bluuebunny/crossref_metadata_2025 huggingface dataset:
Current status of electronic health literacy among pregnant women with gestational diabetes mellitus and their perceptions of online health information: a mixed-methods study
Authors: Xu Jingqi , Chen Yujia , Zhao Jing , Wang Jiarun , Chen Jianfei , Pan Xinlong , Zhang Wei , Zheng Jin , Zou Zhijie , Chen Xiaoli , Zhang Yingzi
Published: May 2024

Background

Women diagnosed with gestational diabetes mellitus often rely on internet-based health information for managing their condition. This study aims to investigate the present state of electronic health literacy among women with gestational diabetes mellitus, analyze the influencing factors, and explore their experiences regarding accessing, comprehending, evaluating, and applying online health information pertinent to gestational diabetes mellitus.

Methods

A sequential explanatory mixed methods research design was adopted in this study. Initially, 235 women with gestational diabetes mellitus participated in a cross-sectional survey. The research tools included general information and the Chinese version of the electronic Health Literacy Scale (eHEALS). Descriptive analyses were conducted to describe the characteristics of the sample, and multiple linear regression analyses were used to explore the factors influencing electronic health literacy among women with gestational diabetes mellitus. Secondly, 11 women with gestational diabetes mellitus joined semi-structured in-depth interviews to obtain their perceptions about online health information. The data were analyzed using inductive content analysis to develop themes.

Results

The median score of eHEALS in the Chinese version among 235 women diagnosed with gestational diabetes mellitus was 29 (interquartile range [IQR], 26 to 32). Factors influencing electronic health literacy among these women included accessing health information from medical professionals (β = 0.137, p = 0.029) and utilizing health information from applications (β = 0.159, p = 0.013). From the qualitative phase of the study, four thematic categories emerged: reasons and basis for accessing health information from the Internet; address barriers to accessing and applying online health information; desires for a higher level of online health information services; outcomes of accessing and applying online health information.

Conclusion

The electronic health literacy of women diagnosed with gestational diabetes mellitus remains suboptimal and warrants improvement. The sources of access to health information affect electronic health literacy in women with gestational diabetes mellitus. Moreover, women facing gestational diabetes encounter numerous impediments when attempting to access health-related information online, underscoring the necessity for enhanced online health information services to meet their needs.
Effects of different doses of intranasal dexmedetomidine on related complications and parents’ satisfaction in anesthetized children: a systematic review
Authors: Hu Wei , Wang Ming , Sun Fei
Published: May 2024

Background

Agitation/delirium is commonly seen in children after anesthesia, and a proper dose of dexmedetomidine can prevent this complication. This study aimed to investigate the effects of different doses of Dexmedetomidine (DEX) on agitation/delirium and other complications in anesthetized children, providing clinical evidence for dose recommendations of DEX.

Methods

This study was conducted based on the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). A systematic search was conducted in the Cochrane Library, PubMed, Web of Science, and EMBASE. Two independent researchers performed literature screening, data extraction, and assessed the methodological quality. Data analysis was conducted using R and STATA 16.0.

Results

In the final analysis, 20 randomized controlled trials (RCTs) involving 2521 children were included. The results showed that in comparison to normal saline, 1 µg/kg, 1.5 µg/kg, and 2 µg/kg intranasal DEX significantly reduced the incidence of post-anesthetic emergence agitation in children with the most effective dose being 2 µg/kg (SUCRA = 0.91). Compared with normal saline, 1 µg/kg, 1.5 µg/kg, and 2 µg/kg intranasal DEX reduced patient’s need for postoperative analgesia, with the most effective dose being 1.5 µg/kg (SUCRA = 0.78). However, 1 µg/kg DEX performed the best in reducing Pediatric Anaesthesia Emergence Delirium (PAED) Scale score (SUCRA = 0.88).

Conclusion

Compared with normal saline, intranasal administration of 2 µg/kg DEX and 1.5 µg/kg DEX are the optimal doses to reduce the incidence of agitation and the need for postoperative pain relief in children under general anesthesia. Given effectiveness and safety, intranasal use of 1 µg/kg DEX appears to be the most effective dosage for anesthetized children.
A qualitative study on inner experience of self-management behavior among elderly patients with type 2 diabetes in rural areas
Authors: Zhang Zi-chen , Du Qiu-hui , Jia Hong-hong , Li Yu-min , Liu Yu-qin , Li Shao-bo
Published: May 2024

Background

As a chronic metabolic disease, diabetes poses a serious threat to human health and has become a major public health problem in China and worldwide. In 2020, 30% of Chinese people (aged ≥ 60 years) reported having diabetes mellitus. Moreover, individuals with diabetes living in rural areas face a significantly higher mortality risk compared to those in urban areas. In this study, we explored the inner experience of self-management behaviors in elderly patients with type 2 diabetes in rural areas to inform targeted interventions.

Methods

A phenomenological research design was used to explore the inner experience of self-management in rural elderly diabetes. Ten elderly diabetic patients were sampled from December 2022 to March 2023 in rural areas of Yangcheng County, Jincheng City, ShanXi Province, China. The seven-step Colaizzi phenomenological was used to analyze the interview data and generate themes.

Results

Four themes emerged: “Insufficient self-management cognition”, “Negative self-management attitude”, “Slack self-management behavior”, and “No time for self-management”.

