bluuebunny/crossref_metadata_2025 huggingface dataset:
Scalable Pythagorean Mean-based Incident Detection in Smart Transportation Systems
Authors: Islam Md. Jaminur , Talusan Jose Paolo , Bhattacharjee Shameek , Tiausas Francis , Dubey Abhishek , Yasumoto Keiichi , Das Sajal K.
Published: June 2023

Modern smart cities need smart transportation solutions to quickly detect various traffic emergencies and incidents in the city to avoid cascading traffic disruptions. To materialize this, roadside units and ambient transportation sensors are being deployed to collect speed data that enables the monitoring of traffic conditions on each road segment. In this article, we first propose a scalable data-driven anomaly-based traffic incident detection framework for a city-scale smart transportation system. Specifically, we propose an incremental region growing approximation algorithm for optimal Spatio-temporal clustering of road segments and their data; such that road segments are strategically divided into highly correlated clusters. The highly correlated clusters enable identifying a Pythagorean Mean-based invariant as an anomaly detection metric that is highly stable under no incidents but shows a deviation in the presence of incidents. We learn the bounds of the invariants in a robust manner such that anomaly detection can generalize to unseen events, even when learning from real noisy data. Second, using cluster-level detection, we propose a folded Gaussian classifier to pinpoint the particular segment in a cluster where the incident happened in an automated manner. We perform extensive experimental validation using mobility data collected from four cities in Tennessee and compare with the state-of-the-art ML methods to prove that our method can detect incidents within each cluster in real-time and outperforms known ML methods.
Context-aware Answer Selection in Community Question Answering Exploiting Spatial Temporal Bidirectional Long Short-Term Memory
Authors: Ahmed Muzamil , Khan Hikmat Ullah , Khan Muhammad Attique , Tariq Usman , Kadry Seifedine
Published: June 2023

Community Question Answering (CQA) sites provide knowledge sharing facility as the users can post questions and other users can share their answers. The selection of top-quality answers from the set of answers in a thread is a significant and challenging task in Natural Language Processing (NLP). To address this issue, we propose a deep learning based spatial temporal Bidirectional Long Short-Term Memory (Bi-LSTM) algorithm. The existing studies mainly focus only computing semantic similarity between questions and answers using votes given by the users. The proposed hybrid approach, based on both forward and backward, consider question to answer and answer to answer similarity. The forward LSTM captures the spatial impact of the answer to estimate the relevancy, whereas the backward LSTM learns temporal features with the answer to predict the best quality answer. Moreover, spatial Bi-LSTM captures past and future dependencies for a better understanding of context and to improve the effectiveness of answer selection. For extracting meaningful information from noisy text data, data is preprocessed following standard steps such as tokenization, parsing, lemmatization, stop words removal, part of speech tagging and entities extraction. Word embeddings-based Paragraph to vector (par2vec) has additional input nodes to represent paragraph information in vector for context understanding. The empirical analysis carried out on the SemEval CQA dataset shows that the proposed model outperforms state-of-art answer selection approaches.
Exploring the Lived Experience of Behavior Change Technologies: Towards an Existential Model of Behavior Change for HCI
Authors: Rapp Amon , Boldi Arianna
Published: June 2023

The majority of behavior change and persuasive technologies are exclusively addressed to modify a specific behavior. However, the focus on behavior may cloud the “existential aspects” of the process of change. To explore the lived and meaning-laden experience of behavior change, we interviewed 23 individuals who have used behavior change technology in their everyday life. The study findings highlight that behavior change is tied to meanings that point to existential matters, relates to a nexus of life circumstances, and unfolds over long periods of time. By contrast, the technology used by the participants appears mostly to focus on the present target behavior, ignoring its links to the participants’ life “context” and “time,” also providing scarce help for sense-making. Based on these findings, we surface a preliminary “existential model of behavior change,” identify several barriers that may prevent the modification of behavior and propose some design suggestions to overcome them.
Policy Evolution of Government Procurement of Public Services in China: A Text-Mining Perspective
Authors: Zhu Dongdan , Zhang Yuting , Lu Zhengnan
Published: June 2023

The in-depth mining of policy text of Government Procurement of Public Services (GPPS) is helpful to distinguish stage characteristics and evolution logic of the policy. Through text-mining technology, the current research analyzes the policy text of GPPS from 1995 to 2021 in China. Firstly, the GPPS policy is divided into three stages according to the key policy nodes. Secondly, the TF-IDF algorithm is adopted to obtain keywords at each stage, and the static stage characteristics are summarized by constructing the complex network of the extracted keywords. Finally, the policy is clustered into several categories with the help of K-means cluster analysis, and the characteristic of each category is achieved through secondary word segmentation, so as to figure out the dynamic evolution logic of each policy category at divided stages. Results show that the development of the GPPS policy in China presents a point-to-face change feature, manifested in the evolution logic of “government purchase—government procurement of public service—all-round supporting policy.” And policy priorities at different stages, namely, policy tools, will change according to the development of economy and variation of demands.
Evaluation of Whole Carcass Composting as a Mortality Disposal Option for African Swine Fever Virus-Infected Swine
Authors: Gabbert Lindsay , Martignette Lauren , Zurita Mariceny , Barrera Jose , Neilan John
Published: June 2023

