bluuebunny/crossref_metadata_2025 huggingface dataset:
Risk Factors for Shoulder Injuries in Female Athletes Playing Overhead Sports: A Systematic Review
Authors: Steele Malia C. , Lavorgna Tessa R. , Ierulli Victoria K. , Mulcahey Mary K.
Published: June 2024

Context:

Sports involving overhead motions put substantial biomechanical demands on the shoulder and may result in injuries.

Objective:

To determine risk factors (RFs) for shoulder injuries in female athletes who play overhead sports and evaluate strategies to reduce shoulder injuries in these athletes.

Data Sources:

A systematic electronic search was performed according to Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) guidelines. Databases included were PubMed, Tulane Matas Library Search Engine, and Google Scholar, with search terms: “Overhead injuries/Shoulder AND female athletes AND Risk Factors.”

Study Selection:

Of the initial 1574 studies identified, 314 were evaluated for eligibility by full-text review and 291 studies were excluded. Overall, 23 studies were included in this study. Studies were published from 2000 to 2021, subject age range was 15 to 35 years, with documented prevalence of shoulder injuries in female athletes playing overhead sports.

Study Design:

Systematic review.

Level of Evidence:

Level 2.

Data Extraction:

Two independent researchers completed abstract and full-text review. Data extraction used the Covidence and Cochrane Consumer guide template.

Results:

Volleyball was the most common sport with shoulder injuries (6/23; 26%) followed by softball 5/23 (22%), swimming 5/23 (22%), gymnastics 4/23 (17%), tennis 3/23 (13%), water polo 2/23 (8%), and basketball 1/23 (4%). Six RFs (dominant shoulder, volume/overuse, time in sport, older age at time of injury, past injury, and multidirectional instability) were described. Of the 23 studies, 9 (39%) identified the dominant shoulder as a RF for sustaining injury (mean risk ratio [RR], 2.04), while 6 (26%) cited volume of repetition and overuse as a prominent RF (RR, 1.45).

Conclusion:

This systematic review demonstrates important RFs for shoulder injuries in female athletes associated with playing overhead sports. Multiple prevention strategies are described. Prevention programs are helpful in reducing the risk of reinjury.
Headscarf bans in the public workplace before the Court of Justice: OP v. Commune d’Ans or the Art of Ambiguity
Authors: Ringelheim Julie
Published: June 2024

OP v Commune d'Ans, handed down on 28 November 2023, is the fifth judgment issued by the Court of Justice of the European Union on a ban on the wearing of religious symbols in employment, but the first to concern a public workplace. This article argues that the judgment does not help clarify the issue. It is ambiguous and provides only vague guidance to national courts. Two aspects of its reasoning are particularly puzzling: firstly, the absence of any discussion on the very meaning and implications of the neutrality of the public service; and secondly, the recognition of a margin of discretion not only for states but also for sub-state entities, such as municipalities, in determining the concrete content of that principle.
Rapid and sustained response to luspatercept and eltrombopag combined treatment in one case of clonal cytopenias of undetermined significance with prior failure to cyclosporin and androgen therapy: a case report
Authors: Xu Jing , Yan Yixin , Zong Siwen , Ye Wencan , Zheng Jifu , Min Chao , Wang Qingming , Li Zhenjiang
Published: June 2024

Clonal cytopenia of undetermined significance (CCUS) has the characteristics of high-risk transformation into myelodysplastic syndromes. At present, there are few effective treatments for CCUS, and there is no consensus or evidence-based recommendation. We present a case demonstrating a rapid, significant and sustained response to combined treatment with luspatercept and eltrombopag, following the failure of cyclosporin and androgen therapy. Even after discontinuing luspatercept for 10 months, trilineage haematopoiesis remained normal with the use of cyclosporin and other haematopoietic stimulants. This case suggests that the inhibition of transforming growth factor-β could potentially have an immunomodulatory effect, thereby promoting the recovery of haematopoietic function. Luspatercept, along with Acalabrutinib or Cyclosporine, may synergistically stimulate haematopoiesis.
A pancreatic pseudocyst sitting in the mediastinum—A case report of an unusual occurrence
Authors: Amin Said , Shahab Aymen , Khan Asad Ali , Gul Mudasir , Liaqat Aiman , Ullah Hamid , Ali Kashif , Qazi Abdur Rahman
Published: June 2024

Pancreatitis can produce several complications such as pseudocyst, which can happen in acute and chronic pancreatitides. Pseudocysts are typically found in the abdomen but can rarely extend into the mediastinum. Atypical symptoms such as dyspnea, dysphagia, coughing, vomiting, abdominal or chest pain, and hemoptysis are usually the notable complaints. CT scan, MRI, and endoscopic ultrasound are valuable diagnostic modalities. Drainage and surgical removal of the pseudocyst are the treatment options. Herein, we outline the case of a young female with episodic chest and epigastric discomfort, dysphagia, and weight loss. Previously, she was incorrectly diagnosed with gastroesophageal reflux disease and peptic ulcer. A mediastinal pseudocyst secondary to chronic pancreatitis was found to be the cause. The patient underwent surgical removal of the pseudocyst and a pancreaticojejunostomy. Significant improvement was noticed at follow-up. This article highlights the possibility of such unusual conditions and the importance of a proper assessment while treating patients with epigastric pain.
Politician responses to material incentives for participation in surveys: Experimental evidence from South Africa
Authors: Lockwood Sarah , Lieberman Evan
Published: June 2024