Conclusion

The level of self-management among elderly patients with type 2 diabetes in rural areas is low. Healthcare professionals should develop targeted interventions aimed at enhancing their cognitive levels, modifying their coping styles, and improving their self-management abilities to improve their quality of life.
Perceptions and experience of rural older people in oral health management in China: a qualitative study
Authors: An Ran , Jiang Guanghua , Wu Zitong , Liu Meizi , Sohaib Muhammad , Chen Wenfeng
Published: May 2024

Background

To explore the perceptions and experience of oral health management among rural older people in China.

Methods

Qualitative methodologies were used in this study. Face-to-face semi-structured interviews were conducted. Thirteen older adults in rural areas were purposively sampled at two metropolitan hospitals in Hunan, China. The data were transcribed and thematically analyzed, and MAXQDA software was used to assist with coding.

Results

Three overarching major themes and ten sub‑themes capturing the perceptions and experience of oral health management among rural older people were identified. Three themes emerged from the thematic analysis: oral health cognitive bias, poor management behaviors, and limited oral health services. Oral health management as a whole is negative, oral health behaviors are poor, oral health service utilization is limited.

Conclusions

Based on these findings, there is great scope here for improving the current status of oral health for rural older people around awareness, behavior, and access. Oral health education, improved oral health services and primary oral health promotion are warranted.
Prevalence and risk indicators of early childhood caries among toddlers in Caloocan City, Philippines: a cross-sectional study
Authors: Oliveros-Villarico Maritess , Pungchanchaikul Patimaporn , Watthanasaen Supatra , Chaichit Rajda , Pitiphat Waranuch
Published: May 2024

Background

Limited published data exist on early childhood caries (ECC) among children 2 years old and below. The study aimed to determine ECC prevalence and its association with socio-demographic indicators, feeding practices and oral health behaviours among children aged 2 years and below in the Philippines.

Methods

A cross-sectional study observed young children aged 4–24 months in primary health centers. Each child’s caregiver was interviewed and dental examinations were done on every child by one calibrated dentist using the ICDAS. Poisson regression using robust variance estimator analysis identified significant variables associated with ECC.

Results

Seven hundred three healthy children were observed at a mean age of 13.3 ± 2.4 months. ECC prevalence was 29.2% (95% confidence interval: 26.0–32.7) among toddlers who showed a mean number of 6.7 ± 3.1 erupted teeth. Multiple regression revealed that child’s age (prevalence ratio, PR = 1.07), caregiver’s educational level (PR = 1.43), continued breastfeeding (PR = 1.36), frequent eating (PR = 1.24), visible plaque observed by the caregiver (PR = 1.34) and in the oral examination (PR = 2.90) were significant to ECC prevalence.

Conclusions

ECC is alarmingly prevalent in toddlers, marked by early onset and untreated decay. Prioritizing preventive measures in the first two years of life is crucial for understanding dietary impacts and promoting oral hygiene.
Overdose responses among rural people who use drugs: A multi-regional qualitative study
Authors: Baker Robin , Fredericksen Rob J , Rudolph Abby E , Stopka Thomas J , Walters Suzan M , Fadanelli Monica , Bolinski Rebecca S , Sibley Adams L , Stack Erin , Crane Heidi M , Korthuis P Todd , Seal David W
Published: May 2024

Background

Efforts to distribute naloxone have equipped more people with the ability to reverse opioid overdoses but people who use drugs are often reluctant to call 911 due to concerns for legal repercussions. Rural communities face unique challenges in reducing overdose deaths compared to urban communities, including limited access to harm reduction services as well as greater concerns about stigma and privacy.

Methods

The Rural Opioid Initiative was funded in 2017 to better understand the health-related harms associated with the opioid crisis in rural US communities and consists of eight studies spanning ten states and 65 counties. Each study conducted semi-structured qualitative interviews with people who use drugs to understand contextual factors influencing drug use and health behaviors. We analyzed qualitative data from seven studies with data available at the time of analysis to understand peer response to overdose.

Results

Of the 304 participants interviewed, 55% were men, 70% were white, 80% reported current injection drug use, and 60% reported methamphetamine use. Similar to what has been found in studies focused on urban settings, people who use drugs in rural communities use a range of strategies to reverse overdoses, including non-evidence-based approaches. Several reported that multiple doses of naloxone are needed to reverse overdose. Three themes emerged around the willingness to call 911, including (1) hesitancy to call 911 for fear of legal consequences, (2) negative perceptions or experiences with law enforcement officers, and (3) efforts to obtain medical intervention while avoiding identification/law enforcement involvement.

Conclusion

People who use drugs employ multiple strategies to attempt overdose reversal, including non-evidence-based approaches. Greater education about the most effective and least harmful strategies is needed. Reluctance to call 911 is rooted in concerns about potential legal consequences as well as perceptions about law enforcement officers, which may be heightened in rural communities where people who use drugs are more easily identified by law enforcement. People who use drugs will go to great strides to connect their peers to needed medical services, suggesting that comprehensive interventions to reduce interactions with law enforcement officers and eliminate legal consequences for reporting overdoses are critical.
Deep learning-based automatic measurement system for patellar height: a multicenter retrospective study
Authors: Liu Zeyu , Wu Jiangjiang , Gao Xu , Qin Zhipeng , Tian Run , Wang Chunsheng
Published: May 2024

Background

The patellar height index is important; however, the measurement procedures are time-consuming and prone to significant variability among and within observers. We developed a deep learning-based automatic measurement system for the patellar height and evaluated its performance and generalization ability to accurately measure the patellar height index.