African swine fever (ASF) epizootic outbreaks often result in the deaths of large numbers of swine either through confirmed or suspected disease or depopulation for outbreak control. Identification of effective biosecure livestock mortality disposal methods, capable of inactivating ASF virus (ASFV) in contaminated carcasses, remains an important component for development of localized outbreak response and recovery plans. In this study, we evaluated ASFV inactivation and viral DNA degradation during composting of ASFV-infected swine carcasses in an Animal Biosafety Level 3-Ag (ABSL3-Ag) high-containment vivarium utilizing virus isolation (VI) and real-time polymerase chain reaction (RT-PCR). Four ASFV-infected pigs, approximately 54 kg, were composted for 37 days in a static, nonaerated windrow assembled using wood chips, horse manure, and pine shavings as the primary sources of carbon. The windrow daily temperature was sustained at ≥55°C for 18 days. Spleen samples, collected over 28 days, were negative for infectious ASFV by virus isolation on day 5 but remained positive for ASFV DNA by RT-PCR through day 28. At the conclusion of the study, bone marrow, muscle, and pinna samples were collected from composted carcasses, in addition to carbon materials in the windrow. No infectious ASFV was detected by virus isolation in any of the decomposed tissues or carbon samples. However, ASFV DNA remained detectable in all swine tissues (n = 36) and in 14/16 sentinel carbon samples at the end of the study, indicating that positive detection of ASFV DNA did not correlate with virus infectivity. In conclusion, infectious ASFV was rapidly eliminated in ASFV-infected swine during composting of whole carcasses by day 5, coinciding with a temperature increase in the compost pile to ≥55°C.
Targeted Knockdown of Macrophage Migration Inhibitory Factor Enhances UVB Irradiation-Induced Apoptosis Via Increasing ROS Generation in Oral Squamous Cell Carcinoma
Authors: Chen Tian , Chen Qibing , Li Fen , Zeng Manli , Wang Bingru , Huang Shiyong , Chen Shiming , Tao Zezhang
Published: June 2023

Objectives: We investigated the effects of macrophage migration inhibitory factor (MIF) knockdown or overexpression combined with ultraviolet radiation B (UVB) irradiation on cell proliferation and apoptosis of oral squamous cell carcinoma (OSCC). Methods: MIF expression in OSCC and adjacent tissues was detected by immunohistochemistry. MIF expression in human immortalized oral epithelial cells (HIOEC) and OSCC cells was detected by western blotting. MIF was knocked down or overexpressed in OSCC cell lines (SCC-25 and CAL-27). OSCC cells were set up into control (CON), MIF overexpression/knockdown (oeMIF/shMIF), CON + UVB, and oeMIF + UVB/shMIF + UVB groups based on their exposure to UVB irradiation. Cell line proliferation was studied using a cell counting kit-8 (CCK-8) and colony formation assays. Flow cytometry was applied for determination of apoptosis, cell cycle, reactive oxygen species (ROS) abundance, and mitochondrial membrane potential. Apoptosis-related proteins were assayed by western blotting. Results: The expression of MIF was significantly higher in OSCC tissues and cell lines than in adjacent tissues and HIOEC. MIF knockdown accompanied by UVB irradiation significantly hampered cell viability and proliferation compared to MIF knockdown or UVB irradiation alone. Western blotting and flow cytometry showed that MIF knockdown combined with UVB irradiation not only induced apoptosis via the mitochondrial pathway but also mediated the cell cycle. Flow cytometry showed that ROS and mitochondrial membrane potential depolarization were increased in the combination treatment groups compared with the mono-treatment groups. Additionally, the ROS scavenger N-acetylcysteine significantly attenuated MIF knockdown combined with UVB irradiation-induced apoptosis and reversed MIF knockdown combined with UVB irradiation-induced MAPK activation. Conclusion: MIF knockdown combined with UVB irradiation significantly inhibited the proliferation of OSCC cells. MIF was involved in UVB-induced ROS generation and enhanced UVB irradiation-induced mitochondria-dependent apoptosis of OSCC cells by activating the MAPK pathway. This suggests that MIF-targeted therapy combined with UVB irradiation may be a novel approach for treating OSCC.
Accessibility, Retention and Interactivity of Online Co-Creation Workshops: A Qualitative Post-Hoc Analysis
Authors: Boone Anke , Braeckman Lutgart , Michels Nele , Kindermans Hanne , Van Hoof Elke , Van den Broeck Kris , Godderis Lode
Published: June 2023

Introduction: Co-creation is becoming increasingly popular to develop interventions that can achieve results beyond scientific findings. Workshops are one of the main ways to collect data and generate ideas in co-creation, which traditionally have been conducted at a fixed, physical location. However, organising face-to-face workshops is considered challenging, due to the transportation time, low flexibility and high costs. This study aims to investigate the online format of co-creation workshops and to discuss methodological considerations. Methods: Co-creation workshops were organised with 78 medical students, general practitioner (GP) trainees and specialist trainees from five Belgian universities. The study included four different cohorts, namely first-year bachelors ( n = 12), first-year masters ( n = 13), first-year GP trainees ( n = 14) and first-year specialist trainees ( n = 39). Three consequential online workshops were organised for each cohort, resulting in 12 workshops in total. The collected data included qualitative data (video-and audio recordings, notes from interdisciplinary team discussions, Miro boards) and quantitative data (registrations and actual attendance rates). All workshops were transcribed verbatim and thematically analysed using NVivo. Results: The participants reported increased flexibility and reduced costs as main benefits of the online format. In addition, the online platforms Miro and Microsoft Teams were considered dynamic and inspiring, facilitating high levels of engagement and interactivity. However, the online format also showed some challenges, such as the need for a digitally educated population and a stable internet connection. Conclusion: This study has shown that online workshops, also in the highly interactive method of co-creation, provide a viable alternative to collect data and generate ideas. This is particularly the case, when the target population is geographically dispersed, has a high workload and is digitally educated. Online workshops, however, also face limitations and challenges that need to be considered when choosing this format.
Research on the Rescue Time of the Taiwan Marathon Emergency Medical Service System Between 2013 and 2021
Authors: Hsia Tsu-I , Wei Chih-Yuan , Fann Li-Yun , Kao Wei-Fong , Chien Wu-Chien , Huang Han-Bin
Published: June 2023