Political scientists routinely focus their investigations on the attitudes and behaviours of politicians and increasingly study them through systematic surveys. As with all surveys, researchers aim to maximize response rates, but we know little about the incentives that motivate politicians to participate in survey research. In this paper, we consider whether financial incentives in the form of small cash payments or participation in lotteries for slightly larger rewards increase participation. Based on a randomized control trial (RCT) conducted as part of an effort to survey local councillors in South Africa, we find that, if anything, material incentives depress response rates overall – weighing against their use in future surveys. However, we also find some heterogeneity in estimated effects by political party, which may indicate that the intentional provision of material incentives can affect sample compositions in ways that may be beneficial for some studies. While our findings in this regard are only suggestive, they should inform future research and research methods.
Market and Supply Chain Orientation; Dynamic Capabilities Leading to Innovation and Operational Capabilities
Authors: Al Azzani Hamed Ali , Mat Jusoh Normal , Abbas Aamir
Published: June 2024

SMEs always need survival tools or strategies such as orientation and capabilities to survive in the competitive market, as they can help in improving performance. Therefore, this research has highlighted important capabilities and orientations influencing SMEs’ performance in Oman. It has examined the effect of supply chain orientation and market orientation on SMEs’ performance with mediating role of innovation capabilities and operational capabilities. Moreover, it investigated the role of strategic flexibility as a moderator between innovation capabilities and SMEs’ performance in Oman. The survey method was used to collect primary data from managers and supervisors of SMEs functional in Oman. Data analysis was done using AMOS, and structural equation modeling (SEM) was conducted. The moderation was examined by using the Hayes process macro on SPSS. The results revealed that market orientation and SC orientation positively influence SMEs’ innovation capabilities, operational capabilities, and performance. These capabilities also help in enhancing performance. Moreover, they mediate the relationship between “supply chain orientation and SMEs’ performance” and “market orientation and SMEs’ performance.” Furthermore, strategic flexibility does not moderate the effect of innovation capabilities on SMEs’ performance.
Examining Cognitive and Social Proximities’ Influence on Cluster Firms’ Green Technological Innovation
Authors: Han Mei , Xu Bilin
Published: June 2024

Green technological innovation (GTI) has the dual externalities of promoting technological advancements and facilitating environmental protection. GTI assists manufacturing clusters respond to emission reduction and environmental protection challenges. Non-geographic proximity is vital in promoting knowledge sharing among organizations, facilitating GTI’s effective implementation; in this regard, a gap exists in the current literature. Using data from 330 cluster firms in China’s fine chemical industry and drawing on the knowledge-based view, this study explores how cognitive and social proximities affect GTI in cluster firms. The key findings are as follows: First, cognitive and social proximities are crucial factors driving GTI. Second, knowledge sharing mediates the relationship between proximity and GTI. Third, technological distance positively moderates the relationship between social proximity and green product innovation, and that between social proximity and end-of-pipe technological innovation. These findings have critical implications for cluster firms looking to cultivate network relationships based on distinct types of GTI.
Exploring Political Expression Among Indonesian Youth on YouTube: An Investigation of Social Identity and Source Credibility
Authors: Venus Anter , Intyaswati Drina , Ayuningtyas Fitria
Published: June 2024

The high consumption rate of YouTube media compared to other social media platforms is a notable feature of contemporary media usage. This is particularly significant in Indonesia, where the current situation demands increased political involvement, particularly among young people. Given the polarization among citizens, political expression through social media has emerged as an effective means of sharing opinions and views. YouTube, with its vast user base and accessibility, has become a prominent platform for such expression. Therefore, this study aims to evaluate the role of social identity, personal identity, source credibility, and word of mouth in political expression. Social Identity and Source Credibility Theories are integrated to form a study model. A sample of 435 YouTube users residing in Jakarta was obtained by distributing questionnaires through social media using the survey method. Furthermore, the Structural Equation Model (SEM) analysis showed that each social identity, personal identity, source credibility, and word of mouth directly affects political expression. The negative relationship between social identity and political expression, as well as source credibility with political expression, requires further study involving motivational and attitudinal variables.
Moral Entrepreneurship and the Ethics of Artificial Intelligence in Digital Psychiatry
Authors: Vale Mira D.
Published: June 2024

Researchers who use artificial intelligence (AI) and machine learning tools face pressure to pursue “ethical AI,” yet little is known about how researchers enact ethical standards in practice. The author investigates the development of AI ethics using the case of digital psychiatry, a field that uses machine learning to study mental illness and provide mental health care. Drawing on ethnographic research and interviews, the author analyzes how digital psychiatry researchers become “moral entrepreneurs,” actors who wield their social influence to define ethical conduct, through two practices. First, researchers engage in moral discovery, identifying gaps in regulation as opportunities to articulate ethical standards. Second, researchers engage in moral enclosure, specifying a community of people licensed to do moral regulation. With these techniques, digital psychiatry researchers demonstrate ethical innovation is essential to their professional identity. Yet ultimately, the author demonstrates how moral entrepreneurship erects barriers to participation in ethical decision making and constrains the focus of ethical consideration.
Ethical Dilemmas and Collaborative Resolutions in Machine Learning Research for Health Care
Authors: Zilberstein Shira
Published: June 2024

