bluuebunny/crossref_metadata_2025_split huggingface dataset:
Different doses of epidural morphine combined with multimodal analgesia strategies for postpartum pain management: study protocol for a single-centre, double-blind randomised, pragmatic clinical trial
Authors: Yu Rou , Lin Xuemei 
Published: December 2024

IntroductionThe neuraxial morphine has been regarded as the gold standard for postpartum analgesia. However, the recent advancements in patient-controlled analgesia and various regional nerve blocks have led to the implementation of multimodal analgesia strategies, which aim to reduce opioid usage and associated complications while ensuring satisfactory pain relief. The objective of this research is to investigate the optimal dosage of epidural morphine for alleviating moderate and severe pain after caesarean sections in healthy parturients, as well as reducing unnecessary burden of respiratory monitoring resources.Methods and analysisThe present single-centre randomised controlled pragmatic clinical trial aims to enrol a total of 310 healthy parturients with American Society of Anesthesiologists grade I/II, who are scheduled for caesarean section under combined spinal and epidural anaesthesia at West China Second University Hospital of Sichuan University. The recruitment process has not yet commenced and is anticipated to commence in March 2024, concluding in September 2024. Enrolled patients will be evenly distributed into five groups, namely morphine groups (M1–M4) and the control group (M0). The primary outcome measure is the incidence rate of postoperative use Numerical Rating Scale (NRS) pain score ≥4 points within 24 hours, which will be primarily assessed through bedside follow-up conducted by investigators and patient self-assessment at 2, 4, 6, 8, 12 and 24 hours postoperatively. The secondary outcomes encompass the following: incidence of postoperative NRS score ≥4 within 48 hours, occurrence of SpO2 <90% (during air inhalation)/ SpO2 <95% (during nasal cannula oxygen inhalation) and respiratory rate (RR)＜10 breaths/min recorded on the bedside monitoring, Ramsay sedation score, administration of rescue analgesics and total usage of patient-controlled intravenous analgesia pump, time to first flatus and food intake, maternal and neonatal urinary morphine concentrations, and any other maternal adverse reactions such as nausea, vomiting, pruritus, urinary retention and neonatal depression. The administration of local anaesthetics, surgical procedures and the timing for administering rescue analgesics will not be subject to any restrictions.Ethics and disseminationEthical approval has been obtained from the Ethics Committee of West China Second University Hospital, Sichuan University (2022(269)).Trial registration numberChiCTR2400080350.
Exploring patients’ views regarding the support and rehabilitation needs of people living with myocardial ischaemia and no obstructive coronary arteries: a qualitative interview study
Authors: Humphreys Helen , Paddock Danielle , Brown Sarah , Cowie Aynsley , Berry Colin , Dawkes Susan , Nichols Simon 
Published: December 2024

ObjectivesThis study aimed to generate new qualitative insights to understand the rehabilitation needs of people living with a confirmed or presumed diagnosis of ischaemia with no obstructive coronary arteries (INOCA), explore which aspects of current cardiovascular prevention and rehabilitation programmes could meet the needs of people with INOCA and where adjustments (if any) may be appropriate.DesignSemistructured qualitative interview study.ParticipantsInterviews were undertaken (n=17; 88% female, age range 31–69 years) with people with a confirmed or presumed diagnosis of INOCA.ResultsFindings highlighted concerns around a lack of evidence-based guidance for cardiovascular prevention and rehabilitation programmes for patients with INOCA. Participants expressed a desire for modular cardiovascular prevention and rehabilitation programmes that could be accessed flexibly to accommodate episodic fluctuations in symptoms. Participants suggested that existing cardiovascular prevention and rehabilitation programme content needed adjustment including enhanced psychosocial support, supervised low-impact physical activity and specialist dietary advice and medication reviews. Additional elements specific to INOCA should be made available as appropriate including acute care planning and a module to provide information and support for female-specific issues. The importance of involving INOCA patients in the codesign of future programmes and associated training was emphasised.ConclusionsPeople with INOCA are willing to engage with cardiovascular prevention and rehabilitation programmes and express a desire for more support. This patient group shares some barriers to rehabilitation programme attendance with other cardiac patient groups, but they also have specific concerns about the need for improved professional knowledge and evidence-based guidance regarding the management of INOCA. Cardiovascular rehabilitation programmes need to be delivered flexibly and individually tailored to ensure the relapsing and remitting nature of INOCA and associated support needs are addressed.
Identifying attributes of effective cigar warnings: a choice-based conjoint experiment in an online survey of US adults who smoke cigars
Authors: Jarman Kristen L , Kistler Christine E , Thrasher James F , Kowitt Sarah D , Ranney Leah M , Cornacchione Ross Jennifer , Chrzan Keith , Sheeran Paschal , Goldstein Adam O 
Published: December 2024