Methods

We developed a dataset containing 3,923 lateral knee X-ray images. Notably, all X-ray images were from three tertiary level A hospitals, and 2,341 cases were included in the analysis after screening. By manually labeling key points, the model was trained using the residual network (ResNet) and high-resolution network (HRNet) for human pose estimation architectures to measure the patellar height index. Various data enhancement techniques were used to enhance the robustness of the model. The root mean square error (RMSE), object keypoint similarity (OKS), and percentage of correct keypoint (PCK) metrics were used to evaluate the training results. In addition, we used the intraclass correlation coefficient (ICC) to assess the consistency between manual and automatic measurements.

Results

The HRNet model performed excellently in keypoint detection tasks by comparing different deep learning models. Furthermore, the pose_hrnet_w48 model was particularly outstanding in the RMSE, OKS, and PCK metrics, and the Insall–Salvati index (ISI) automatically calculated by this model was also highly consistent with the manual measurements (intraclass correlation coefficient [ICC], 0.809–0.885). This evidence demonstrates the accuracy and generalizability of this deep learning system in practical applications.

Conclusion

We successfully developed a deep learning-based automatic measurement system for the patellar height. The system demonstrated accuracy comparable to that of experienced radiologists and a strong generalizability across different datasets. It provides an essential tool for assessing and treating knee diseases early and monitoring and rehabilitation after knee surgery. Due to the potential bias in the selection of datasets in this study, different datasets should be examined in the future to optimize the model so that it can be reliably applied in clinical practice.

Trial registration

The study was registered at the Medical Research Registration and Filing Information System (medicalresearch.org.cn) MR-61-23-013065. Date of registration: May 04, 2023 (retrospectively registered).
Treatment of late left bronchopleural fistula after left pneumonectomy through right thoracic approach assisted by extracorporeal membrane oxygenation
Authors: Li Wenhao , Liu Kejun , Liao Xiaozu , Li Binfei , Liang Yi , Huang Weizhao
Published: May 2024

Background

Bronchopleural fistula (BPF) is a rare but fatal complication after pneumonectomy. When a BPF occurs late (weeks to years postoperatively), direct resealing of the bronchial stump through the primary thoracic approach is challenging due to the risks of fibrothorax and injury to the pulmonary artery stump, and the surgical outcome is generally poor. Here, we report a case of late left BPF following left pneumonectomy successfully treated using a right thoracic approach assisted by extracorporeal membrane oxygenation (ECMO).

Case presentation

We report the case of a 57-year-old male patient who underwent left lower and left upper lobectomy, respectively, for heterochronic double primary lung cancer. A left BPF was diagnosed at the 22nd month postoperatively, and conservative treatment was ineffective. Finally, the left BPF was cured by minimally invasive BPF closure surgery via the right thoracic approach with the support of veno-venous extracorporeal membrane oxygenation (VV-ECMO).

Conclusions

Advanced BPF following left pneumonectomy can be achieved with an individualized treatment plan, and the right thoracic approach assisted by ECMO is a relatively simple and effective method, which could be considered as an additional treatment option for similar patients.
Neuropathological lesions in intravenous BCG-stimulated K18-hACE2 mice challenged with SARS-CoV-2
Authors: Sánchez-Morales Lidia , Porras Néstor , García-Seco Teresa , Pérez-Sancho Marta , Cruz Fátima , Chinchilla Blanca , Barroso-Arévalo Sandra , Diaz-Frutos Marta , Buendía Aránzazu , Moreno Inmaculada , Briones Víctor , Risalde María de los Ángeles , de la Fuente José , Juste Ramón , Garrido Joseba , Balseiro Ana , Gortázar Christian , Rodríguez-Bertos Antonio , Domínguez Mercedes , Domínguez Lucas
Published: May 2024

In the wake of the COVID-19 pandemic caused by SARS-CoV-2, questions emerged about the potential effects of Bacillus Calmette-Guérin (BCG) vaccine on the immune response to SARS-CoV-2 infection, including the neurodegenerative diseases it may contribute to. To explore this, an experimental study was carried out in BCG-stimulated and non-stimulated k18-hACE2 mice challenged with SARS-CoV-2. Viral loads in tissues determined by RT-qPCR, histopathology in brain and lungs, immunohistochemical study in brain (IHC) as well as mortality rates, clinical signs and plasma inflammatory and coagulation biomarkers were assessed. Our results showed BCG-SARS-CoV-2 challenged mice presented higher viral loads in the brain and an increased frequency of neuroinvasion, with the greatest differences observed between groups at 3–4 days post-infection (dpi). Histopathological examination showed a higher severity of brain lesions in BCG-SARS-CoV-2 challenged mice, mainly consisting of neuroinflammation, increased glial cell population and neuronal degeneration, from 5 dpi onwards. This group also presented higher interstitial pneumonia and vascular thrombosis in lungs (3–4 dpi), BCG-SARS-CoV-2 mice showed higher values for TNF-α and D-dimer values, while iNOS values were higher in SARS-CoV-2 mice at 3–4 dpi. Results presented in this study indicate that BCG stimulation could have intensified the inflammatory and neurodegenerative lesions promoting virus neuroinvasion and dissemination in this experimental model. Although k18-hACE2 mice show higher hACE2 expression and neurodissemination, this study suggests that, although the benefits of BCG on enhancing heterologous protection against pathogens and tumour cells have been broadly demonstrated, potential adverse outcomes due to the non-specific effects of BCG should be considered.
Advances in solar pond technology and prospects of efficiency improvement methods
Authors: Mbelu Onyedika V. , Adeyinka Adekanmi M. , Yahya Daniel I. , Adediji Yaqub B. , Njoku Howard
Published: May 2024