Background:

While there are several studies on marathon injuries worldwide, there are no related studies on the Taipei Marathon regarding the rescue time of onsite injury cases, the incidence of out-of-hospital cardiac arrest (OHCA) cases, and the success rate of recovery of spontaneous circulation (ROSC). This study aims to fill that gap.

Hypothesis:

The rescue time onsite of contact injury cases was in the prime time for lifesaving.

Study Design:

Descriptive epidemiological study.

Level of Evidence:

Level 2c.

Methods:

This is a retrospective study of numerical and timeflow data using descriptive statistics. Our data were obtained from records of the Taipei Marathon from 2013 to 2021. These included (1) notification data, (2) the time record of the emergency care personnel in contact with patients, (3) incidence of OHCA, (4) the success rate of ROSC, (5) the location of occurrence of OHCA, and (6) emergency medical service capacity and configuration.

Results:

The average time taken for first contact was 1.56 minutes in OHCA cases, and the total incidence rate of OHCA in 9 years was 4 people per 100,000 people, with a 100% ROSC success rate. Further, the location of OHCA cases was mostly in Q4 of the race (66.67%), followed by Q3 (22.22%) and Q2 (1.11%). The average number of emergency care personnel per marathon was 78, spread across 6 rescue and 6 medical stations and equipped with 8 ambulances and 35 automated external defibrillators.

Conclusion:

Shortening the arrival time of medical personnel to the scene and implementing a complete chain of survival can improve survival rates. Other ways to provide faster and more timely emergency rescue services require further study.

Clinical Relevance:

Contact with patients as soon as possible, timely implementation of cardiopulmonary resuscitation, and use of an automated external defibrillator are the basic requirements of the chain of survival theory.
Secondary bile acids function through the vitamin D receptor in myeloid progenitors to promote myelopoiesis
Authors: Thompson Brandon , Lu Shan , Revilla Julio , Uddin Md Jashim , Oakland David N. , Brovero Savannah , Keles Sunduz , Bresnick Emery H. , Petri William A. , Burgess Stacey L.
Published: June 2023

Metabolic products of the microbiota can alter hematopoiesis. However, the contribution and site of action of bile acids is poorly understood. Here, we demonstrate that the secondary bile acids, deoxycholic acid (DCA) and lithocholic acid (LCA), increase bone marrow myelopoiesis. Treatment of bone marrow cells with DCA and LCA preferentially expanded immunophenotypic and functional colony-forming unit–granulocyte and macrophage (CFU-GM) granulocyte-monocyte progenitors (GMPs). DCA treatment of sorted hematopoietic stem and progenitor cells (HSPCs) increased CFU-GMs, indicating that direct exposure of HSPCs to DCA sufficed to increase GMPs. The vitamin D receptor (VDR) was required for the DCA-induced increase in CFU-GMs and GMPs. Single-cell RNA sequencing revealed that DCA significantly upregulated genes associated with myeloid differentiation and proliferation in GMPs. The action of DCA on HSPCs to expand GMPs in a VDR-dependent manner suggests microbiome-host interactions could directly affect bone marrow hematopoiesis and potentially the severity of infectious and inflammatory disease.
A Fondazione Italiana Linfomi cohort study of R-COMP vs R-CHOP in older patients with diffuse large B-cell lymphoma
Authors: Arcari Annalisa , Rigacci Lugi , Tucci Alessandra , Puccini Benedetta , Usai Sara Veronica , Cavallo Federica , Fabbri Alberto , Balzarotti Monica , Pelliccia Sabrina , Luminari Stefano , Pennese Elsa , Zilioli Vittorio Ruggero , Mahmoud Abdurraouf Mokhtar , Musuraca Gerardo , Marino Dario , Sartori Roberto , Botto Barbara , Gini Guido , Zanni Manuela , Hohaus Stefan , Tarantini Giuseppe , Flenghi Leonardo , Tani Monica , Di Rocco Alice , Merli Michele , Vallisa Daniele , Pagani Chiara , Nassi Luca , Dessì Daniela , Ferrero Simone , Cencini Emanuele , Bernuzzi Patrizia , Mammi Caterina , Marcheselli Luigi , Tabanelli Valentina , Spina Michele , Merli Francesco
Published: June 2023

Rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisone (R-CHOP) is the most commonly used regimen for the upfront treatment of diffuse large B-cell lymphoma (DLBCL). However, it is associated with cardiotoxicity, especially in older patients. Substituting doxorubicin with non-PEGylated liposomal doxorubicin (R-COMP) may reduce the risk of cardiac events, but its efficacy has never been demonstrated in prospective trials. We describe the characteristics and outcome of patients with DLBCL aged ≥65 years prospectively enrolled in the Elderly Project by the Fondazione Italiana Linfomi and treated with full doses of R-CHOP or R-COMP per local practice. Starting from 1163 patients, 383 (55%) were treated with R-CHOP and 308 (45%) with R-COMP. Patients treated with R-COMP were older (median age, 76 vs 71 years), less frequently fit at simplified geriatric assessment (61% vs 88%; P < .001), and had a more frequent baseline cardiac disorders (grade >1, 32% vs 8%; P < .001). Three-year progression-free survival (PFS) was similar between R-CHOP and R-COMP (70% and 64%); 3-year overall survival was 77%, and 71% respectively. R-CHOP was associated with better PFS vs R-COMP only in the Elderly Prognostic Index (EPI) low-risk group. The two groups had similar rates of treatment interruptions due to toxicities or of cardiac events (P = 1.00). We suggest R-COMP is a potentially curative treatment for older patients with intermediate- or high-risk EPI, even in the presence of a baseline cardiopathy. R-CHOP is confirmed as the standard therapy for low risk patients.
Expected effects of accident data recording technology evolution on the identification of accident causes and liability
Authors: Vida Gábor , Török Árpád
Published: June 2023

Background

The classic accident reconstruction process is based on information recorded manually at the scene and gathered from witness statements. Liability cannot always be determined if no objective data are available, especially for accidents at traffic lights. Even Event Data Recorder (EDR) data (speed, braking, gas/brake pedal operation, etc.) will not improve the assessment of such a liability situation significantly, since vehicle movements cannot be synchronized in time with the phase plan of the intersection control. This problem could be solved if globally synchronized time data (Global Navigation Satellite Systems) were available, or a camera recorded the signal of the given traffic lights. In our study, the technology that goes beyond EDR data was defined as EDR+ data recording technology.

Aim

The aim of this article is to rank the assessability of different types of accidents through the statistical analysis of a publicly available database, taking into account the different data recording technologies.

Methods

An in-dept statistical analysis of 124 accidents and the corresponding liability investigations is provided. Also, analysis is carried out on estimated levels of assessability if modern data recording technologies had been applied for the same accident set.

Results

This study reveals the impact of the introduction, spread and wide application of the examined types of data recording technology on assessability. It is also explored what kind of data recording technology would be necessary to ensure the level of assessability required to establish liability for accidents.

Conclusion

The flexible framework presented here is suitable for comparing the assessability of road accidents according to accident type and data recording technology.
Arteriovenous fistula in a renal allograft with gross hematuria and subsequent acute kidney injury due to urinary tract obstruction: a case report
Authors: Aoki Yujiro , Kawamura Takeshi , Shiraga Nobuyuki , Yonekura Takashi , Maeda Maho , Kurihara Sota , Sekine Yoshitaka , Shishido Seiichiro , Sakai Ken
Published: June 2023

Background

Arteriovenous fistula (AVF) due to renal allograft biopsy is mechanical trauma resulting from the penetration of small arteries and veins by a core needle. Most AVFs are reported to resolve asymptomatically and spontaneously. This report presents a patient with acute kidney injury (AKI) due to urinary tract obstruction caused by a bleeding AVF in a renal allograft.

Case presentation

A 22-year-old Japanese woman who underwent living-donor kidney transplantation (KT) at 3 years due to end-stage renal disease caused by focal segmental glomerulosclerosis (FSGS) presented with a renal transplant AVF (gourd-shaped; 42 × 19 × 20 mm). The AVF was unexpectedly discovered by ultrasound before a surveillance biopsy at 10 years after KT. The patient had a history of recurrent FSGS, had undergone several renal allograft biopsies after KT, and did not experience symptoms or growth of the AVF for years. Nineteen years after KT, the patient developed AKI with sudden, asymptomatic, gross hematuria and anuria. Plain computed tomography revealed a hematoma in the pelvis of the renal allograft and bladder tamponade. The AVF was successfully treated by coil embolization. Hemodialysis was performed for AKI, and graft function was gradually recovered.

Conclusions

Unexpected bleeding from a renal transplant AVF may lead to transplant dysfunction. Angiographic embolization against the ruptured renal transplant AVF may prevent rebleeding and rescue the renal allograft.
FAP, CD10, and GPR77-labeled CAFs cause neoadjuvant chemotherapy resistance by inducing EMT and CSC in gastric cancer
Authors: Zhao Zehua , Zhu Yanmei
Published: June 2023

Objective

A significant proportion of patients can not benefit from neoadjuvant chemotherapy (NCT) due to drug resistance. Cancer-associated fibroblasts (CAFs) influence many biological behaviours of tumors, including chemo-resistance. This study aims to explore whether CAFs expressing FAP, CD10, and GPR77 affect the efficacy of NCT and the prognosis of patients with gastric cancer, and its mechanism.