Drawing on ethnographic, interview, and textual data with researchers creating machine learning solutions for health care, the author explains how researchers justify their projects while grappling with uncertainties about the benefits and harms of machine learning. Researchers differentiate between a hypothesized world of machine learning and a “real” world of clinical practice. Each world relates to distinct frameworks for describing, evaluating, and reconciling uncertainties. In the hypothesized world, impacts are hypothetical. They can be operationalized, controlled, and computed as bias and fairness. In the real world, impacts address patient outcomes in clinical settings. Real impacts are chaotic and uncontrolled and relate to complex issues of equity. To address real-world uncertainties, researchers collaborate closely with clinicians, who explain real-world implications, and participate in data generation projects to improve clinical datasets. Through these collaborations, researchers expand ethical discussions, while delegating moral responsibility to clinicians and medical infrastructure. This preserves the legitimacy of machine learning as a pure, technical domain, while allowing engagement with health care impacts. This article contributes an explanation of the interplay between technical and moral boundaries in shaping ethical dilemmas and responsibilities, and explains the significance of collaboration in artificial intelligence projects for ethical engagement.
Double diffusive convection for MHD peristaltic movement of Carreau nanofluid with Hall effects
Authors: Kazmi SN , Abbasi FM , Iqbal J
Published: June 2024

This study investigates the magnetohydrodynamics (MHD) peristaltic motion of double diffusive convection of Carreau nanofluid through an asymmetric channel. Hall and magnetic field effects are also incorporated. The governing equations are simplified under the assumptions of large wavelength and small Reynolds number. Resulting set of equations are solved numerically and graphs are obtained to analyze the influences of pertinent flow parameters such as Hartmann number, Hall parameter, Grashof number, solutal Grashof, thermophoresis parameter, Brownian motion, and Dufour and Soret parameters on different flow profiles. Isotherms and trapping phenomena are also discussed via graphs. The outcomes reveal that higher values of Hall parameter improve velocity profile. Large values of hydrodynamic parameters enhance the nanofluid’s temperature. For higher values of the Hartmann number, the velocity profile near the channel walls improves. It is also observed that the nanoparticle Grashof and thermal Grashof numbers exhibit opposite behaviors on both channel walls. Additionally, the temperature profile increases with improving values of the thermophoresis parameter and Brownian motion, while the solutal (species) concentration profile decreases under these conditions. The pumping rate of the peristaltic flow is maintained through thermal and nanoparticles Grashof number. Streamlines and isotherms are regulated through Hartmann number and Hall parameter. Furthermore, it is observed that the pressure gradient decreases for higher Hartmann number due to the influence of the “Lorentz force” which imparts physical resistance to the liquid. This study may help in various fields of science and engineering, particularly in understanding natural phenomena, heat and mass transport in fluid systems, chemical engineering, physiology, and medical sciences.
Division by countries of origin? Visualizing the spatial distributions of international migrants in Guangzhou, China
Authors: Tan Yiming , Chen Zifeng
Published: June 2024

Socio-spatial segregation of immigrants or other ethno-racial groups in Western cities has been extensively investigated. In the recent decades, China has also witnessed a substantial growth of international immigrants. In the city of Guangzhou, one of the most famous destinations in China for transnational migration, the spatial presence of international migrants has received scholarly attention, mostly focusing on single racial groups. In this study, we present two cartograms using cellphone data to visualize the spatial distributions of multiple groups of international migrants, namely, the African migrants, the European and North American migrants, and the Japanese and Korean migrants, in Guangzhou. The cartograms indicate that the spatial distributions of migrants from Africa and those from the European, North American, and East Asian countries are considerably divided in Guangzhou, suggesting a possible ethno-racial segregation among the international migrants in this Chinese city. Such an issue is largely under-researched in the existing literature.
‘It is important to feel invited’: what patients require when using the Utrecht Symptom Diary – 4 Dimensional, a qualitative exploration
Authors: Lormans Tom , de Graaf Everlien , de Vries Sita , Leget Carlo , Teunissen Saskia
Published: June 2024

Background:

In palliative care, the Utrecht Symptom Diary – 4 Dimensional (USD-4D), a Dutch-adapted and validated patient-reported outcome measure, supports multidimensional symptom management through identification and monitoring of, as well as dialogue on symptoms and needs. For the USD-4D to optimally support patients’ autonomy, it is essential to know what patients need to use it.

Objective:

This study aims to identify what patients need when using the USD-4D in clinical palliative care.

Design:

A generic qualitative design with primary and secondary analyses of semistructured interviews.

Methods:

Patients ⩾18 years with a life-limiting illness were purposefully recruited within hospice and home care settings if they were in their last year of life as identified by the surprise question. Patients had to be aware of their life-threatening condition. Patients were selected in two tranches. In the first tranche, patients had to have completed the USD-4D at least once. The second tranche consisted of patients who were not familiar with the USD-4D in clinical practice and were interviewed in a previous study on the content validity of the USD-4D. The interviews were transcribed verbatim and were subjected to thematic analysis.

