. Additionally, studies should examine the creation of a specific index of functions of independence in each toileting behaviour.
Effects of Tai Chi and Qigong on cognitive and physical functions in older adults: systematic review, meta-analysis, and meta-regression of randomized clinical trials
Authors: Park Moonkyoung , Song Rhayun , Ju Kyoungok , Shin Jacqueline C. , Seo Jisu , Fan Xing , Gao Xianqi , Ryu Ahyun , Li Yuelin
Published: June 2023

Background

Older adults experience age-related declines in physical and cognitive functions due to interactions between aging and chronic diseases. Tai Chi and Qigong (TCQ) might be beneficial in improving the physical function and delaying the cognitive decline of this population. The potential underlying mechanism was explored to determine the effects of TCQ on cognitive function via direct or indirect pathways.

Purpose

The objective of this systematic review was to determine the effects of TCQ on cognitive and physical functions in older adults using meta-analysis, and to determine the impact of TCQ on cognitive function while controlling for physical function using a meta-regression approach.

Methods

A systematic search of 13 electronic databases (in English, Korean, and Chinese languages) identified 10,292 potentially eligible studies published between inception and May 2022. The bias in individual studies was assessed using the Cochrane Risk of Bias (version 2.0) tool. The heterogeneity of the studies was evaluated using a 95% prediction interval, and the meta-analysis and meta-regression were implemented using the Comprehensive Meta-Analysis (version 3) software.

Results

Our search identified 17 randomized studies (n = 2,365, mean age = 70.3 years). The results of the meta-analysis that used a random-effects model indicated that TCQ had significant effects on both cognitive (Hedges' g = 0.29, 95% confidence interval [CI] = 0.17 to 0.42) and physical (Hedges' g = 0.32, 95% CI = 0.19 to 0.44) functions. We used meta-regression to explore the effect size of TCQ in association with physical function level. The regression model was significant (Q = 25.01,p = .070), and 55% of the heterogeneity was explained by physical function as a moderator variable. The effects of TCQ on cognitive function remained significant in this model when controlling for the effect of physical function (β = 0.46,p = .011).

Conclusion

This meta-regression of 17 randomized studies strongly suggests that TCQ has beneficial effects on physical and cognitive functions in older adults. The effect of TCQ on cognitive function remained significant after taking into account the significant effects of physical function as a moderator. The findings imply the potential health benefits of TCQ by promoting cognitive function in older adults directly and indirectly through enhancing physical function.

PROSPERO registration number

*PROSPERO international prospective register of systematic reviews, registration ID CRD42023394358.
Association between ambient air pollutants and upper respiratory tract infection and pneumonia disease burden in Thailand from 2000 to 2022: a high frequency ecological analysis
Authors: Choo Esther Li Wen , Janhavi A. , Koo Joel Ruihan , Yim Steve H. L. , Dickens Borame L , Lim Jue Tao
Published: June 2023

Background

A pertinent risk factor of upper respiratory tract infections (URTIs) and pneumonia is the exposure to major ambient air pollutants, with short term exposures to different air pollutants being shown to exacerbate several respiratory conditions.

Methods

Here, using disease surveillance data comprising of reported disease case counts at the province level, high frequency ambient air pollutant and climate data in Thailand, we delineated the association between ambient air pollution and URTI/Pneumonia burden in Thailand from 2000 – 2022. We developed mixed-data sampling methods and estimation strategies to account for the high frequency nature of ambient air pollutant concentration data. This was used to evaluate the effects past concentrations of fine particulate matter (PM2.5), sulphur dioxide (SO2), and carbon monoxide (CO) and the number of disease case count, after controlling for the confounding meteorological and disease factors.

Results

Across provinces, we found that past increases in CO, SO2, and PM2.5 concentration were associated to changes in URTI and pneumonia case counts, but the direction of their association mixed. The contributive burden of past ambient air pollutants on contemporaneous disease burden was also found to be larger than meteorological factors, and comparable to that of disease related factors.