The rising global energy demand necessitates innovative solutions for harnessing renewable energy sources. Solar ponds have received attention as they present a viable means to address this challenge by absorbing and storing solar radiation. This article provides a comprehensive review of solar pond technology, including its principles, applications, heat extraction mechanisms, and approaches to optimize performance, with special attention to the salt-gradient solar pond. Additionally, the article identifies challenges that currently hinder the large-scale adoption of solar pond technology and offers recommendations for future research. By providing a detailed analysis of the current trends and future research directions, this paper seeks to contribute to the ongoing efforts to improve these systems, exploring various approaches to increase their efficiency and make them more economical and environmentally sustainable.
The Fading Treatment Effects of a Multifaceted Asset-Transfer Program in Ethiopia
Authors: Barker Nathan , Karlan Dean , Udry Christopher , Wright Kelsey
Published: May 2024

We study the long-run effects of a big-push “graduation” program in Ethiopia in which very poor households received a one-time transfer of productive assets (mainly livestock), technical training, and access to savings accounts. After seven years, treatment effects on wealth and consumption remain economically meaningful but dissipated relative to the two- and three-year results. Treatment effects on other outcomes attenuated further. Based on absolute well-being (e.g., food security) not dropping, we argue that the treatment effect dissipation is driven primarily by improved living standards for control households rather than losses of the previously accrued benefits for the treatment households. (JEL D12, G51, I31, I32, I38, J24, O12)
Trade and Trees
Authors: Harstad Bård
Published: May 2024

International trade and natural resource exploitation interact in multiple ways. This paper first presents a dynamic game in which the South (S) exploits (e.g., deforests) in order to export (e.g., lumber and agricultural products). Because of negative externalities, the North might lose from trade, unless the resource has already been depleted. Anticipating this, S exploits faster. All negative results are reversed if renegotiation-proof tariffs can be contingent on the size of the remaining resource stock. Larger gains from trade, and more attractive terms of trade, can be used to slow exploitation. Combined with export subsidies, the outcome is first best. (JEL C73, D62, F11, F13, F18, Q23, Q57)
Το ιστορικό τραύμα και προφορική ιστορία
Authors: Μηλιώνης Παναγιώτης
Published: May 2024

Βασικός εννοιολογικός άξονας της παρούσας εργασίας είναι η θυματοκεντρική προσέγγιση, ειδικότερα όσον αφορά στην ανάδειξη της ατζέντας των οικογενειών των θυμάτων αναγκαστικής εξαφάνισης. Μέσα σε αυτό το πλαίσιο επιχειρείται να διερευνηθεί το δυσεπίλυτο αυτό ζήτημα με σύμμαχο τις «φωνές» των θυμάτων, των μαρτύρων, των δημοσιογράφων, των θεσμικών παραγόντων, των λογοτεχνών, παράλληλα με τη διεθνή βιβλιογραφία, τους διεθνείς οργανισμούς και τις εκθέσεις των αρμόδιων διεθνών επιτροπών. Η μελέτη αμφισβητεί τις μοιρολατρικές προσεγγίσεις για τις κληρονομιές της βίας που εδράζονται αποκλειστικά στον λόγο για τα ανθρώπινα δικαιώματα και οι οποίες προέρχονται από εθνικές και διεθνείς ελίτ, μακριά από τα άτομα που έχουν πληγεί περισσότερο από τις συγκρούσεις. Η διατριβή διακρίνεται σε δύο μέρη. Στο πρώτο μέρος παρατίθεται το θεωρητικό πλαίσιο των εννοιών του ιστορικού τραύματος, της μεταβατικής δικαιοσύνης και των αναγκών των θυμάτων, ενώ στο δεύτερο μέρος παρουσιάζονται τα αποτελέσματα της πρωτογενούς έρευνας μέσα από διεξοδικά αποσπάσματα των συνεντεύξεων των αφηγητών. Επιπρόσθετα, μέσα από τη διερεύνηση διαφορετικών πλαισίων (δικαστική ανθρωπολογία, δημοσιογραφία, λογοτεχνία, κοινωνία των πολιτών, ακαδημαϊκή κοινότητα) ερευνώνται οι προϋποθέσεις για την απονομή ιστορικής δικαιοσύνης στις δύο κοινότητες. Ο ουσιαστικός στόχος είναι μέσω της εξατομικευμένης προσέγγισης που μεθοδολογικά τεκμαίρεται με τη συνέντευξη προφορικής ιστορίας, να ακουστούν τα θύματα για τα δεινά που υπέστησαν μετά από δεκαετίες αποσιώπησης και περιθωριοποίησης και, στη συνέχεια, σε συνεργασία με την κοινωνία των πολιτών να διαπιστωθεί η δυνατότητα αντιμετώπισης των παραβιάσεων, αποκατάστασης των θυμάτων και συμφιλίωσης των δυο κοινοτήτων. Μια απόδοση ιστορικής δικαιοσύνης, η οποία για να επέλθει σε μια κοινωνία χρόνιων ανισοτήτων και έλλειψης ουσιαστικής συμπαράστασης των θυμάτων, συνθήκη που επικράτησε και στις δύο κοινότητες έως σήμερα, πρέπει να κατανοηθεί τόσο σε ευρύ όσο και σε εξατομικευμένο επίπεδο. Το βασικό ερευνητικό ερώτημα της παρούσας διατριβής είναι εάν το ιστορικό τραύμα -που δημιουργήθηκε στην περίπτωση της Κύπρου και διερευνάται στην εργασία αυτή με τη μορφή του ζητήματος των αγνοουμένων- μπορεί να αντιμετωπιστεί ώστε να υπάρξει αποκατάσταση και να απονεμηθεί ιστορική δικαιοσύνη στις οικογένειες των θυμάτων. Διερευνάται, κατά συνέπεια, εάν οι οικογένειες των θυμάτων στην Κύπρο αισθάνονται ότι έχουν κατανοηθεί οι ανάγκες τους, καθώς πρόκειται, ως γνωστόν, για μια κοινωνία που έχει βιώσει ειδεχθή εγκλήματα και εκτεταμένες παραβιάσεις ανθρωπίνων δικαιωμάτων στο πρόσφατο παρελθόν, ενώ, παράλληλα, ζει μια παρατεταμένη συνθήκη «παγωμένης σύγκρουσης» (Frozen Conflict) και διχοτόμησης του νησιού.
An Evaluation of R448A as R404A low GWP Alternative in a Supermarket Refrigeration Application
Authors: Dreepaul Raj Kumar , Bhujun B. S. , Busawo K.
Published: May 2024