Results:

Twenty-five patients were included (14 men, ages 44–87). Patients’ needs when using the USD-4D were summarized in three themes: (1) feeling invited, (2) being aware of the purpose and function of the USD-4D, and (3) experiencing a personal and nonjudgmental approach.

Conclusion:

For patients to optimally benefit from the USD-4D as a supportive measure of their autonomy in clinical palliative care, it is essential that they feel invited to use it. Healthcare providers are tasked with setting the right preconditions for patients to want and to be able to use the USD-4D. For patients, this means healthcare providers should always be attuned to their personal preferences when communicating the purpose and function of the USD-4D and when they enter into dialogue with them.
Study protocol for evaluating the efficacy of early pulmonary rehabilitation combined with an internet-based patient management model in patients with COPD: a practical, multicentre, randomised controlled study from China
Authors: Ye Wang , Danye Li , Jingjing Cui , Siyu Zhang , Jiaxi Wang , Siyuan Wang , Hongmei Zhao , Chen Wang
Published: June 2024

Background

COPD, a preventable and treatable disease, is characterised by persistent respiratory symptoms and airflow limitations, with high incidence, disability, mortality and disease burden. Currently, drug treatments mainly include bronchodilators and glucocorticoids, which are used to alleviate symptoms and improve lung function. Traditional medical care models and patients' lack of understanding of the disease result in regular and long-term hospitalisations, affect patients’ quality of life and cause a need to explore more effective comprehensive intervention plans.

Methods

This study is designed as a multicentre, randomised controlled trial consisting of three parallel groups. Group A will receive early pulmonary rehabilitation in the hospital and remote internet pulmonary rehabilitation after discharge. Group B will receive the same early pulmonary rehabilitation in the hospital but outpatient pulmonary rehabilitation after discharge for 8 weeks and routine follow-up management. Group C will receive outpatient pulmonary rehabilitation during a stable period of 3–4 weeks after discharge and routine follow-up management. 1482 patients will be enrolled from 10 centres in China. The primary outcome measures will be the readmission rate due to acute exacerbation at 90 days and the 12-month readmission rate due to acute exacerbation. The secondary outcomes will mainly include differences in all-cause mortality; the number of acute exacerbations; COPD Assessment Test, modified Medical Research Council scale and St George's Respiratory Questionnaire scores; the pulmonary rehabilitation treatment completion rate; patient compliance; and patient and physician satisfaction scores among the three groups at 3, 6 and 12 months after the different interventions. In addition, the proportion of people with ≥2 acute exacerbations within 12 months and the time of the first acute exacerbation will also be included.

Conclusions

This study aims to further verify the substitutability of remote internet pulmonary rehabilitation for outpatient rehabilitation and its short-term and long-term effects in patients, providing comprehensive interventional evidence for the treatment of COPD.
Comparing preprocessing strategies for 3D-Gene microarray data of extracellular vesicle-derived miRNAs
Authors: Takemoto Yuto , Ito Daisuke , Komori Shota , Kishimoto Yoshiyuki , Yamada Shinichiro , Hashizume Atsushi , Katsuno Masahisa , Nakatochi Masahiro
Published: June 2024

Background

Extracellular vesicle-derived (EV)-miRNAs have potential to serve as biomarkers for the diagnosis of various diseases. miRNA microarrays are widely used to quantify circulating EV-miRNA levels, and the preprocessing of miRNA microarray data is critical for analytical accuracy and reliability. Thus, although microarray data have been used in various studies, the effects of preprocessing have not been studied for Toray’s 3D-Gene chip, a widely used measurement method. We aimed to evaluate batch effect, missing value imputation accuracy, and the influence of preprocessing on measured values in 18 different preprocessing pipelines for EV-miRNA microarray data from two cohorts with amyotrophic lateral sclerosis using 3D-Gene technology.

Results

Eighteen different pipelines with different types and orders of missing value completion and normalization were used to preprocess the 3D-Gene microarray EV-miRNA data. Notable results were suppressed in the batch effects in all pipelines using the batch effect correction method ComBat. Furthermore, pipelines utilizing missForest for missing value imputation showed high agreement with measured values. In contrast, imputation using constant values for missing data exhibited low agreement.

Conclusions

This study highlights the importance of selecting the appropriate preprocessing strategy for EV-miRNA microarray data when using 3D-Gene technology. These findings emphasize the importance of validating preprocessing approaches, particularly in the context of batch effect correction and missing value imputation, for reliably analyzing data in biomarker discovery and disease research.
Evaluating vonoprazan and tegoprazan for gastroesophageal reflux disease treatment in Chinese Healthcare: an EVIDEM framework analysis
Authors: Xue Chaojun , Du Yuhan , Yang Haotian , Jin Huixin , Zhao Yue , Ren Bingnan , Dong Zhanjun
Published: June 2024

Background

In Chinese healthcare settings, drug selection decisions are predominantly influenced by the Pharmacy & Therapeutics Committee (PTC). This study evaluates two recently introduced potassium-competitive acid blockers, vonoprazan (VPZ) and tegoprazan (TPZ), utilizing the Evidence and Value: Impact on DEcisionMaking (EVIDEM) framework.