Conclusions

By developing a novel statistical methodology, we prevented subjective variable selection and discretization bias to detect associations, and provided a robust estimate on the effect of ambient air pollutants on URTI and pneumonia burden over a large spatial scale.
Effect of different ventilation modalities on the early prognosis of patients with sleep apnea after acute ischemic stroke–––protocol for a prospective, open-label and randomised controlled trial
Authors: Li Zhuanyun , Pang Ming , Yu Yaling , Peng Tianfeng , Hu Zhenghao , Niu Ruijie , Wang Xiaorong , Zhang Jinnong
Published: June 2023

Background

Sleep apnea is highly prevalent after acute ischemic stroke (AIS) and has increased stroke-related mortality and morbidity. The conventional sleep apnea treatment is continuous positive airway pressure (CPAP) ventilation. However, it is poorly tolerated by patients and is not used in all stroke patients. This protocol describes the impact of high-flow nasal cannula (HFNC) oxygen therapy compared to nasal continuous positive airway pressure (nCPAP) ventilation or usual care on the early prognosis of patients with sleep apnea after AIS.

Methods

This randomised controlled study will be conducted in the intensive care unit of the Department of Neurology at the Wuhan Union Hospital. According to the study plan, 150 patients with sleep apnea after AIS will be recruited. All patients are randomly allocated in a 1:1:1 ratio to one of three groups: the nasal catheter group (standard oxygen group), the HFNC group, and the nCPAP group. Patients receive different types of ventilation after admission to the group, and their tolerance while using the different ventilation is recorded. Patients will be followed up by telephone three months after discharge, and stroke recovery is recorded. The primary outcomes were 28-day mortality, the incidence of pulmonary infection and endotracheal intubation.

Discussion

This study analyses different ventilation modalities for early interventions in patients with sleep apnea after AIS. We will investigate whether nCPAP and HFNC reduce early mortality and endotracheal intubation rates and improve distant neurological recovery in patients.

Trial registration

This trial was registered at ClinicalTrials.gov (NCT05323266; 25 March 2022).
Trimester-specific reference intervals and profile of coagulation parameters for Chinese pregnant women with diverse demographics and obstetric history: a cross-sectional study
Authors: Dai Jing , Mao Peimin , Pu Cunying , Wang Xuefeng , Liu Xiaoyan
Published: June 2023

Background

Owing to the changes in childbirth policy in China, this work aimed to update the trimester-specific reference intervals (RIs) for Chinese pregnant women with diverse demographics and obstetric history. This study also investigated how advanced maternal age (AMA) (> 35 years old), gravity, and parity influence gestational coagulation parameters.

Methods

In this prospective cross-sectional study, five coagulation parameters were measured using assays provided by Roche diagnostics on Cobas t 711: prothrombin time (PT), activated partial thromboplastin time (APTT), thrombin time (TT), fibrinogen (Fib), and D-dimer, and the trimester-specific 2.5th -97.5th and 95th (D-dimer only) percentiles RIs were established accordingly. Linear regressions were undertaken to analyze the association with demographic characteristics and obstetric history for each parameter.

Results

893 eligible pregnant women in different trimesters and at AMA/non-AMA and 275 non-pregnant healthy women were enrolled. For the first, second, and third trimester, respectively, RIs were as follows: APTT (s): 24.8–35.7, 24.6–34.1, and 23.5–34.7; TT (s): 14.4–17.3, 14.1–16.7, and 14.2–17.5; PT (s): 8.30–10.20, 8.00-9.77, and 7.92–9.57; PT-INR: 0.86–1.06, 0.83–1.02, and 0.82–0.98; Fib (g/L): 2.76–4.97, 3.14–5.31, and 3.44–5.93; D-dimer (µg/ml): 0-0.969, 0-2.14, and 0-3.28. No statistically significant differences were observed in TT, D-dimer, and APTT between the AMA and non-AMA women, while PT and PT-INR were shorter and Fib was higher in the AMA group. The association of gravidity and parity with each coagulation parameter is statistically significant (p < 0.05). PT and PT-INR were shortened and D-dimer decreased as gravidity increased. Longer PT and PT-INR, shorter APPT, higher D-Dimer, and lower Fib were associated with increasing parity.

Conclusions

This work updated the gestational coagulation profiles of Chinese pregnant women and established trimester-specific RIs accordingly. Establishing specific RIs based on AMA, parity, and gravidity might not be necessary.
Mosquito bed net use and associated factors among pregnant women in Rwanda: a nationwide survey
Authors: Kawuki Joseph , Donkor Elorm , Gatasi Ghislaine , Nuwabaine Lilian
Published: June 2023

Background

In malaria-endemic countries such as Rwanda, the appropriate use of mosquito bed nets is an effective intervention for malaria prevention. Despite being one of the demographics most impacted by malaria, there is a dearth of literature on the usage of mosquito bed nets by pregnant women in Rwanda. The study aimed to assess the prevalence and associated factors for mosquito bed net use among pregnant women in Rwanda.