In this paper we compare the efficacy of a supermarket refrigeration system using R404A and R488 (a mixture of Hydrofluorocarbons (HFC) and Hydro-Fluoro-Olefin (HFO)) in tropical climate of Mauritius. More specifically, the Total Equivalent Warming Impact (TEWI) model of the refrigeration system working on various refrigerants is used to assess the Coefficient of Performance (COP), leaks in the refrigeration circuit and equivalent CO2 emitted. It is demonstrated that the COP for R448 is 20% higher for low temperature application under the same working circumstances and refrigeration power. It is also demonstrated that the TEWI for R448A is 16% lesser. Therefore, based on these findings, R448A is a very effective short-term replacement for R404A refrigerant in the commercial refrigeration field in Mauritius, both from an environment and energy perspective. Additionally, it can be used in place of R404A without any system modification. R448A is currently not widely accessible on the market and is a relatively more expensive refrigerant.
Lojas Virtuais: Inovação, Tecnologia e Calor Humano
Authors: Matos Luís , Sciencia do Prado Lucas
Published: May 2024

O presente caso de ensino retrata as dificuldades encontradas e estratégias adotadas pela empresa Magazine Luiza para se desenvolver no mercado com a implantação de lojas virtuais, atendendo seus objetivos e as necessidades de seus clientes. Partindo do ponto de vista Loja Virtual ou lojas sem produtos, surgiram outras oportunidades para a empresa, demonstrando a importância do e-commerce para varejo e ainda apresentando a atuação do Magazine Luiza. O objetivo deste caso de ensino é gerar conhecimento sobre a importância do e-commerce, da tecnologia e da integração com lojas físicas, considerando um caso de destaque no varejo nacional. Assim, a partir do caso é possível compreender os diferentes formatos varejistas e a sua integração numa estratégia omnichannel. Além disso, é possível avaliar a necessidade de adaptação do composto varejistas nas decisões de marketing, pensando na evolução do modelo das lojas virtuais.
Palavras-chave: inovação. E-commerce; competitiva; tecnologia; Varejo.
Il mòcheno
Authors: Cognola Federica
Published: May 2024

The aim of this article is to illustrate the Mòcheno language through a discussion of the historical development of the Mòcheno community, the etymology of the word Mòcheno, an overview of its key phonological, morphological, syntactic and lexical properties. It will be shown that the Mòcheno language is a conservative variety exhibiting typical traits of Middle-High German (1050–1350), which belongs to the Southern Bavarian dialects group. The contact with Romance varieties can surely be found but is to be considered marginal.
Developing a chatbot to support victim-survivors who are subjected to domestic abuse: considerations and ethical dilemmas
Authors: Butterby Kate , Lombard Nancy
Published: May 2024

This Open Space piece discusses the implementation of a chatbot for victim-survivors who are subjected to domestic abuse. Being deployed as part of the ISEDA project (Innovative Solutions to Eliminate Domestic Abuse), a Horizon Europe project involving 15 partners from nine European countries, the chatbot will aim to provide women who are subjected to domestic abuse with information about domestic abuse, local support services, links to emergency services and potentially act as a place to store evidence that can be used in court. We discuss the ethical considerations surrounding the implementation of the chatbot within the project, and use of technology to support women within the domestic abuse sector in general. We highlight some of the positives alongside pitfalls of this way of working, and outline some of the considerations surrounding longevity of the chatbot in light of empowering under-funded women’s services.
Peer-Mediated Programs Amidst a Pandemic: Perspectives on Implementation, Impact, and Future Considerations
Authors: Pulido Stephanie , Matthews Amy , Owen-DeSchryver Jamie , Harr-Smith Lindsey , Carter Erik W.
Published: May 2024