ObjectiveLittle evidence exists on which cigar warning statement attributes may impact cigar warning effectiveness; research is needed to identify the most effective cigar warning topics and text. This study was designed to inform the development of improved cigar warnings.DesignWe conducted a choice-based conjoint experiment. The experiment systematically manipulated cigar warning statement attributes, including cancer health effect (mention of colon cancer and/or oral cancer), non-cancer health effect (mention of heart disease and/or blood clots), causal language, warning marker word, verb use and tobacco type. Participants evaluated eight choice sets, each containing three cigar warnings with contrasting attributes, and chose the warnings that most and least encouraged them to quit smoking cigars. Using a Bayesian mixed logit model, we estimated the relative importance of each attribute and the attribute part-worth utility.SettingAn online survey of adults in the USA.ParticipantsWe enrolled 959 US adults who used little cigars, cigarillos, or large cigars in the past 30 days using an online survey from October to December 2020.Primary outcome measuresThe primary outcomes for the experiment are relative attribute importance and attribute part-worth utility.ResultsThe most important attributes to participant selection of warnings were the non-cancer and the cancer health effects (29.3%; 95%CI 28.6% to 30.0% and 29.0%; 95% CI 28.4% to 29.6%, respectively), followed by causal language (16.3%; 95% CI 15.7% to 16.8%), marker word (10.3%; 95% CI 9.9% to 10.7%), verb use (8.8%; 95% CI 8.5% to 9.2%) and tobacco type (6.3%, 95% CI 5.9% to 6.6%).ConclusionsOur findings indicate that health effects are the most important attributes when designing cigar warning statements, but other attributes, like causal terminology, also influence perceived warning effectiveness. Based on our findings, ‘DANGER: Tobacco causes heart disease and blood clots’ is an example of a highly effective warning statement for cigars.
Serial Paediatrics Omics Tracking in Myalgic Encephalomyelitis (SPOT-ME): protocol paper for a multidisciplinary, observational study of clinical and biological markers of paediatric myalgic encephalomyelitis/chronic fatigue syndrome in Australian adolescents aged 12–19 years
Authors: Thomas Natalie , Chau Tracey , Tantanis Darcy , Huang Katherine , Scheinberg Adam , Gooley Paul R , Josev Elisha K , Knight Sarah J , Armstrong Christopher W 
Published: December 2024

IntroductionMyalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) is a disabling condition that can affect adolescents during a vulnerable period of development. The underlying biological mechanisms for ME/CFS remain unclear and have rarely been investigated in the adolescent population, despite this period representing an age peak in the overall incidence. The primary objective of this is to provide a foundational set of biological data on adolescent ME/CFS patients. Data generated will be compared with controls and over several time points within each patient to potentially develop a biomarker signature of the disease, identify subsets or clusters of patients, and to unveil the pathomechanisms of the disease.Methods and analysisThis protocol paper outlines a comprehensive, multilevel, longitudinal, observational study in paediatric ME/CFS. ME/CFS patients aged 12–19 years and controls will donate biosamples of urine, blood, and peripheral blood mononuclear cells for an in-depth omics profiling analysis (whole-genome sequencing, metabolomics and quantitative proteomics) while being assessed by gold-standard clinical and neuropsychological measures. ME/CFS patients will then be provided with a take-home kit that enables them to collect urine and blood microsamples during an average day and during days when they are experiencing postexertional malaise. The longitudinal repeated-measures study design is optimal for studying heterogeneous chronic diseases like ME/CFS as it can detect subtle changes, control for individual differences, enhance precision and boost statistical power. The outcomes of this research have the potential to identify biomarker signatures, aid in understanding the underlying mechanisms, and ultimately, improve the lives of children with ME/CFS.Ethics and disseminationThis project was approved by the Royal Children’s Hospital’s Human Research Ethics Committee (HREC 74175). Findings from this study will be disseminated through peer-reviewed journal publications and presentations at relevant conferences. All participants will be provided with a summary of the study’s findings once the project is completed.
Estimated global and regional incidence and prevalence of herpes simplex virus infections and genital ulcer disease in 2020: mathematical modelling analyses
Authors: Harfouche Manale , AlMukdad Sawsan , Alareeki Asalah , Osman Aisha M M , Gottlieb Sami , Rowley Jane , Abu-Raddad Laith J , Looker Katharine J 
Published: December 2024

ObjectivesGenital herpes simplex virus (HSV) type 1 and 2 infections are lifelong and can cause symptomatic genital ulcer disease (GUD). HSV-2 almost always causes sexually transmitted genital infection, while HSV-1 mainly causes oral infection but can be sexually transmitted to cause genital infection. This study estimated genital infection with both HSV types and associated GUD globally in 2020, breaking down the data by WHO region and sex for females and males.MethodsA calibrated mathematical model was employed to generate estimates for the incidence and prevalence of HSV-2 infection, genital HSV-1 infection, and GUD caused by both HSV types. Estimates for non-genital infections caused by HSV-1 were also generated. Model input was derived from a comprehensive systematic review and meta-analyses of HSV prevalence data for all WHO regions.ResultsGlobally in 2020 there were 25.6 million (95% uncertainty interval (UI) 23.1–29.4 million) people aged 15–49 years with new HSV-2 infections, and 519.5 million (95% UI 464.3–611.3 million), or 13.3% (95% UI 11.9–15.6%), with existing (prevalent) HSV-2 infections. In addition, there were 16.8 million (95% UI 10.6–22.4 million) people aged 15–49 years with new genital HSV-1 infections and 376.2 million (95% UI 235.6–483.5 million), or 10.2% (95% UI 6.4–13.1%), with prevalent genital HSV-1 infections. The estimated number of people aged 15–49 years with at least one episode of HSV-attributable GUD in 2020 was 187.9 million (95% UI 116.0–291.8 million) for HSV-2, and 16.7 million (95% UI 9.3–25.2 million) for HSV-1, totalling 204.6 million (95% UI 132.3–306.5 million).ConclusionGenital HSV infections have a high incidence and prevalence worldwide, contributing to a significant GUD disease burden. New prevention and treatment measures, such as prophylactic and therapeutic HSV vaccines, are needed critically to control HSV infections and reduce the associated disease burden.
Optimizing vertical transmission control: A hybrid neural network approach with Wolbachia for Zika virus
Authors: Azhar Ehtsham , Batool Sadia , Jamal Muhammad , Ahmed Iftikhar , Ali Hashmat , Hafeez Yaser 
Published: December 2024