Methods

We used weighted data from the 2020 Rwanda Demographic and Health Survey of 870 pregnant women, and multistage stratified sampling was used to select participants. Multivariable logistic regression was conducted to determine the factors associated with mosquito bed net use, using SPSS (version 26).

Results

Of the 870 pregnant women, 57.9% (95%CI: 54.6–61.1) used mosquito bed nets. However, 16.7% did not use bed nets among those owning bed nets. On one hand, older age (AOR = 1.59, 95%CI: 1.04–2.44), primary education (AOR = 1.18, 95%CI: 1.07–2.23), being married (AOR = 2.17, 95%CI: 1.43–3.20), being from Kigali region (AOR = 1.97, 95%CI: 1.19–3.91), partner’s education (AOR = 1.22, 95%CI: 1.13–3.41), having recently visited a health facility (AOR = 2.07, 95%CI: 1.35–3.18), and being in the third pregnancy trimester (AOR = 2.14, 95%CI: 1.44–3.18) were positively associated with mosquito bed net use. On the other hand, low wealth index (AOR = 0.13, 95%CI: 0.07–0.24), and being from Eastern region (AOR = 0.42, 95% CI: 0.26–0.66) had a negative association.

Conclusions

About half of the pregnant women in Rwanda used mosquito bed nets and the usage was associated with various socio-demographics. There is a need for appropriate risk communication and continuous sensitisation to improve mosquito net use among pregnant women. Early antenatal care attendance and partner engagement in malaria prevention and mosquito net use, as well as consideration of household dynamics, are also crucial in improving not only mosquito net coverage but also utilization.
Ninety-degree angled collimator: a dosimetric study related to dynamic intensity-modulated radiotherapy in patients with endometrial carcinoma
Authors: Serarslan Alparslan , Daştan Yalçın , Aksu Telat , Yıldız Rana Elif , Gürsel Bilge , Meydan Deniz , Okumuş Nilgün Özbek
Published: June 2023

Background

Our purpose was to ensure that the dose constraints of the organs at risk (OARs) were not exceeded while increasing the prescription dose to the planning target volume (PTV) from 45 to 50.4 Gray (Gy) with the dynamic intensity-modulated radiotherapy (IMRT) technique. While trying for this purpose, a new dynamic IMRT technique named 90° angled collimated dynamic IMRT (A-IMRT) planning was developed by us.

Methods

This study was based on the computed tomography data sets of 20 patients with postoperatively diagnosed International Federation of Gynecology and Obstetrics stage 2 endometrial carcinoma. For each patient, conventional dynamic IMRT (C-IMRT, collimator angle of 0° at all gantry angles), A-IMRT (collimator angle of 90° at gantry angles of 110°, 180°, 215°, and 285°), and volumetric modulated arc therapy (VMAT) were planned. Planning techniques were compared with parameters used to evaluate PTV and OARs via dose-volume-histogram analysis using the paired two-tailed Wilcoxon’s signed-rank test; p < 0.05 was considered indicative of statistical significance.

Results

All plans achieved adequate dose coverage for PTV. Although the technique with the lowest mean conformality index was A-IMRT (0.76 ± 0.05) compared to both C-IMRT (0.79 ± 0.04, p = 0.000) and VMAT (0.83 ± 0.03, p = 0.000), it protected the OARs especially the bladder (V45 = 32.84 ± 2.03 vs. 44.21 ± 6.67, p = 0.000), rectum (V30 = 56.18 ± 2.05 vs. 73.80 ± 4.75, p = 0.000) and both femoral heads (V30 for right = 12.19 ± 1.34 vs. 21.42 ± 4.03, p = 0.000 and V30 for left = 12.58 ± 1.48 vs. 21.35 ± 4.16, p = 0.000) better than C-IMRT. While the dose constraints of the bladder, rectum and bilateral femoral heads were not exceeded in any patient with A-IMRT or VMAT, they were exceeded in 19 (95%), 20 (100%) and 20 (100%) patients with C-IMRT, respectively.