Methods

The study employed the 10th edition of EVIDEM, which includes a core model with five domains and 13 criteria. Two independent expert panels were involved: the PTC expert panel, tasked with assigning weights using a 5-point scale, defining scoring indicators, examining the evidence matrix, scoring, and decision-making; and the evidence matrix expert panel, responsible for conducting a systematic literature review, creating the evidence matrix, and evaluating the value contributions of VPZ and TPZ.

Results

The analysis estimated the value contributions of VPZ and TPZ to be 0.59 and 0.54, respectively. The domain of ‘economic consequences of intervention’ showed the most significant variation in value contribution between the two drugs, followed by ‘comparative outcomes of intervention’ and ‘type of benefit of intervention’.

Conclusion

Employing the EVIDEM framework, VPZ’s value contribution was found to be marginally superior to that of TPZ. The EVIDEM framework demonstrates potential for broader application in Chinese medical institutions.
Predictive value of the Naples prognostic score on postoperative delirium in the elderly with gastrointestinal tumors: a retrospective cohort study
Authors: Song Chenhao , Yu Dongdong , Li Yi , Liu Meinv , Zhang Huanhuan , He Jinhua , Li Jianli
Published: June 2024

Background

Postoperative delirium (POD) is a common complication among elderly patients after surgery. The Naples Prognostic Score (NPS), a novel prognostic marker based on immune-inflammatory and nutritional status, was widely used in the assessment of the prognosis of surgical patients. However, no study has evaluated the relationship between NPS and POD. The aim of this article was to investigate the association between NPS and POD and test the predictive efficacy of preoperative NPS for POD in elderly patients with gastrointestinal tumors.

Materials and methods

In the present study, we retrospectively collected perioperative data of 176 patients (≥ 60 years) who underwent elective gastrointestinal tumor surgery from June 2022 to September 2023. POD was defined according to the chart-based method and the NPS was calculated for each patient. We compared all the demographics and laboratory data between POD and non-POD groups. Univariate and multivariate logistic regression analysis was used to explore risk factors of POD. Moreover, the accuracy of NPS in predicting POD was further assessed by utilizing receiver operating characteristic (ROC) curves.

Results

20 had POD (11.4%) in a total of 176 patients, with a median age of 71 (65–76). The outcomes by univariate analysis pointed out that age, ASA status ≥ 3, creatinine, white blood cell count, fasting blood glucose (FBG), and NPS were associated with the risk of POD. Multivariate logistic regression analysis further showed that age, ASA grade ≥ 3, FBG and NPS were independent risk factors of POD. Additionally, the ROC curves revealed that NPS allowed better prognostic capacity for POD than other variables with the largest area under the curve (AUC) of 0.798, sensitivity of 0.800 and specificity of 0.667, respectively.

Conclusion

Age, ASA grade ≥ 3, and FBG were independent risk factors for POD in the elderly underwent gastrointestinal tumor surgery. Notably, the preoperative NPS was a more effective tool in predicting the incidence of POD, but prospective trials were still needed to further validate our conclusion.

Trial registration

The registration information for the experiment was shown below. (date: 3rd January 2024; number: ChiCTR2400079459)
Comparison of gene set scoring methods for reproducible evaluation of tuberculosis gene signatures
Authors: Wang Xutao , VanValkenberg Arthur , Odom Aubrey R. , Ellner Jerrold J. , Hochberg Natasha S. , Salgame Padmini , Patil Prasad , Johnson W. Evan
Published: June 2024

Background

Blood-based transcriptional gene signatures for tuberculosis (TB) have been developed with potential use to diagnose disease. However, an unresolved issue is whether gene set enrichment analysis of the signature transcripts alone is sufficient for prediction and differentiation or whether it is necessary to use the original model created when the signature was derived. Intra-method comparison is complicated by the unavailability of original training data and missing details about the original trained model. To facilitate the utilization of these signatures in TB research, comparisons between gene set scoring methods cross-data validation of original model implementations are needed.

Methods

We compared the performance of 19 TB gene signatures across 24 transcriptomic datasets using both rrebuilt original models and gene set scoring methods. Existing gene set scoring methods, including ssGSEA, GSVA, PLAGE, Singscore, and Zscore, were used as alternative approaches to obtain the profile scores. The area under the ROC curve (AUC) value was computed to measure performance. Correlation analysis and Wilcoxon paired tests were used to compare the performance of enrichment methods with the original models.

Results

For many signatures, the predictions from gene set scoring methods were highly correlated and statistically equivalent to the results given by the original models. In some cases, PLAGE outperformed the original models when considering signatures’ weighted mean AUC values and the AUC results within individual studies.

Conclusion

Gene set enrichment scoring of existing gene sets can distinguish patients with active TB disease from other clinical conditions with equivalent or improved accuracy compared to the original methods and models. These data justify using gene set scoring methods of published TB gene signatures for predicting TB risk and treatment outcomes, especially when original models are difficult to apply or implement.
Clinically inapparent mpox virus (MPXV) infections among clients of three anonymous Community Based Voluntary Counselling and Testing centres in Berlin, Germany, 2022–2023
Authors: Koppe Uwe , Jansen Klaus , Schmidt Axel Jeremias , Weber Christoph , Schulze Heike , Kulis-Horn Robert Kasimir , Tiemann Carsten , Marcus Ulrich
Published: June 2024

Introduction

Since the mpox outbreak in 2022, it was unclear if and how often infections with mpox virus (MPXV) were clinically inapparent, i.e. not presenting to clinical care with mpox symptoms. Moreover, it was hypothesized that MPXV circulated in the affected communities before the outbreak was officially detected.