Schoolwide peer-mediated programs have long been advocated as an avenue for promoting inclusion, friendship, and learning for students with autism and other developmental disabilities. Such interactive programs faced complexities amid the COVID-19 pandemic. We surveyed representatives of 91 elementary and secondary schools implementing a peer-mediated program called Peer to Peer (Ziegler et al., 2020). Participants described how the pandemic impacted program involvement, implementation, and inclusion across two school years. In open-ended questions, participants described program adaptations and how the pandemic deepened their commitment to inclusion. We discuss implications for research and practice aimed at strengthening peer-mediated programs to advance inclusion and belonging within—and after—a global pandemic.
Difference in Narnia: Giants, Dwarfs, and Others
Authors: Graham Jean E.
Published: May 2024

Abstract: In the Chronicles of Narnia , C. S. Lewis describes giants and dwarfs in a manner that inadvertently suggests their inferiority in body, and sometimes in intellect and morality. While Lewis asks readers to refrain from open mockery of such characters, we can move beyond common politeness to empathy for others.
Single-modulator, dual comb serrodyne spectroscopy
Authors: Stroud Jasper R. , Long David A. , Plusquellic David F.
Published: May 2024

Dual optical frequency comb spectroscopy allows for high speed, broadband measurements without any moving parts. Here, we combine differential chirp downconversion to probe large spectral bandwidths and serrodyne modulation to separate the positive and negative sidebands in a single modulator. As an initial demonstration, we apply this approach to measure a sharp cavity resonance to illustrate the system performance. We then measure methane transitions in the near-infrared and compare the resulting spectra to models based upon the current spectroscopic databases. The serrodyne method has lower hardware requirements compared to many existing approaches, and its simplicity enables a high degree of mutual coherence between the two combs. Further, this method is readily amenable to chip-scale photonic integration.
Diabetes mellitus as a risk factor for severe dengue fever and West Nile fever: A meta-analysis
Authors: Lu Hong-Zheng , Xie Yu-Zhuang , Gao Chen , Wang Ying , Liu Ting-Ting , Wu Xing-Zhe , Dai Fang , Wang Duo-Quan , Deng Sheng-Qun
Published: May 2024

Background

Dengue fever (DF) and West Nile fever (WNF) have become endemic worldwide in the last two decades. Studies suggest that individuals with diabetes mellitus (DM) are at a higher risk of developing severe complications from these diseases. Identifying the factors associated with a severe clinical presentation is crucial, as prompt treatment is essential to prevent complications and fatalities. This article aims to summarize and assess the published evidence regarding the link between DM and the risk of severe clinical manifestations in cases of DF and WNF.

Methodology/Principal findings

A systematic search was conducted using the PubMed and Web of Science databases. 27 studies (19 on DF, 8 on WNF) involving 342,873 laboratory-confirmed patients were included in the analysis. The analysis showed that a diagnosis of DM was associated with an increased risk for severe clinical presentations of both DF (OR 3.39; 95% CI: 2.46, 4.68) and WNF (OR 2.89; 95% CI: 1.89, 4.41). DM also significantly increased the risk of death from both diseases (DF: OR 1.95; 95% CI: 1.09, 3.52; WNF: OR 1.74; 95% CI: 1.40, 2.17).

Conclusions/Significance

This study provides strong evidence supporting the association between DM and an increased risk of severe clinical manifestations in cases of DF and WNF. Diabetic individuals in DF or WNF endemic areas should be closely monitored when presenting with febrile symptoms due to their higher susceptibility to severe disease. Early detection and appropriate management strategies are crucial in reducing the morbidity and mortality rates associated with DF and WNF in diabetic patients. Tailored care and targeted public health interventions are needed to address this at-risk population. Further research is required to understand the underlying mechanisms and develop effective preventive and therapeutic approaches.
Spatialtemporal evolution characteristics of ozone in China and its response to urbanization
Authors: Wang Li-Min , Ran Zi-Yi , Wu Xiang-Li , Wang Heng-Yu , Zhao Li-Bin
Published: May 2024

Based on the background of urbanization in China, we used the dynamic spatial panel Durbin model to study the driving mechanism of ozone pollution empirically. We also analyzed the spatial distribution of ozone driving factors using the GTWR. The results show that: i) The average annual increase of ozone concentration in ambient air in China from 2015 to 2019 was 1.68μg/m3, and 8.39μg/m3 elevated the year 2019 compared with 2015. ii) The Moran’s I value of ozone in ambient air was 0.027 in 2015 and 0.209 in 2019, showing the spatial distribution characteristics of "east heavy and west light" and "south low and north high". iii) Per capita GDP industrial structure, population density, land expansion, and urbanization rate have significant spillover effects on ozone concentration, and the regional spillover effect is greater than the local effect. R&D intensity and education level have a significant negative impact on ozone concentration. iv) There is a decreasing trend in the inhibitory effect of educational attainment and R&D intensity on ozone concentration, and an increasing trend in the promotional effect of population urbanization rate, land expansion, and economic development on ozone concentration. Empirical results suggest a twofold policy meaning: i) to explore the causes behind the distribution of ozone from the new perspective of urbanization, and to further the atmospheric environmental protection system and ii) to eliminate the adverse impacts of ozone pollution on nature and harmonious social development.
Spatiotemporal variations in migratory bird diversity and abundance along the coast of Gochang getbol
Authors: Lee Myung-Bok , Lee Ju-Hyun , Bing Gi-Chang , Choi Won-Suk , Ha Jung-Moon , Jang Jae-Ung , Kim Se-Yeong , Son Jong-Ju , Chang Ah-Jin , Lee Ji-Young , Cho Dae-Han , Sung Ha-Cheol
Published: May 2024