Conclusions

OARs are better protected when external beam radiotherapy is applied to the pelvis at a dose of 50.4 Gy by turning the collimator angle to 90° at some gantry angles with the dynamic IMRT technique in the absence of VMAT.
Managing low corneal astigmatism in patients with presbyopia correcting intraocular lenses: a narrative review
Authors: Rocha-de-Lossada Carlos , Rodríguez-Vallejo Manuel , Rodríguez-Calvo-de-Mora Marina , Ribeiro Filomena J , Fernández Joaquín
Published: June 2023

Cataract surgery has become a refractive procedure in which emmetropia is the goal, with the implantation of extended depth-of-focus or multifocal intraocular lenses (IOLs) being the commonly selected option to restore vision beyond the far distance. The selection criteria for implanting these lenses can differ from those for monofocal IOLs and even between technologies, as eye characteristics can affect postoperative visual performance. Corneal astigmatism is an eye characteristic that can affect visual performance differently, depending on the implanted IOL. The magnitude of corneal astigmatism, the tolerance of the IOL to this astigmatism, economic aspects, comorbidities, and the efficacy of astigmatism treatment are factors that can make surgeons’ doubt as to what astigmatism treatment should be applied to each patient. This review aims to summarize the current evidence related to low astigmatism tolerance in presbyopia-correcting lenses, the efficacy achieved through corneal incisions, and their comparison with the implantation of toric IOLs.
Positivity rate, trend and associated risk factors of mother-to-child transmission of HIV among HIV-exposed infants
Authors: Gutema Gadissa , Tola Habteyes Hailu , Fikadu Dinka , Leta Dereje , Bejiga Birra , Tura Jaleta Bulti , Abdella Saro , Mamo Hassen
Published: June 2023

Background

Mother-To-Child-Transmission (MTCT) of Human Immunodeficiency Virus (HIV) occurs during pregnancy, delivery and breastfeeding, and cause infection among several new-borns. However, there is limited recent evidence on the burden of MTCT of HIV in Ethiopia from a large-scale data. Thus, this study aimed to determine the positivity rate, trend and associated risk factors of MTCT among HIV-exposed infants.

Methodology

A cross-sectional study was conducted among 5,679 infants whose specimen referred to Ethiopian Public Health Institute HIV referral laboratory for Early Infant Diagnosis (EID) from January 01, 2016, to December 31, 2020. Data were extracted from the national EID database. Frequencies and percentages were used to summarize the data on characteristics of infants. Logistic regression analysis was employed to identify factors associated with positivity rate of MTCT of HIV. Level of significance was set at 5%.

Results

The mean age of the infants was 12.6 (± 14.6) weeks with an age range of 4 to 72 weeks. Half of the infants (51.4%) were female. The positivity rate of MTCT decreased from 2.9% in 2016 to 0.9% in 2020 with five-year average positivity rate of 2.6%. HIV test after six weeks (Adjusted odds ratio (AOR) = 2.7; 95% confidence interval (CI): (1.8–4.0,)); p < 0.001), absence of prevention of mother-to-child-transmission (PMTCT) service (AOR = 4.6; 95% CI: (2.9–7.4)); p = 0.001), nevirapine prophylaxis not received (AOR = 2.0; 95% CI: (1.3–3.2)); p < 0.001), and unknown ART status of the mother at delivery (AOR = 11; 95% CI: (5.5–22.1)); p < 0.001) were significantly associated with MTCT of HIV.

Conclusion

The positivity rate of MTCT of HIV was showing declining tendency gradually in the study period. Strengthening PMTCT service, early HIV screening and starting ART for pregnant women, and early infant diagnosis are required to reduce the burden of HIV infection among infants exposed to HIV.
Successful laparoscopic resection of fallopian tube abscess caused by Escherichia coli in a 12-year-old adolescent virgin:a case report and review of the literature
Authors: He Xi-Feng , Du Xiu-Ping , Qiao Cui-Feng
Published: June 2023

Background

Upstream infection with vaginal flora can develop into tubal endothelial damage and tubal edema, which can lead to tubal obstruction and fallopian tube abscess if left untreated. Fallopian tube abscess in adolescent virgins is very rare, it may lead to long-term or even lifelong complications once it occurred.

Case presentation

A 12-year-old adolescent virgin with no history of sexual intercourse and previous physical fitness who presented with lower abdominal pain with nausea and vomiting for 22 h, body temperature up to 39.2 °C. Laparoscopic surgery revealed an abscess in the left fallopian tube, the left fallopian tube was surgically removed, successfully treated, and the pus was cultured for escherichia coli.