Methods

We retrospectively tested rectal and urethral swabs, and pooled samples for presence of MPXV. Samples were obtained from routine STI testing of three anonymous Community Based Voluntary Counselling and Testing (CBVCT) centres in Berlin, in 2022 and 2023. Testing results were linked to anonymously provided behavioural data.

Results

Overall, 9,053 samples from 6,600 client visits were included. Clinically inapparent MPXV infections were detectable in 1.1% of the samples. We did not find MPXV infections in the month before the first cases appeared in Berlin or between October 2022 and January 2023 when case numbers were low in Germany. However, during the outbreak period in 2022, we found clinically inapparent MPXV infections among 2.2% of the clients and during summer/autumn 2023 among 0.3%. The number of condomless anal/vaginal intercourse partners within the previous 6 months and PrEP use were identified as predictors of clinically inapparent MPXV infection.

Conclusion

Clinically inapparent MPXV infections occurred during the mpox outbreak in Berlin in 2022 and post-outbreak in summer/autumn 2023. Unrecognized MPXV circulation in Berlin before the recognition of the outbreak in May 2022 appears unlikely. However, low-level sustained circulation of clinically inapparent MPXV infections need to be acknowledged in mpox prevention strategies.
Impact of mobile health technologies on human papillomavirus vaccination uptake among mothers of unvaccinated girls aged 9–14 years in Lagos, Nigeria (mHealth-HPVac): study protocol of a randomised controlled trial
Authors: Okunade Kehinde S. , Adejimi Adebola A. , Adekanye Temitope V. , Allsop Matthew J. , Adelabu Hameed , Thomas-Ogodo Olufemi , Onyeka Tonia C. , Lawanson Teniola , Akaba Godwin O. , Salako Omolola , Anorlu Rose I. , Berek Jonathan S.
Published: June 2024

Background

Despite the availability of effective vaccines, human papillomavirus (HPV) vaccine uptake remains low in most resource-limited settings including Nigeria. Mobile health technology (mHealth) has the potential to empower patients to manage their health, reduce health disparities, and enhance the uptake of HPV vaccination.

Aim

The “mHealth-HPVac” study will assess the effects of mHealth using short text messages on the uptake of HPV vaccination among mothers of unvaccinated girls aged 9–14 years and also determine the factors influencing the uptake of HPV vaccination among these mothers.

Methods

This protocol highlights a randomised controlled trial involving women aged 25–65 years who will be enrolled on attendance for routine care at the General Outpatient clinics of Lagos University Teaching Hospital, Lagos, Nigeria between July and December 2024. At baseline, n = 123 women will be randomised to either a short text message or usual care (control) arm. The primary outcome is vaccination of the participant’s school-age girl(s) at any time during the 6 months of follow-up. The associations between any two groups of continuous variables will be assessed using the independent sample t-test for normally distributed data, or the Mann-Whitney U test for skewed data. For two groups of categorical variables, the Chi-square (X2) test or Fisher’s exact test will be used, as appropriate. Using the multivariable binary logistic regression model, we will examine the effects of all relevant sociodemographic and clinical variables on HPV vaccination uptake among mothers of unvaccinated but vaccine-eligible school-age girls. Statistical significance will be reported as P < 0.05.

Discussion

The mHealth-Cervix study will evaluate the impact of mobile technologies on HPV vaccination uptake among mothers of unvaccinated but vaccine-eligible school-age girls in Lagos, Nigeria as a way of contributing to the reduction in the wide disparities in cervical cancer incidence through primary prevention facilitated using health promotion to improve HPV vaccination uptake.

Registration

PACTR202406727470443 (6th June 2024).
Nonfamilial cherubism in a 6-month-old infant: a case report
Authors: Hamzavi Seyedeh Sedigheh , Askari Alireza , Bahrololoom Rosemina , Mokhtari Maral , Sanaei Dashti Anahita , Yarmahmoodi Fatemeh , Rashidi Somaye
Published: June 2024

Background

Cherubism is known as a very rare autosomal dominant familial disorder of childhood caused by a mutation in the SH3BP2 gene on 4p16.3. It has not yet been observed at birth and is usually diagnosed in children aged 2–7. Here, we present a non-hereditary case of cherubism at a very early age.

Case presentation

A 6-month-old girl presented with bilateral progressive jaw enlargement. On physical examination, bilateral asymmetrical jaw enlargement, predominantly on the left side, and some enlarged, non-tender, mobile submandibular lymph nodes were detected. No other abnormality was observed. Further investigations with radiology suggested cherubism and Burkitt’s lymphoma as differential diagnoses. Later on, histopathologic evaluations were suggestive of cherubism. No surgical interventions were indicated, and the child is on regular follow-ups.