Methods

One hundred seventy-one patients with locally progressive gastric adenocarcinoma who had undergone NCT and radical surgery were collected. Immunohistochemistry was used to detect the expression of FAP, CD10, and GPR77 in CAFs; the EMT markers (N-cadherin, Snail1, and Twist1) and the CSC markers (ALDH1, CD44, and LGR5) in gastric cancer cells. The χ2 test was used to analyze the relationship between the expression of CAF, EMT, and CSC markers and the clinicopathological factors, as well as the relationship between CAF markers and EMT, and CSC markers. Logistic regression and Cox risk regression were used to analyze the relationship between the expression of CAF, EMT, and CSC markers and TRG grading and OS; Kaplan-Meier analysis was used for survival analysis and plotting the curves.

Results

The expression of CAF markers FAP, CD10, and GPR77 was closely associated with that of EMT markers; FAP and CD10 were closely related to CSC markers. In the univariate analysis of pathological response, CAF markers (FAP, CD10, GPR77), EMT markers (N-cadherin, Snail1, Twist1), and CSC markers (ALDH1, LGR5, CD44), were all closely associated with pathological response (all p < 0.05). Only Twist1 was an independent factor affecting pathological response in multifactorial analysis (p = 0.001). In a univariate analysis of OS, expression of FAP and CD10 in CAF, as well as expression of EMT biomarkers (N-cadherin, Snail1), were significant factors influencing patient prognosis (all p < 0.05). Multifactorial analysis revealed N-cadherin (p = 0.032) and Snail1 (p = 0.028), as independent prognostic factors affecting OS.

Conclusion

FAP, CD10, and GPR77 labeled CAF subgroup may lead to NCT resistance and poor prognosis by inducing EMT and CSC of gastric cancer cells in locally advanced gastric cancer patients.
Prevalence and predictors of vision impairment among older adults in India: evidence from LASI, 2017–18
Authors: Srivastava Shobhit , Kumar Manish , Muhammad T. , Debnath Paramita
Published: June 2023

Background

Older adults experience a natural decline in health, physical and cognitive functionality, and vision impairment (VI) is one among them and has become an increasing health concern worldwide. The present study assessed the association of chronic morbidities such as diabetes, hypertension, stroke, heart diseases and various socioeconomic factors with VI among older Indian adults.

Methods

Data for this study were derived from the nationally-representative Longitudinal Ageing Study in India (LASI), wave-1 (2017–18). VI was assessed using the cut-off of visual acuity worse than 20/80, and additional analysis was carried out using the definition of VI with a cut-off of visual acuity worse than 20/63. Descriptive statistics along with cross-tabulation were presented in the study. Proportion test was used to evaluate the significance level for sex differentials in VI among older adults. Additionally, multivariable logistic regression analysis was conducted to explore the factors associated with VI among older adults.

Results

About 33.8% of males and 40% of females suffered from VI in India (visual acuity worse than 20/80). Meghalaya (59.5%) had the highest prevalence for VI among older males followed by Arunachal Pradesh (58.4%) and Tripura (45.2%). Additionally, Arunachal Pradesh (77.4%) had the highest prevalence for VI among females followed by Meghalaya (68.8%) and Delhi (56.1%). Among the health factors, stroke [AOR: 1.20; CI: 1.03–1.53] and hypertension [AOR: 1.12; CI: 1.01–1.22] were the significant risk factors for VI among older adults. Additionally, being oldest old [AOR: 1.58; CI: 1.32–1.89] and divorced/separated/deserted/others [AOR: 1.42; CI: 1.08–1.87] were significantly associated with VI. Moreover, older adults with higher educational status [AOR: 0.42; CI: 0.34, 0.52], currently working [AOR: 0.77; CI: 0.67, 0.88], from urban areas [AOR: 0.86; CI: 0.76–0.98] and from western region [AOR: 0.55; CI: 0.48–0.64] had lower odds of VI in this study.

Conclusion

This study identified higher rates of VI among those who are diagnosed with hypertension or stroke, currently unmarried, socioeconomically poorer, less educated and urban resident older people that can inform strategies to engage high risk groups. The findings also suggest that specific interventions that promote active aging are required for those who are socioeconomically disadvantaged as well as visually impaired.
Foot deformity and quality of life among independently ambulating children with spina bifida in South Korea
Authors: Yun Hyeseon , Choi Eun Kyoung , Kim Hyun Woo , Ha Jeong Sook , Kim Doo Sung , Park Kun-Bo
Published: June 2023

Background

Children with spina bifida (SB) may have congenital or acquired foot deformities due to neurological defects in the spinal cord. As the musculoskeletal system keeps growing, foot deformities can develop or become aggravated. Thus, healthcare providers should provide constant monitoring and proper orthopedic management. Since foot deformities can affect not only the gait but also the daily life of children with SB, it is necessary to investigate the impact of foot deformities on everyday life. The purpose of this study was to examine the relationship between foot deformity and health-related quality of life (HRQoL) among independently ambulating children with SB.

Methods

This cross-sectional study examined the associations between foot deformity and HRQoL using two patient-reported outcome measures (Oxford Ankle Foot Questionnaire, Pediatric Outcomes Data Collection Instrument) in 93 children with SB aged 7–18 years between January 2020 and July 2021.

Results

Children with foot deformity (n = 54) reported lower scores in all subscales (physical, school and play, emotional, and footwear) of the Oxford Ankle Foot Questionnaire for children than those without foot deformity (n = 39; p < 0.001). Additionally, in terms of the Pediatric Outcomes Data Collection Instrument, children with foot deformity also reported poorer scores in four subscales (transfer and basic mobility, sports and physical functioning, comfort and pain, happiness with physical functioning; p < 0.001) than those without foot deformity, whereas upper extremity functioning was not significantly affected. Children with foot deformities, particularly those with bilateral foot deformities, equinus deformities, or mixed deformities, which are different types of right and left foot deformities, have a lower perceived HRQoL (p < 0.05).