Conclusion

It is important to consider possibility of tubal infection in young.
Evaluating step-down, intermediate care programme in Buckinghamshire, UK: a mixed methods study
Authors: Liapi Fani , Chater Angel Marie , Kenny Tina , Anderson Juliet , Randhawa Gurch , Pappas Yannis
Published: June 2023

Background

Intermediate care (IC) services are models of care that aim to bridge the gap between hospital and home, enabling continuity of care and the transition to the community. The purpose of this study was to explore patient experience with a step-down, intermediate care unit in Buckinghamshire, UK.

Methods

A mixed-methods study design was used. Twenty-eight responses to a patient feedback questionnaire were analysed and seven qualitative semi-structured interviews were conducted. The eligible participants were patients who had been admitted to the step-down IC unit. Interview transcripts were analysed using thematic analysis.

Findings

Our interview data generated five core themes: (1) “Being uninformed”, (2) “Caring relationships with health practitioners”, (3) “Experiencing good intermediate care”, (4) “Rehabilitation” and (5) “Discussing the care plan”. When comparing the quantitative to the qualitative data, these themes are consistent.

Conclusions

Overall, the patients reported that the admission to the step-down care facility was positive. Patients highlighted the supportive relationship they formed with healthcare professionals in the IC and that the rehabilitation that was offered in the IC service was important in increasing mobility and regaining their independence. In addition, patients reported that they were largely unaware about their transfer to the IC unit before this occurred and they were also unaware of their discharge package of care. These findings will inform the evolving patient-centred journey for service development within intermediate care.
Impact of work and coping factors on mental health: Australian truck drivers’ perspective
Authors: Pritchard Elizabeth , van Vreden Caryn , Xia Ting , Newnam Sharon , Collie Alex , Lubman Dan I. , de Almeida Neto Abilio , Iles Ross
Published: June 2023

Introduction

Truck driving is one of the most common male occupations worldwide. Drivers endure long working hours, isolation, separation from family, compromised sleep, and face rigid regulatory requirements. Studies have documented the work factors contributing to poor health outcomes, however these have not been explored in the Australian context. The aim of this grounded theory study was to explore the impact of work and coping factors on mental health of Australian truck drivers from their perspective.

Methods

Recruitment used a purposive snowball sampling, through social media campaigns and direct email invites. Interview data were collected via phone/teleconference, audio recorded and typed verbatim. Inductive coding and thematic analysis were completed with triangulation of themes.

Results

Seventeen interviews were completed (94% male). Six themes arose, two supporting (Connections; Coping methods), and four disrupting mental health (Compromised supports; Unrealistic demands; Financial pressures; Lack of respect). Drivers had concerns regarding the many things beyond their control and the interactions of themes impacting their health even further.

Conclusion

This study explored the impact of work and coping factors affecting truck driver mental health in Australia. Themes described the importance of connections and coping methods drivers had to support their health. Many factors that compromised their health were often outside their control. These results highlight the need for a multi-faceted collaboration between stakeholders; the driver, employing companies, policy makers/regulators and the public to address the negative impact of truck driving on mental health.
Defining indicators for the scoping stage of health impact assessment to evaluate tobacco control policy in the city of Beijing
Authors: Zheng Yunting , Shi Yuhui , Ji Ying , Liu Xiurong , Lin Haoxiang , Chen Meijun , Yun Qingping , Chang Chun
Published: June 2023

Introduction

Beijing initiated the nation’s most comprehensive tobacco control program that adheres to the WHO Framework Convention on Tobacco Control. This study aimed to identify a set of indicators for the scoping of an Health Impact Assessment (HIA) to assess this policy.

Methods

This study used a modified Delphi process. It proposed a tobacco control health impact framework based on the Driving forces- Pressure- State- Exposure- Effect- Action model and the Determinants of Health Theory. After a review of current surveillance system and literature, a working group of 13 experts with multidisciplinary background was established to formulate indicator evaluation criteria and conduct indicator scoring. Each indicator was scored by experts according to four evaluation criteria chosen. Indicators that obtained a total score above 80% and with standard error less than 5 were selected as the final set of indicators. Kendall’s coefficient of concordance was calculated.

Results

Twenty-three out of 36 indicators were selected. Smoking prevalence, mortality rate, hospital admission rate, tobacco consumption and hospital admission fees of smoking related diseases achieved more than 90% of total scores and ranked as the top five. Kendall’s concordance coefficient was 0.218 for all indicators. For all model composition, Kendall’s concordance coefficients were statistically significant.