Tidal flats provide critical habitat for migratory waterbird species; however, populations of migratory waterbirds have significantly declined due to tidal flat loss and degradation caused by human activities, particularly in Asia. Gochang getbol is one of tidal flats located on the southwest coast of South Korea and a center of clam production. Using bird monitoring data collected at five zones (zone1 to zone5) established across Gochang getbol and near coastal area, we examined distribution patterns of migratory bird diversity and conservation-related species along the coast of Gochang getbol. The intensity of human activity ‒ mudflat culture (mostly bivalve) and aquaculture was relatively high at zone2 and zone3, occupying > 30% of 2km circular area surrounding most sample points of these zones. Zone1 and particularly zone4 contained more natural/semi-natural habitats (less disturbed mudflats and wetlands) and zone5 had smallest mudflat than others. Shannon diversity, species richness, and abundance of migratory birds differed between zones (Anova test, P ≤ 0.02) except Shannon diversity in winter. In fall, all values were higher at zone4 than zone3 and zone5. In winter, zone1 showed greatest species richness and higher abundance than zone2, zone3, and zone5. In spring, while most differences were found between zone4 and zone5, abundance at zone4 was somewhat higher than zone2. The results from the fourth corner analysis indicated that abundance of species foraging at mudflat level was positively associated with zone1 (winter) but negatively with zone3 (fall). Sandpipers were positively associated with zone4. Abundance distribution maps of conservation-related species, created by inverse distance-weighted interpolation modeling, also showed high abundance of most conservation-related species at zone4 and 1. The findings of our study suggest the importance of natural/semi-natural habitat, and the possible link between human activity and distribution patterns of migratory birds in Gochang getbol. While we need further investigation on direct response of migratory birds to human activity, areas with low human activity with more natural/semi-natural habitat, e.g., zone4 and zone1 may be crucial for the conservation of migratory birds.
A systematic review of barriers and facilitators to antenatal screening for HIV, syphilis or hepatitis B in Asia: Perspectives of pregnant women, their relatives and health care providers
Authors: Sabin Lucie , Haghparast-Bidgoli Hassan , Miller Faith , Saville Naomi
Published: May 2024

Background

Despite improvements, the prevalence of HIV, syphilis, and hepatitis B remains high in Asia. These sexually transmitted infections (STIs) can be transmitted from infected mothers to their children. Antenatal screening and treatment are effective interventions to prevent mother-to-child transmission (MTCT), but coverage of antenatal screening remains low. Understanding factors influencing antenatal screening is essential to increase its uptake and design effective interventions. This systematic literature review aims to investigate barriers and facilitators to antenatal screening for HIV, syphilis, and hepatitis B in Asia.

Methods

We conducted a systematic review by searching Ovid (MEDLINE, Embase, PsycINFO), Scopus, Global Index Medicus and Web of Science for published articles between January 2000 and June 2023, and screening abstracts and full articles. Eligible studies include peer-reviewed journal articles of quantitative, qualitative and mixed-method studies that explored factors influencing the use of antenatal screening for HIV, syphilis or hepatitis B in Asia. We extracted key information including study characteristics, sample, aim, identified barriers and facilitators to screening. We conducted a narrative synthesis to summarise the findings and presented barriers and facilitators following Andersen’s conceptual model.

Results

The literature search revealed 23 articles suitable for inclusion, 19 used quantitative methods, 3 qualitative and one mixed method. We found only three studies on syphilis screening and one on hepatitis B. The analysis demonstrates that antenatal screening for HIV in Asia is influenced by many barriers and facilitators including (1) predisposing characteristics of pregnant women (age, education level, knowledge) (2) enabling factors (wealth, place of residence, husband support, health facilities characteristics, health workers support and training) (3) need factors of pregnant women (risk perception, perceived benefits of screening).

Conclusion

Knowledge of identified barriers to antenatal screening may support implementation of appropriate interventions to prevent MTCT and help countries achieve Sustainable Development Goals’ targets for HIV and STIs.
Improved U-net network asphalt pavement crack detection method
Authors: Zhang Qiong , Chen Shanshan , Wu Yue , Ji Zhonghang , Yan Fei , Huang Shiling , Liu Yunqing
Published: May 2024

Road crack detection is one of the important parts of road safety detection. Aiming at the problems such as weak segmentation effect of basic U-Net on pavement crack, insufficient precision of crack contour segmentation, difficult to identify narrow crack and low segmentation accuracy, this paper proposes an improved U-net network pavement crack segmentation method. VGG16 and Up_Conv (Upsampling Convolution) modules are introduced as backbone network and feature enhancement network respectively, and the more abstract features in the image are extracted by using the Block depth separable convolution blocks, and the multi-scale features are captured and enhanced by higher level semantic information to improve the recognition accuracy of narrow cracks in the road surface. The improved network embedded the Ca(Channel Attention) attention mechanism in U-net’s jump connection to enhance the crack portion to suppress background noise. At the same time, DG_Conv(Depthwise GSConv Convolution) module and UnetUp(Unet Upsampling) module are added in the decoding part to extract richer features through more convolutional layers in the network, so that the model pays more attention to the detailed part of the crack, so the segmentation accuracy can be improved. In order to verify the model’s ability to detect cracks in complex backgrounds, experiments were carried out on CFD and Deepcrack datasets. The experimental results show that compared with the traditional U-net network F1-score and mIoU have increased by 13.6% and 9.9% respectively. Superior to advanced models such as U-net, Segnet and Linknet in accuracy and generalization ability, the improved model provides a new method for asphalt pavement crack detection. The model is more conducive to practical application and ground deployment, and can be applied in road maintenance projects.
A model for skin cancer using combination of ensemble learning and deep learning
Authors: Hosseinzadeh Mehdi , Hussain Dildar , Zeki Mahmood Firas Muhammad , A. Alenizi Farhan , Varzeghani Amirhossein Noroozi , Asghari Parvaneh , Darwesh Aso , Malik Mazhar Hussain , Lee Sang-Woong
Published: May 2024