Conclusions

Among independently ambulating children with SB, those with foot deformities showed lower HRQoL. Moreover, children with foot deformities tend to have other clinical problems, including bladder and bowel dysfunction. Therefore, orthopedic management should consider the multifaceted factors that affect children’s daily life and HRQoL.
“I just get scared it’s going to happen again”: a qualitative study of the psychosocial impact of pediatric burns from the child’s perspective
Authors: Woolard Alix , Wickens Nicole , McGivern Lisa , de Gouveia Belinelo Patricia , Martin Lisa , Wood Fiona , Janse van Rensburg Elmie , Milroy Helen
Published: June 2023

Background

Advances in medicine have improved the chances of survival following burn injuries, however, psychosocial outcomes have not seen the same improvement, and burn injuries can be distressing for both the child or young person, negatively affecting their wellbeing. Pediatric burn patients are at a higher risk of developing psychopathology compared to the general population. In order to promote resilience and prevent psychopathology post-burn injury for pediatric burn patients, it is crucial to understand the experience of children and young people after a burn. This study aimed to understand the psychosocial impact that a pediatric burn has as perceived by the pediatric burn patient.

Methods

Seven pediatric burn patients were interviewed from the Perth Metropolitan area on average 3.1 years after their injury. All participants had been admitted to hospital for their acute injury and stayed for a median length of 2 days in hospital. Interviews with pediatric patients took place online, and the patients were asked about their mental health, coping strategies, changes to lifestyle and supports following their burn injury. The interviews were transcribed and then thematically analysed using an inductive approach.

Results

Three overarching themes were developed from the interviews: burn-specific impact on the child or young person (including appearance concerns, family factors, and lifestyle factors), the psychological impact (including positive and negative impact on mental health), and factors supporting the recovery journey (including coping strategies and support services). The participants in our study highlighted issues they faced during recovery, the positive and negative impacts of the injury and recovery process and provided suggestions for future opportunities to bolster resilience and promote growth for pediatric burn patients who may face similar challenges in the future.

Conclusion

Factors that improve the mental health and wellbeing of pediatric burn patients should be promoted, such as mental health and social supports, the promotion of adaptive coping mechanisms, and meeting the needs of the family unit as a whole. Ultimately, the implementation of trauma-focused, family centred interventions is crucial for the psychosocial recovery of pediatric burn survivors.
Engaging the agricultural community in the development of mental health interventions: a qualitative research study
Authors: King Emma , Lamont Kate , Wendelboe-Nelson Charlotte , Williams Chris , Stark Cameron , van Woerden Hugo C , Maxwell Margaret
Published: June 2023

Background

Farmers and those involved in the wider agricultural industry have a high suicide rate. They are also a ‘hard to reach’ group who make less than average use of mental health services. There is therefore a need to understand how best to develop interventions that meet their needs. The aims of this study were to develop a deeper understanding of the farming context and target population and to engage farmers in the shaping of two potential mental health interventions that could be incorporated in a pilot RCT.

Methods

The study was informed throughout by a reference group, who assisted in co-production of the research materials. A snowball approach was used to recruit interested individuals who had an association with farming. Twenty one telephone interviews were undertaken and analysed using the six phases of thematic analysis proposed by Braun and Clarke.

Results

Key themes (and sub-themes shown in brackets) related to the study aims were: everyday life (work-life balance; isolation and loneliness); farm management (technology and social media; production, people management, learning and teaching; external pressures; livestock and farm production; financial aspects); demographics (effects of aging); engagement (appropriate wording when talking about mental health; recognising need for help; religion; normalising mental health issues; approaching the conversation); training (mental health training for supporters of the farming community; health & safety and the inclusion of mental health training); and personal stories and experiences, which was an emerging theme.

Conclusions

Recruiting farmers into research studies is best done by meeting farmers where they are found, for example, farmers marts. Accessibility of content, tailoring to the farming community, and guided support are key to effective recruitment and retention.
The relationship between childhood traumatic experience and suicidal tendency in non-suicidal self-injury behavior patients
Authors: Cheng Fang , Shi Linwei , Wang Shujun , Jin Qiong , Xie Huabing , Wang Beini , Zhang Wenwu
Published: June 2023

Background

Individuals with non-suicidal self-injury (NSSI) behavior are usually prone to repeated, intentional, direct harm to their own bodies that is not allowed by society without suicidal ideation. Under this behavior guidance, childhood traumatic experience may easily cause a series of psychological comorbidity symptoms, such as anxiety and depression, finally leading to a suicidal tendency.

Methods

A total of 311 adolescent NSSI behavioral patients were recruited at the Ningbo Kangning hospital, Zhejiang Province according to the DSM-5 diagnostic criteria. Demographic data, childhood abuse and neglect, internet addiction, self-esteem, anxiety, and suicidal tendency were evaluated. A structural equation model with a path induction mechanism was constructed to evaluate the relationship between distal and proximal factors related to suicidal tendencies due to childhood traumatic experiences in NSSI behavioral individuals.