Conclusion

This study identified a set of twenty-three indicators for scoping of HIA of a comprehensive tobacco control policy in Beijing based on a tobacco control health impact conceptual framework. The set of indicators achieved high scores and statistically significant consistency and has great potential to promote the evaluation of tobacco control policy in a global city. Further study might use the set of indicators for HIA on tobacco control policy to analyze empirical data.
Process evaluation of a kindergarten-based intervention for obesity prevention in early childhood: the Toybox study Malaysia
Authors: Cheah W. L. , Poh B. K. , Ruzita A. T. , Lee J. A. C. , Koh D. , Reeves S. , Essau C. , Summerbell C. , Noor Hafizah Y , Anchang G. N. J. , Gibson E. L.
Published: June 2023

Background

Toybox is a kindergarten-based intervention program that targets sedentary behavior, snacking and drinking habits, as well as promoting physical activity in an effort to improve healthy energy balance-related behaviors among children attending kindergartens in Malaysia. The pilot of this program was conducted as a randomized controlled trial (RCT) involving 837 children from 22 intervention kindergartens and 26 control kindergartens respectively. This paper outlines the process evaluation of this intervention.

Methods

We assessed five process indicators: recruitment, retention, dosage, fidelity, and satisfaction for the Toybox program. Data collection was conducted via teachers’ monthly logbooks, post-intervention feedback through questionnaires, and focus group discussions (FGD) with teachers, parents, and children. Data were analyzed using quantitative and qualitative data analysis methods.

Results

A total of 1072 children were invited. Out of the 1001 children whose parents consented to join, only 837 completed the program (Retention rate: 88.4%). As high as 91% of the 44 teachers and their assistants engaged positively in one or more of the process evaluation data collection methods. In terms of dosage and fidelity, 76% of parents had received newsletters, tip cards, and posters at the appropriate times. All teachers and their assistants felt satisfied with the intervention program. However, they also mentioned some barriers to its implementation, including the lack of suitable indoor environments to conduct activities and the need to make kangaroo stories more interesting to captivate the children’s attention. As for parents, 88% of them were satisfied with the family-based activities and enjoyed them. They also felt that the materials provided were easy to understand and managed to improve their knowledge. Lastly, the children showed positive behaviors in consuming more water, fruits, and vegetables.

Conclusions

The Toybox program was deemed acceptable and feasible to implement by the parents and teachers. However, several factors need to be improved before it can be expanded and embedded as a routine practice across Malaysia.
Effects of a videoconference-based therapeutic exercise intervention on the musculoskeletal pain of eldercare workers: protocol for the ReViEEW randomized controlled trial
Authors: Espin Ander , Irazusta Jon , Segovia Celaya Itziar , Mosquera Lajas Álvaro , González-Templado Vanesa , Rodriguez-Larrad Ana
Published: June 2023

Background

Prevalence of musculoskeletal pain is high among eldercare workers, and therapeutic exercise has shown to be effective for its management. Although telerehabilitation is an increasingly used alternative for delivering therapeutic exercise, no studies have assessed synchronous group telerehabilitation interventions for the management of musculoskeletal disorders. Thus, the aim of this article is to describe the protocol of a randomized controlled trial that will assess the effects of a videoconference-based group therapeutic exercise intervention on the musculoskeletal pain of eldercare workers.

Methods

This multicenter trial will randomly assign 130 eldercare workers to either a control or experimental group. Participants in the control group will not receive any intervention, and participants in the experimental group will take part in a 12-week remote supervised videoconference-based intervention, consisting of 2 weekly 45-min group sessions. Each session will include 4 sets of 6 progressive resistance exercises for the lower limbs, upper limbs and trunk, performed with bodyweight and elastic bands at moderate-high intensity. Following the 12 weeks, participants in the experimental group will be provided with material for autonomously carry on the therapeutic exercises and advised to continue performing 2 weekly sessions on their own until a 48-week follow-up. Assessments will be performed at baseline, 12 and 48 weeks. Primary outcome will be average pain intensity in the low back during the last 7 days, measured by the 0–10 Numerical Rating Scale. Secondary outcomes will include additional measures of musculoskeletal pain, psycho-affective state, work-related variables, and physical fitness.