In this study, we investigate cutting-edge control strategies designed to address the global health threat posed by the Zika virus. Our exploration utilizes an advanced numerical approach, the artificial neural network (ANN), complemented by the hybrid efficiency of global and local search schemes. The research delves into the distinctive properties of Wolbachia, a bacterium, assessing its potential to hinder virus transmission and regulate the population of Ades aegypti mosquitoes, the primary carriers of the Zika virus. The study employs a rigorous mathematical framework, categorizing individuals into distinct compartments such as newborns, adults, Wolbachia-uninfected mosquitoes, and Wolbachia-infected mosquitoes. We pinpoint the disease-free equilibrium (DFE) and compute the basic reproductive number [Formula: see text]. Through extensive simulations, we scrutinize the model’s stability by manipulating critical parameters, including biting rates [Formula: see text], mosquito death rates [Formula: see text], and pregnancy delays [Formula: see text]. Importantly, our model incorporates the dynamics of Zika transmission and its correlation with microcephaly, both with and without the presence of Wolbachia. To numerically handle the dynamic model, we introduce a computational procedure, visually illustrating how the presence of Wolbachia significantly impacts infected classes, leading to a reduction in new cases and an improvement in overall model stability. We propose the utilization of the global optimization genetic algorithm (GA) and local search interior point algorithm (IPA) to solve the model. We devised an error-based objective function for the differential model, which was then optimized using the hybrid computational efficiency of GA-IPA. The validation of our proposed computational method, ANNPs-GA-IPA, involved a comprehensive comparison of the results obtained against reference solutions, affirming the accuracy and reliability of our approach.
The Effects of Regional Banks on Carbon Emissions: A Quasi-Natural Experiment of City Commercial Banks in China
Authors: Zhou Xiaoxiao , Lin Junjie , Zhang Hua , Shahzad Umer 
Published: December 2024

Financial support is essential to reduce carbon emissions (CEs) and achieve the green transformation of China. To detect the nexus of local finance and CEs, we constructed a two-sector (clean and dirty sectors) model to identify the channels from city commercial banks (CCBs) to CEs involving capital scale, structure, and efficiency. Using the setting of CCBs as a quasi-natural experiment, we applied difference-in-differences (DID), instrument variable (IV), and spatial DID methods to test the effects of the construction of CCBs on CEs in China during 2003 to 2018. The construction of CCBs promoted CEs in cities by offsetting the technological effect and stimulating electricity consumption expansion (scale effect) and reindustrialization (structural effect). CCBs’ branches strengthened the promotion effect of CCBs’ construction on CEs, but the mergers of CCBs mitigated the effect. The effects varied across regions with different features (covering location, per capita income, financial development, environmental regulation, industrial and energy structure, carbon source, and so on). The construction of CCBs showed a spatial spillover effect, increasing the CEs of neighbors. Accordingly, suggestions were proposed to reduce CEs by optimizing CCBs management, policy making, and local carbon reduction efforts. JEL Classification: E44, G28, O16
Spillover Effects and Regional Determinants in the Ecuadorian Clean-Cooking Program: A Spatiotemporal Econometric Analysis
Authors: Obaco Moisés , Davi-Arderius Daniel , Pontarollo Nicola 
Published: December 2024

Developing countries are making great efforts to electrify, reduce dependence on fossil fuels and deal with climate change. In 2014, Ecuador launched the clean-cooking program Programa de Cocción Eficiente (PCE) aimed at replacing liquefied petroleum gas (LPG)-fired cookstoves and boilers with electric devices. This paper explores the spatial determinants of participation in this program using detailed subnational socioeconomic data and a monthly electricity dataset (2015–2021) at the parish level. We identify relevant spillover effects in participation, which are higher in parishes with a better quality of supply. Moreover, participation in other subsidized programs positively affects participation in the PCE. Policy recommendations include the need to perform detailed spatial analyses and implement a place-based approach to these programs, considering potential spatial effects and the spatial heterogeneity of parishes. Finally, regulatory incentives to improve the quality of supply are essential to increasing the success of these programs. JEL Classification: Q01, Q43, Q52, Q56
Association between the number of glucose-lowering drugs in use, diet quality, and nutrient intake among adults with type 2 diabetes mellitus
Authors: Bussuan Renata Maksoud , Bersch-Ferreira Ângela Cristine , Marcadenti Aline 
Published: December 2024