Results

Among the 311 subjects included in the survey, 250 (80.39%) suffered traumatic experiences, such as emotional abuse/physical abuse/sexual abuse/emotional neglect or physical neglect in their childhood, 303 (97.43%) had suicidal ideation, 271 (87.14%) showed the total score of self-esteem, 148 (47.59%) had different degrees of Internet addiction tendency, and 286 (91.96%) showed obvious anxiety. The established path model fit well (GFI = 0.996, RMSEA = 0.03), and the model showed that self-esteem, anxiety, and childhood traumatic experience had standardized coefficients of -0.235 (z = -4.742, p < 0.01), 0.322 (z = 6.296, p < 0.01), 0.205 (z = 4.047, p < 0.01), respectively, with suicidal ideation path, suggesting that self-esteem, Internet addiction, and anxiety showed significant mediating effects in the process of childhood traumatic experience affecting suicidal ideation.

Conclusion

In the context of childhood traumatic experience, it is often accompanied by a series of regulatory behaviors such as Internet addiction, self-esteem, and so on, which finally leads to anxiety, mental symptoms, and even suicidal tendencies. The results provide effective support for the structural equation modeling to evaluate the multi-level influence of NSSI behavior individuals and emphasize that childhood familial factors may lead to psychiatric comorbidity symptoms and suicidal behavior.
The risk of all-cause mortality associated with anxiety: a retrospective cohort study using ‘The Health Improvement Network’ database
Authors: Russell Rebecca , Minhas Sonica , Chandan Joht Singh , Subramanian Anuradhaa , McCarthy Noel , Nirantharakumar Krishnarajah
Published: June 2023

Background

Anxiety is a prevalent condition with a substantial associated burden of morbidity. Previous literature investigating effects of anxiety on mortality rates has found conflicting results. This is in part due to inadequate consideration of comorbid depression as a confounder and analysing sub-types of anxiety together. The objective of this study was to compare mortality risks in people diagnosed with anxiety.

Methods

We undertook a retrospective cohort study using the ‘The Health Improvement Network’ database (a UK primary care dataset) between 1st January 2005 to 1st January 2018. 345 903 patients with anxiety (exposed group) were matched to 691 449 unexposed patients. Cox regression analyses were used to adjusted hazard ratios (HRs) for mortality risk.

Results

During the study period 18 962 patients (5·5%) died in the exposed group compared to 32 288 (4·7%) in the unexposed group. This translated into a crude HR for all of 1·14 (95% CI 1·12 − 1·16), which remained significant after adjustment for key co-variates (including depression) giving a final HR of 1·05 (95% CI 1·03 − 1·07). When broken down by sub-type of anxiety (10·3% (35, 581) had phobias, 82·7% (385,882) has ‘other’ types, and 7·0% (24,262) had stress related anxiety) there were markedly different effect sizes. The adjusted model for the stress-related anxiety sub-type demonstrated a HR of 0·88 (95% CI 0·80 − 0·97). Conversely, the HR was increased in ‘other’ sub-types to 1·07 (95% CI 1·05 − 1·09) and non-significant in phobia types of anxiety.

Conclusion

A complex relationship is found between anxiety and mortality. The presence of anxiety slightly increased the risk of death, but this risk varies depending on the type of anxiety diagnosed.
Profile and quality of life of the adult population in good health according to the level of vitality: European NHWS cross sectional analysis
Authors: Tardy Anne-Laure , Marguet Sophie , Costantino Halley , Stewart Andrew , Mackie deMauri , Saba Grèce , Amand Caroline
Published: June 2023

Background

The World Health Organization’s definition of health highlights the importance of mental and physical wellbeing and not only disease state. However, lack of awareness on the burden of impaired vitality and its impact on the quality of life of the general healthy population prevents healthcare providers from delivering appropriate solutions and advice. This study aims to better characterize this population in Europe and identify the profile and the health reported outcomes associated with impaired vitality.

Methods

This retrospective observational study included National Health and Wellness Survey (NHWS) data collected in healthy participants aged 18–65 years from five European Union countries in 2018. Socio-demographic and lifestyle characteristics, comorbidities, attitudes towards healthcare systems, Patient Activation Measure, health-related quality of life outcomes (EQ-5D), and work productivity and activity impairment were analysed according to SF-12 vitality score subgroups (≥ 60, 50– < 60, 40– < 50, < 40).

Results

A total of 24,295 participants were enrolled in the main analysis. Being a female, younger, having a lower income and being obese or having sleep and mental disorders was associated with an increased risk of impaired vitality. This was associated with a higher consumption of healthcare resources along with having a weak patient-physician relationship. Participants who were disengaged in the self-management of their health were 2.6 times more likely to have a low level of vitality. For participants in the lowest vitality group, odds of mobility problems increased by 3.4, impairment of usual activity by 5.8, increased of pain and discomfort by 5.6 and depression and anxiety by 10.3, compared with participants in the highest vitality group. Also, odds of presenteeism increased by 3.7, overall work impairment by 3.4 and daily activity losses by 7.1.