Discussion

This will be the first trial, to our knowledge, assessing whether a remote delivery of a group therapeutic exercise intervention via videoconference is effective for reducing the musculoskeletal pain, improving the psycho-affective state and physical fitness, and enhancing the work-related parameters in eldercare workers. If successful, this study will provide innovative tools for implementing effective, scalable and affordable interventions to tackle musculoskeletal disorders in the workplace. It will also highlight the utility of telehealth, and address the importance of therapeutic exercise to manage musculoskeletal pain in a critical population for the future of the aging societies as it is the eldercare workers.

Trial registration

The study protocol was prospectively registered at ClinicalTrials.gov (registration number: NCT05050526) on September 20, 2021.
The relative area score for sublingual varices reliability measurement: a diagnostic study
Authors: Klein Christian R. , Stoppenbrink David , Geier Jannik , Mayr Andreas , Stark Helmut
Published: June 2023

Background

Sublingual varices (SV) and their predictive potential for other clinical parameters is a much studied topic in oral medicine. SVs have been well studied as predictive markers for many common diseases such as arterial hypertension, cardiovascular disease, smoking, type 2 diabetes mellitus and age. Despite many prevalence studies, it is still unclear how the reliability of SV inspection affects its predictive power. The aim of this study was to quantify the inspection reliability of SV.

Methods

In a diagnostic study, the clinical inspection of 78 patients by 23 clinicians was examined for the diagnosis of SV. Digital images of the underside of the tongue were taken from each patient. The physicians were then asked to rate them for the presence of sublingual varices (0/1) in an online inspection experiment. Statistical analysis for inter-item and inter-rater reliability was performed in a τ-equivalent measurement model with Cronbach's $$\alpha$$
α
and Fleiss κ.

Results

The interrater reliability for sublingual varices was relatively low with κ = 0.397. The internal consistency of image findings for SV was relatively high with α≈ 0.937. This shows that although SV inspection is possible in principle, it has a low reliability R. This means that the inspection finding (0/1) of individual images often cannot be reproduced stably. Therefore, SV inspection is a difficult task of clinical investigation. The reliability R of SV inspection also limits the maximum linear correlation $${r}_{max}$$

r

max

of SV with an arbitrary other parameter Y. The reliability of SV inspection R = 0.847 limits the maximum correlation to $${r}_{max}$$

r

max

(SV, Y) = 0,920—a 100% correlation was a priori not achievable in our sample. To overcome the problem of low reliability in SV inspection, we propose the RA (relative area) score as a continuous classification system for SV, which normalises the area of visible sublingual veins to the square of the length of the tongue, providing a dimensionless measure of SV.

Conclusions

The reliability of the SV inspection is relatively low. This limits the maximum possible correlation of SV with other (clinical) parameters. SV inspection reliability is an important indicator for the quality of SV as a predictive marker. This should be taken into account when interpreting previous studies on SV and has implications for future studies. The RA score could help to objectify the SV examination and thus increase its reliability.
Knowledge and perceptions regarding Human Papillomavirus (HPV) and willingness to receive HPV vaccination among university students in a north-eastern city in Turkey
Authors: Varer Akpinar Ceren , Alanya Tosun Sebnem
Published: June 2023

Background

For a HPV vaccination program to be successful, it is important that the target population has sufficient knowledge about HPV and HPV vaccines. The aim of this study was to evaluate HPV-related knowledge levels among students at a university in northern Turkey, to assess vaccination willingness, and to determine factors associated with HPV-related knowledge.

Methods

This cross-sectional study was conducted on 824 (93.1%) students studying at 16 different faculties. The study population was identified through the proportional stratified sampling method. Data were collected through a questionnaire including socio-demographic characteristics and the HPV Knowledge Scale. Multiple linear regression analysis was performed to identify factors that may be associated with knowledge scores.

Results

43.6% of the students had never heard of HPV, 50.6% of them had never heard of HPV screening tests or HPV vaccination. Only 2.7% of the students were vaccinated against HPV and 15.7% were willing to receive HPV vaccination. Awareness of HPV and willingness to receive vaccination were found to be higher among women, while previous experience with sexual intercourse was higher in men (p < 0.05). The mean HPV knowledge score was quite low (6.74 ± 7.13 out of 29 points). The studying in a field related to health sciences, being a senior student, intending to be vaccinated, being a woman, having had sex were found to be associated with high knowledge levels (p < 0.05).

Conclusions

Educational programmes should be developed to increase university students' knowledge about HPV and the HPV vaccine.