Skin cancer has a significant impact on the lives of many individuals annually and is recognized as the most prevalent type of cancer. In the United States, an estimated annual incidence of approximately 3.5 million people receiving a diagnosis of skin cancer underscores its widespread prevalence. Furthermore, the prognosis for individuals afflicted with advancing stages of skin cancer experiences a substantial decline in survival rates. This paper is dedicated to aiding healthcare experts in distinguishing between benign and malignant skin cancer cases by employing a range of machine learning and deep learning techniques and different feature extractors and feature selectors to enhance the evaluation metrics. In this paper, different transfer learning models are employed as feature extractors, and to enhance the evaluation metrics, a feature selection layer is designed, which includes diverse techniques such as Univariate, Mutual Information, ANOVA, PCA, XGB, Lasso, Random Forest, and Variance. Among transfer models, DenseNet-201 was selected as the primary feature extractor to identify features from data. Subsequently, the Lasso method was applied for feature selection, utilizing diverse machine learning approaches such as MLP, XGB, RF, and NB. To optimize accuracy and precision, ensemble methods were employed to identify and enhance the best-performing models. The study provides accuracy and sensitivity rates of 87.72% and 92.15%, respectively.
The association between caesarean section delivery and obesity at age 17 years. Evidence from a longitudinal cohort study in the United Kingdom
Authors: O. Gorman Tessa , Maher Gillian M. , Al Khalaf Sukainah , Khashan Ali S.
Published: May 2024

Background

Childhood and adolescent obesity are major, preventable public health concerns. Studies to date are inconclusive regarding an association between caesarean section (CS) delivery and offspring obesity, with fewer studies conducted in late adolescence. This study examined the association between CS delivery, with a specific focus on planned CS, and induction of labour and adolescent body mass index (BMI) and body fat percentage (BF%) at age 17 years.

Methods

Data on 8,880 mother-child pairs from the United Kingdom Millennium Cohort Study were analysed. The exposures were mode of delivery (normal vaginal delivery (VD) (reference), assisted VD, planned CS and emergency CS) and mode of delivery by induction of labour status. Crude and adjusted binary logistic regression and linear regression models were fitted examining BMI and BF% at age 17 years respectively, adjusting for several potential confounders.

Results

Adolescents born by CS did not have an elevated BMI or BF% compared to those born by normal VD. The fully adjusted results for overweight and obesity in children born by planned CS, compared to VD, were 1.05 (95% CI: 0.86–1.28) and 0.94 (95% CI: 0.72–1.23), respectively. The results were similar for the associations between CS and BF%, and between induction of labour and BMI.

Conclusion

Overall, this large longitudinal study did not support an association between CS or induction of labour and overweight, obesity or BF%. It is possible that previously reported associations are due to residual or unmeasured confounding and/or underlying indications for CS delivery.
Vitamin C and E antioxidant supplementation may significantly reduce pain symptoms in endometriosis: A systematic review and meta-analysis of randomized controlled trials
Authors: Bayu Patrick , Wibisono Jacobus Jeno
Published: May 2024

Background

The primary challenge encountered by individuals diagnosed with endometriosis is the experience of pain. Emerging research indicates that oxidative stress is implicated in the initiation of pain associated with endometriosis. Vitamins C and E are known for their antioxidative properties. The primary objective of this study is to assess the efficacy of antioxidant supplementation, consisting of these vitamins, in the management of pain associated with endometriosis.

Methods

A comprehensive search was conducted on the ClinicalTrials.gov, Scopus, Europe PMC, and Medline databases up until August 23rd, 2023, utilizing a combination of relevant keywords. This review incorporates literature that examines the relationship between antioxidant supplementation and pain in endometriosis. We employed fixed-effect models to analyze the risk ratio (RR) and present the outcomes together with their corresponding 95% confidence intervals (CI).

Results

A total of five RCTs were incorporated. The results of our meta-analysis indicated that antioxidant supplementation with vitamin C and E combination was associated with higher proportion of endometriosis patients reporting reduced chronic pelvic pain (RR 7.30; 95%CI: 3.27–16.31, p<0.00001, I2 = 0%), alleviations of dysmenorrhea (RR 1.96; 95%CI: 1.25–3.07, p = 0.003, I2 = 39%), and dyspareunia (RR 5.08; 95%CI: 2.10–12.26, p = 0.0003, I2 = 0%) than patients only receiving placebo.

Conclusions

This study suggests the potential ability of vitamin C and E in alleviating pain symptoms experienced by individuals with endometriosis.