Conclusion

Evidence-based trends facilitate the identification of a healthy population with impaired vitality in real-world practice. This study highlights the actual burden of low vitality on daily life activities, particularly on mental health and reduced work productivity. Additionally, our results underline the importance of self-engagement in the management of vitality impairment and highlights the need to implement strategies to address this public health concern in the affected population (HCP-patient communication, supplements, meditation).
Predicting smoking cessation, reduction and relapse six months after using the Stop-Tabac app for smartphones: a machine learning analysis
Authors: Etter Jean-François , Vera Cruz Germano , Khazaal Yasser
Published: June 2023

Background

An analysis of predictors of smoking behaviour among users of smoking cessation apps can provide useful information beyond what is already known about predictors in other contexts. Therefore, the aim of the present study was to identify the best predictors of smoking cessation, smoking reduction and relapse six months after starting to use the smartphone app Stop-Tabac.

Method

Secondary analysis of 5293 daily smokers from Switzerland and France who participated in a randomised trial testing the effectiveness of this app in 2020, with follow-up at one and six months. Machine learning algorithms were used to analyse the data. The analyses for smoking cessation included only the 1407 participants who responded after six months; the analysis for smoking reduction included only the 673 smokers at 6-month follow-up; and the analysis for relapse at 6 months included only the 502 individuals who had quit smoking after one month.

Results

Smoking cessation after 6 months was predicted by the following factors (in this order): tobacco dependence, motivation to quit smoking, frequency of app use and its perceived usefulness, and nicotine medication use. Among those who were still smoking at follow-up, reduction in cigarettes/day was predicted by tobacco dependence, nicotine medication use, frequency of app use and its perceived usefulness, and e-cigarette use. Among those who had quit smoking after one month, relapse after six months was predicted by intention to quit, frequency of app use, perceived usefulness of the app, level of dependence and nicotine medication use.

Conclusion

Using machine learning algorithms, we identified independent predictors of smoking cessation, smoking reduction and relapse. Studies on the predictors of smoking behavior among users of smoking cessation apps may provide useful insights for the future development of these apps and future experimental studies.

Clinical trial registration

ISRCTN Registry: ISRCTN11318024, 17 May 2018. http://www.isrctn.com/ISRCTN11318024.
Associations of health literacy with dental care use and oral health status in Japan
Authors: Murakami Keiko , Aida Jun , Kuriyama Shinichi , Hashimoto Hideki
Published: June 2023

Background

The concept of health literacy has gained prominence in the context of oral health. In Japan, curative dental care is generally under universal health coverage, while preventive dental care requires effort. We used this situation to test the hypothesis that high health literacy is associated with preventive dental care use and good oral health status, but not with curative dental care use, in Japan.

Methods

A questionnaire survey was conducted from 2010 to 2011 among residents aged 25–50 years in Japanese metropolitan areas. Data from 3767 participants were used. Health literacy was measured using the Communicative and Critical Health Literacy Scale, and the total score was categorized into quartiles. Poisson regression analyses with robust variance estimators were conducted to examine the associations of health literacy with curative dental care use, preventive dental care use, and good oral health, adjusted for covariates.

Results

The percentages of curative dental care use, preventive dental care use, and good oral health were 40.2%, 28.8%, and 74.0%, respectively. Health literacy was not associated with curative dental care use; the prevalence ratio (PR) of the highest relative to the lowest quartile of health literacy was 1.04 (95% confidence interval [CI], 0.93–1.18). High health literacy was associated with preventive dental care use and good oral health; the corresponding PRs were 1.17 (95% CI, 1.00–1.36) and 1.09 (95% CI, 1.03–1.15), respectively.

Conclusions

These findings may provide clues for the design of effective interventions to promote preventive dental care use and improve oral health status.
Caretakers’ stated willingness to pay for children’s spectacles in cross river state, Nigeria and its implication for a cross-subsidisation scheme: a cross-sectional study
Authors: Ebri Anne Effiom , O’Neill Ciaran , Azubuike Kenneth , Congdon Nathan , Graham Christine , Lohfeld Lynne , Chan Ving Fai
Published: June 2023

Background

Understanding caretakers’ willingness to pay (WTP) for their children’s spectacles is essential to improving the sustainability of refractive error services and spectacle provision. Therefore, we investigated the willingness of caretakers to pay for their children’s spectacles in a multi-centre study to develop a spectacle cross-subsidisation scheme in the Cross River State (CRS), Nigeria.

Methods

We administered the questionnaire to all caretakers whose children were referred from school vision screenings to four eye centres for full refraction assessment and dispensing of corrective spectacles from 9 August to 31 October 2019. We collected information on socio-demography, children’s refractive error types, and spectacle prescription and then asked the caretakers about their WTP for the spectacles using a structured questionnaire and bidding format (in the local currency, Naira, ₦).

Results

A total of 137 respondents (response rate = 100%) from four centres were interviewed: with greater proportion of women (n = 92, 67.1%), aged between 41 and 50 years (n = 59, 43.1%), government employees (n = 64, 46.7%) and had acquired college or university education (n = 77, 56.2%). Of the 137 spectacles dispensed to their children, 74 (54.0%) had myopia or myopic astigmatism (equal to or greater than 0.50D). The mean stated WTP for the sample population was ₦3,560 (US$ 8.9) (SD ± ₦1,913.4). Men (p = 0.039), those with higher education (p < 0.001), higher monthly incomes (p = 0.042), and government employees (p = 0.001) were more willing to pay ₦3,600 (US$9.0) or more.

Conclusion

Combining our previous findings from marketing analysis, these findings provided a basis to plan for a children’s spectacles cross-subsidisation scheme in CRS. Further research will be needed to determine the acceptability of the scheme and the actual WTP.