bluuebunny/crossref_metadata_2025_split huggingface dataset:
Between the Islamic and Chinese Universal Empires: The Ottoman Empire, Ming Dynasty, and Global Age of Explorations
Authors: Chen Yuan Julian 
Published: October 2021

Abstract
This article studies two sixteenth-century Asian texts: Khitay namah, a Persian travelogue about the Ming dynasty written by the Muslim merchant Ali Akbar and presented to the Ottoman sultan, and Xiyu, an illustrated Chinese geographical treatise with detailed travel itinerary from China to Istanbul by the Ming scholar-official Ma Li. In addition to demonstrating the breadth of Ottoman and Chinese knowledge about each other in the global Age of Exploration, these two books, written respectively for the monarchs of the self-proclaimed Islamic and Chinese universal empires, reflect the Ottoman and Chinese imperial ideologies in an era when major world powers aggressively vied for larger territories and broader international influence. Both the Ottoman and Chinese authors recast the foreign Other as the familiar Self – Ali Akbar constructed an Islamized China while Ma Li depicted a Sinicized Ottoman world – to justify their countries’ claims to universal sovereignty and plans for imperial expansion. Like many contemporary European colonial writers, Ali Akbar’s and Ma Li’s exploration of foreign societies, their literary glorification of their own culture’s supremacy, and their imposition of their own cultural thinking on foreign lands all served their countries’ colonial enterprise in the global Age of Exploration.
Performance of primary health care workers in detection of mental disorders comorbid with epilepsy in rural Ethiopia
Authors: Tsigebrhan Ruth , Fekadu Abebaw , Medhin Girmay , Newton Charles R. , Prince Martin J. , Hanlon Charlotte 
Published: October 2021

AbstractBackgroundTimely detection and management of comorbid mental disorders in people with epilepsy is essential to improve outcomes. The objective of this study was to measure the performance of primary health care (PHC) workers in identifying comorbid mental disorders in people with epilepsy against a standardised reference diagnosis and a screening instrument in rural Ethiopia.MethodsPeople with active convulsive epilepsy were identified from the community, with confirmatory diagnosis by trained PHC workers. Documented diagnosis of comorbid mental disorders by PHC workers was extracted from clinical records. The standardized reference measure for diagnosing mental disorders was the Operational Criteria for Research (OPCRIT plus) administered by psychiatric nurses. The mental disorder screening scale (Self-Reporting Questionnaire; SRQ-20), was administered by lay data collectors. The sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) of PHC worker diagnosis against the reference standard diagnosis was calculated. Logistic regression was used to examine the factors associated with misdiagnosis of comorbid mental disorder by PHC workers.ResultsA total of 237 people with epilepsy were evaluated. The prevalence of mental disorders with standardised reference diagnosis was 13.9% (95% confidence interval (CI) 9.6, 18.2%) and by PHC workers was 6.3% (95%CI 3.2, 9.4%). The prevalence of common mental disorder using SRQ-20 at optimum cut-off point (9 or above) was 41.5% (95% CI 35.2, 47.8%). The sensitivity and specificity of PHC workers diagnosis was 21.1 and 96.1%, respectively, compared to the standardised reference diagnosis. In those diagnosed with comorbid mental disorders by PHC workers, only 6 (40%) had SRQ-20 score of 9 or above. When a combination of both diagnostic methods (SRQ-20 score ≥ 9 and PHC diagnosis of depression) was compared with the standardised reference diagnosis of depression, sensitivity increased to 78.9% (95% (CI) 73.4, 84.4%) with specificity of 59.7% (95% CI 53.2, 66.2%). Only older age was significantly associated with misdiagnosis of comorbid mental disorders by PHC (adjusted odds ratio, 95% CI = 1.06, 1.02 to 1.11).ConclusionRoutine detection of co-morbid mental disorder in people with epilepsy was very low. Combining clinical judgement with use of a screening scale holds promise but needs further evaluation.
“That same stigma...that same hatred and negativity:” a qualitative study to understand stigma and medical mistrust experienced by people living with HIV diagnosed with COVID-19
Authors: Hall Andre , Joseph Olivier , Devlin Samantha , Kerman Jared , Schmitt Jessica , Ridgway Jessica P. , McNulty Moira C. 
Published: October 2021

Abstract
Background
The COVID-19 and HIV epidemics have exacerbated existing inequities among vulnerable groups and severely impacted communities of color. People living with HIV (PLWH), who may already face stigma or discrimination, are at risk of experiencing further stigma as a result of COVID-19, which can result in medical mistrust.

Methods
We performed qualitative interviews between June and August 2020 among 32 PLWH, including 10 individuals diagnosed with COVID-19. A majority of participants perceived themselves as having an increased risk of contracting COVID-19 due to their HIV status.

Results
Of those who tested positive for COVID-19, the majority regarded their HIV diagnosis as having a more profound impact on their lives but found similarities between COVID-19 stigma and HIV-related stigma. Many participants also expressed mistrust.