Conclusion

Non-hereditary Cherubism, despite scarcity, can present in children below two years of age, even as early as the beginning of primary dentition. Accurate and swift diagnosis is essential to avert physical and psychological complications. Our case report shows the importance of keeping cherubism in mind as a differential diagnosis of bone disease, even in children under a year old, and the value of interdisciplinary collaboration in dealing with rare genetic disorders.
Motives and modifying factors for giving or rejecting psychiatric diagnoses in general medicine and psychiatry – a qualitative interview study
Authors: Tebartz van Elst Hannah , Niehoff Claudia , Steinhäuser Jost
Published: June 2024

Background

There is a discussion among general practitioners and psychiatrists regarding over-diagnosing versus under-reporting of psychiatric diagnoses. A deeper understanding of this topic is relevant for providing reasonable health care and for planning future studies. A crucial factor to understanding this discussion is the difference in the prevalence of a disease in each sector. One way to attain knowledge about such prevalences is the analysis of routine care data of the sector in question. However, diagnosis-related data might be modified by several additional influencing factors.

Aims

This study aims to explore what kind of motives and modifying factors play a role for or against giving psychiatric diagnoses in psychiatric and general medical settings.

Methods

Twenty-six semi-structured interviews were conducted with German physicians in the fields of general medicine and psychiatry. Interviews were analysed using content analysis.

Results

The analysis revealed three major motivational categories for finding a diagnosis: (1) “objective matters” such as “categorisation for research”; (2) “functional and performance-related factors” such as “requirement for medication”, “billing aspects” that go with certain diagnoses or “access to adequate care” and (3) “Individual factors” such as the “personality of a physician”. Similarly, factors emerged that lead to not making psychiatric diagnoses like “fear of stigmatization among patients” or “detrimental insurance status with psychiatric diagnosis”. Additionally participants mentioned other reasons for “not diagnosing a psychiatric diagnosis“, such as “coding of other clinical pictures”.

Conclusion

The diagnostic process is a complex phenomenon that goes far beyond the identification of medical findings. This insight should be considered when processing and interpreting secondary data for designing health care systems or designing a study.
Psychometric properties of the health literacy instrument in Brazil (HLS-EU-BR47)
Authors: Saboga-Nunes Luis , Bittlingmayer Uwe H. , Harsch Stefanie , Vincenzi Silvana Ligia , da Silva Silvio Aparecido , Konrath Andréa Cristina , Estabel Lizandra Brasil , da Silva Moro Eliane Lourdes , Santini Luciane Alves , da Silveira Filipe Xerxeneski , Cardoso Darclé , Sebold Roselita , Pereira Barbosa Celeste Aparecida , Farinelli Marta Regina , de Andrade Dalton Francisco
Published: June 2024

Background

Health literacy (HL) is a key component of health promotion and sustainability and contributes to well-being. Despite its global relevance, HL is an under-researched topic in South America but is now debuting its exploration in Brazil. To leverage its benefits for South America, the mere translation of validated tools into Portuguese is insufficient. Rather, it is necessary to examine their validity. This study aims to assess the psychometric properties of the European Health Literacy Questionnaire (HLS-EU-BR47) using the Item Response Theory (IRT) in a population-based sample of adults in Brazil.

Methods

A cross-sectional online study was conducted across Brazil and included 1028 participants aged 18 years and above (80% women). Cronbach’s alpha, McDonald’s omega, factor analysis, graded responses model, Item Characteristic Curve, HL levels based on this, HL standard calculation, IRT, and regular score correlation were computed.

Results

The instrument exhibit high reliability (Cronbach’s alpha 0.95). Factor analysis yielded one factor. IRT was appropriate for data analysis because it allowed quality evaluation of items and constructed a scale to quantify HL. The 47 items and latent features of respondents in the same unit of measurement are positioned in the construction of the HLS-EU-BR47 instrument. The percentages of individuals at each HL level, calculated using IRT, were found to be comparable to those obtained through the standard computation, e.g., 3.2% of people reported very low HL versus 10.8% inadequate HL, 56.2% reported low HL versus 39.5% problematic HL, 31.1% had moderate HL versus 30.1% sufficient HL, and 9.5% had high HL versus 19.7% with excellent HL. The mean HL scores were comparable between women and men (33.9 vs. 33.7, P = 0.36).

Conclusion

This study provides new evidence of the validity of a widely used HL instrument for the population of South America (in this case, Brazil). This tool can be utilized by citizens, health professionals, and regional/national policymakers to inform the development of initiatives to assess and improve the HL of individuals, groups, and communities. Further studies are needed to confirm and extend the findings and to explore the influence of local cultures and practices in the vast Brazilian territory on HL.
Estimating helmet wearing rates via a scalable, low-cost algorithm: a novel integration of deep learning and google street view
Authors: Li Qingfeng , Wang Xianglong , Bachani Abdulgafoor M.
Published: June 2024

Introduction

Wearing a helmet reduces the risk of head injuries substantially in the event of a motorcycle crash. Countries around the world are committed to promoting helmet use, but the progress has been slow and uneven. There is an urgent need for large-scale data collection for situation assessment and intervention evaluation.

Methods

This study proposes a scalable, low-cost algorithm to estimate helmet-wearing rates. Applying the state-of-the-art deep learning technique for object detection to images acquired from Google Street View, the algorithm has the potential to provide accurate estimates at the global level.

Results

Trained on a sample of 3995 images, the algorithm achieved high accuracy. The out-of-sample prediction results for all three object classes (helmets, drivers, and passengers) reveal a precision of 0.927, a recall value of 0.922, and a mean average precision at 50 (mAP50) of 0.956.