Background The use of several glucose-lowering drugs (GLDs) in individuals with type 2 diabetes mellitus is common, but their effects on dietary intake have been little explored. Aim Our study aimed to examine the association between the number of GLDs used by adults with type 2 diabetes mellitus and their diet quality and nutrient intake. Methods This is a cross-sectional analysis of baseline data from a Brazilian national multicenter randomized clinical trial involving participants with type 2 diabetes mellitus aged >30 years. We collected sociodemographic, clinical, biochemical, and anthropometric information and food intake data (24-h dietary recall). Diet quality was assessed by the modified Alternative Healthy Eating Index. Multiple linear regression models were used to examine the association of dietary intake with the number of GLDs in use. Results Our analysis included data from a total of 363 participants, mean age of 60.8 ± 9.5 years, and mean glycated hemoglobin of 8.7 ± 1.5%. Of these, 28.1% were taking one GLD; 48.8% were taking two GLDs; and 23.1% were taking ≥3 GLDs. We found no difference in diet quality, but the intake of total polyunsaturated fatty acids and omega-3 and omega-6 fatty acids was different between the three groups ( p ≤ 0.03). However, this association was no longer seen after adjusting for age, sex, duration of diabetes, prior diagnosis of dyslipidemia, physical activity and mean monthly family income. Conclusions We did not find an association between the number of GLDs in use and either diet quality or nutrient intake in individuals with type 2 diabetes mellitus.
Codevelopment of the dark triad and depressiveness from emerging adulthood to midlife
Authors: Braig Anna , Gonzalez Avilés Tita , Neyer Franz J. 
Published: December 2024

Personality development from emerging adulthood onwards is marked by traits becoming more socially desirable. However, little research exists on developmental trends of so-called dark personality traits. Moreover, the current understanding of longitudinal trends and associations with mental health remains unclear. Addressing this gap, the present study analyzed average (mean-level) changes of the dark triad traits (Machiavellianism, psychopathy, and narcissism) in three birth cohorts over a 4-year period spanning emerging adulthood to midlife, as well as their concurrent and longitudinal associations with depressiveness. We used three data waves, each 2 years apart, from the German Family Panel ( pairfam) to perform growth curve models. The final sample included N = 5,127 participants ranging from 22 to 46 years ( Mage at T1 = 34.59). Results indicated a significant linear downward trend for Machiavellianism and for psychopathy but no linear change in narcissism. All dark triad traits had moderate positive correlations with depressiveness, and changes in these traits showed moderate to strong correlations with changes in depressiveness. Overall, the findings suggest that from emerging adulthood into midlife, individuals high in Machiavellianism and psychopathy develop towards greater social desirability.
Acceptability and feasibility of HIV pre-exposure prophylaxis (PrEP) in Southeast Asia: A scoping review
Authors: Espera Justitia Roma , Reyes Chaia Alyssa , Sarmiento Erla Grace , Sitchon Czarina Mae , Zantua Roueline , Carandang Rogie Royce 
Published: December 2024

Background The availability of HIV pre-exposure prophylaxis (PrEP) in Southeast Asia remains limited compared to regions like Western Europe or North America. Additionally, little is known about how key populations in Southeast Asia perceive the use of PrEP as a prevention tool for HIV. This scoping review aims to provide an overview of the literature on the acceptability and feasibility of HIV PrEP programs in Southeast Asia. Methods We conducted a systematic search using nine electronic databases, gray literature searches, and hand searches of references in included full-text articles. Following PRISMA guidelines for scoping reviews, we focused on original research articles published in English from July 2012 to December 2022. A narrative synthesis was used to summarize the findings. Results We identified 8,871 articles through the database search, removed 1,094 duplicates, and excluded 7,745 articles after title and abstract screening. Over 28 articles met the inclusion criteria. The use of PrEP was found to be highly acceptable, with participants showing a willingness to use and pay for it, moderate usage rates, convenience, and preference over other prevention methods. It was also considered highly feasible due to its effectiveness and successful program implementation. However, barriers included risk compensation, concerns about side effects, the burden of daily pill administration, and, most commonly noted in studies, cost. Conclusion HIV PrEP has been shown to be both acceptable and feasible. The necessity for direct efforts to expand PrEP access in Southeast Asia and address barriers to its uptake and adherence underscores the importance of ongoing monitoring and implementation.