Discussion

The remarkable model performance suggests the algorithm’s capacity to generate accurate estimates of helmet-wearing rates from an image source with global coverage. The significant enhancement in the availability of helmet usage data resulting from this approach could bolster progress tracking and facilitate evidence-based policymaking for helmet wearing globally.
People affected by cancer and their carers from gender and sexually diverse communities: their experiences and the role of smartphone applications
Authors: Winter Natalie , Ugalde Anna , Coyne Elisabeth , Dieperink Karin B. , Jongebloed Hannah , Livingston Patricia
Published: June 2024

Background

People living with cancer, or carers who are from lesbian, gay, bisexual, transgender, queer, intersex or asexual (LGBTQIA+) communities experience unique information and support needs. Accessible technology-based resources providing tailored support are required to promote wellbeing, however this is a growing area of research requiring further investigation. The purpose of this study was to explore the experiences of healthcare services among people living with cancer, and their carers, who belong to sexual or gender diverse communities (LGBTQIA+), and identify how smartphone applications (apps) could support people from LGBTQIA + communities.

Methods

This was a qualitative descriptive study where people living with cancer or carers from LGBTQIA + communities participated in phone interviews. Participants were recruited across Australia via social media advertisements, LGBTQIA + medical practices, and cancer advocacy groups. Participants were asked questions about their experiences, and were provided with screenshots of an existing app and asked to provide feedback on content and inclusiveness. Transcripts were coded and codes grouped together to form similar and concepts. Inductive and deductive analyses were used to create themes.

Results

13 patients (mean age 56 (SD:13)), and three carers (mean age 64 (SD:19)) completed phone interviews. The majority of participants identified their gender as female (patients n = 9, carers 3), and their sexuality as gay or lesbian (patients n = 10, carers n = 3). Four themes were created: (1) navigating disclosure in healthcare, described emotional challenges surrounding disclosure; (2) the power of positive experiences with clinicians, described positive interactions and gaps in care from clinicians; (3) impact of gender and sexuality on informal support, outlined support received from informal network and gaps in support, and; (4) opportunities to increase inclusivity in smartphone apps, generated ideas on how apps can be tailored to meet needs identified.

Conclusion

Disclosure of gender or sexuality, and interactions with clinicians had the potential to impact participants’ experience of cancer care. Gaps in informal networks pointed at how to better support LGBTQIA + communities, and identified opportunities for inclusion in an app that will be tailored and trialled for this community. Future work should focus on addressing systems-level processes in acknowledging and supporting priority groups affected by cancer.
Magnitude of psychological distress and associated factors among war survivor women in Northern, Ethiopia, 2022: a community-based cross-sectional survey
Authors: Salelew Endalamaw , Assefa Yohannes Awoke , Getachew Rediet , Nenko Goshu , Fanta Biruk , Amare Tadele , Demilew Demeke , Dellie Endalkachew , Aschalew Andualem Yalew , Asrade Geta , Demeke Zelalem , Shitu Kegnie , Eriku Getachew Azeze , Worku Chanyalew , Kibret Alemu Kassaw , Haile Tsegaye Gebremedhin , Hunegnaw Melkamu Tamir , Fekadu Haileab , Molla Ayenew , Belew Aysheshim Kassahun , Atnafu Asmamaw , Guadu Tadesse , Yitayal Mezgebu , Worku Netsanet , Gelaye Kassahun Alemu , Azale Telake , Awoke Tadesse
Published: June 2024

Background

Civilian war and internal conflicts increase the incidences of mental health conditions among war survivors. It is crucial to assess war-related psychological consequences in war-affected areas in Ethiopia to intervene in the future. Thus, this study aimed to determine the magnitude of psychological distress and associated factors of psychological distress among war survivor women in Northern, Ethiopia.

Methods

A community-based cross-sectional survey was conducted, and 1596 war survivor women were recruited to participate using a face-to-face interviews with a census sampling technique from May 1–30, 2022. The psychological distress was assessed using a Kessler psychological distress scale (K10). Bi-variable and multi-variable logistic regression analyses were used, and variables with a p-value less than 0.05 in the multivariable analyses were considered statistically significant.

Result

In this study, the response rate was 100% and the prevalence of psychological distress was 44.90% at a 95% CI: (42.40, 47.40). Psychological distress was significantly associated with the education of ability to read and write (AOR = 2.92; 95% CI: 2.12, 4.01), primary education and above (AOR = 3.08; 95% CI: 2.09, 4.54), housewife (AOR = 5.07; 95%CI: 2.64, 9.74), farmer (AOR = 8.92; 95%CI: 4.03, 19.70), emotional violence (AOR = 1.52; 95%CI: 1.05, 2.18), physical violence (AOR = 3.85; 95%CI: 2.37, 6.26) and sexual violence (AOR = 3.25; 95%CI: 1.98, 5.33) whereas being separate was protective for psychological distress (AOR = 0.38; 95%CI: 0.16, 0.92).

Conclusion

The prevalence of psychological distress was found to be high. Therefore, women who are housewives, married, farmers, educated, and who have experienced violence must be the focus of governmental and private collaborative interventions to prevent war-related psychological morbidity and mortality.