Conclusions
These results can be used to better understand the perspectives of PLWH during the COVID-19 pandemic and have important implications for potential COVID-19 vaccine hesitancy and future health crises.
Gender minority stress and access to health care services among transgender women and transfeminine people: results from a cross-sectional study in China
Authors: Sha Yongjie , Dong Willa , Tang Weiming , Zheng Lingling , Huang Xi , Muessig Kathryn E. , Tucker Joseph D. 
Published: October 2021

AbstractBackgroundTransgender and gender diverse individuals often face structural barriers to health care because of their gender minority status. The aim of this study was to examine the association between gender minority stress and access to specific health care services among transgender women and transfeminine people in China.MethodsThis multicenter cross-sectional study recruited participants between January 1st and June 30th 2020. Eligible participants were 18 years or older, assigned male at birth, not currently identifying as male, and living in China. Gender minority stress was measured using 45 items adapted from validated subscales. We examined access to health care services and interventions relevant to transgender and gender diverse people, including gender affirming interventions (hormones, surgeries), human immunodeficiency virus (HIV) and sexually transmitted infections (STIs) testing, pre-exposure prophylaxis (PrEP) and post-exposure prophylaxis (PEP). Multivariable regression was used to measure correlations between gender minority stress and access to health care service.ResultsThree hundred and twenty-four people completed a survey and data from 277 (85.5%) people were analyzed. The mean age was 29 years old (standard deviation [SD] = 8). Participants used hormones (118/277, 42.6%), gender affirming surgery (26/277, 9.4%), HIV testing (220/277, 79.4%), STI testing (132/277, 47.7%), PrEP (24/276, 8.7%), and PEP (29/267, 10.9%). Using gender affirming hormones was associated with higher levels of discrimination (adjusted odds ratio [aOR] 1.41, 95% confidence interval [CI] 1.17–1.70) and internalized transphobia (aOR 1.06, 95%CI 1.00–1.12). STI testing was associated with lower levels of internalized transphobia (aOR 0.91, 95%CI 0.84–0.98).ConclusionsOur data suggest that gender minority stress is closely related to using health services. Stigma reduction interventions and gender-affirming medical support are needed to improve transgender health.
Prevalence and correlates of common mental health problems and recent suicidal thoughts and behaviours among female sex workers in Nairobi, Kenya
Authors: Beksinska Alicja , Jama Zaina , Kabuti Rhoda , Kungu Mary , Babu Hellen , Nyariki Emily , Shah Pooja ,   Maisha Fiti Study Champions, Gwala Demtilla , Oside Daisy , Kamene Ruth , Watata Agnes , Atieno Agnes , Njau Faith , Njeri Elizabeth , Orobi Evelyn , Lwingi Ibrahim , Nyabuto Chrispo , Okumu Monica , Mahero Anne , Ngurukiri Pauline , Irungu Erastus , Adhiambo Wendy , Muthoga Peter , Kaul Rupert , Seeley Janet , Beattie Tara S. , Weiss Helen A. , Kimani Joshua 
Published: October 2021

AbstractBackgroundAdverse childhood experiences (ACEs), poverty, violence and harmful alcohol/substance use are associated with poor mental health outcomes, but few studies have examined these risks among Female Sex Workers (FSWs). We examine the prevalence and correlates of common mental health problems including suicidal thoughts and behaviours among FSWs in Kenya.MethodsMaisha Fiti is a longitudinal study among FSWs randomly selected from Sex Worker Outreach Programme (SWOP) clinics across Nairobi. Baseline behavioural-biological survey (n = 1003) data were collected June–December 2019. Mental health problems were assessed using the Patient Health Questionnaire (PHQ-9) for depression, the Generalised Anxiety Disorder tool (GAD-7) for anxiety, the Harvard Trauma Questionnaire (HTQ-17) for Post-Traumatic Stress Disorder (PTSD) and a two-item tool to measure recent suicidal thoughts/behaviours. Other measurement tools included the WHO Adverse Childhood Experiences (ACE) score, WHO Violence Against Women questionnaire, and the Alcohol, Smoking and Substance Involvement Screening Test (ASSIST). Descriptive statistics and multivariable logistic regression were conducted using a hierarchical modelling approach.ResultsOf 1039 eligible FSWs, 1003 FSWs participated in the study (response rate: 96%) with mean age 33.7 years. The prevalence of moderate/severe depression was 23.2%, moderate/severe anxiety 11.0%, PTSD 14.0% and recent suicidal thoughts/behaviours 10.2% (2.6% suicide attempt, 10.0% suicidal thoughts). Depression, anxiety, PTSD and recent suicidal thoughts/behaviours were all independently associated with higher ACE scores, recent hunger (missed a meal in last week due to financial difficulties), recent sexual/physical violence and increased harmful alcohol/substance. PTSD was additionally associated with increased chlamydia prevalence and recent suicidal thoughts/behaviours with low education and low socio-economic status. Mental health problems were less prevalent among women reporting social support.ConclusionsThe high burden of mental health problems indicates a need for accessible services tailored for FSWs alongside structural interventions addressing poverty, harmful alcohol/substance use and violence. Given the high rates of ACEs, early childhood and family interventions should be considered to prevent poor mental health outcomes.
Assessment of psychometric properties of the questionnaire on supervisor-doctoral student interaction (QSDI) in Iran
Authors: Daryoushi Hooman , Jalali Amir , Karimi Ehsan , Salari Nader , Abbasi Parvin 
Published: October 2021

Abstract
Background
One of the main elements that help students in research projects and composing dissertations is the student-supervisor relationship. A valid and reliable tool to measure this seems essential and it is the objective of the present study to validate and assess the psychometric properties of a questionnaire on supervisor-doctoral student interaction (QSDI) in Iran.

Methods
Before starting the study, a permission from the developer of the tool was secured. Then the tool was forward-backward translated. After preparing the Farsi version of the tool, content validity was confirmed through qualitative and quantitative methods. To examine construct validity, exploratory factor analysis (EFA) and confirmatory factor analysis (CFA) were conducted with participation of 218 and 410 MD, MSc, and PhD students of medical sciences, respectively. To check reliability of the tool, correlation coefficient was used. To examine internal consistency of the tool, Cronbach’s alpha was used. Data analyses were done in SPSS (v.25) and LISREL (v.8).

Results
The EFA and CFA results revealed eight factors and 39 items. The value of R-square for the model was equal to 0.99, which means 99% of changes in the dependent variable (supervisor-student interaction) is attributed to the independent variable (41 items). That is, 99% of the dependent variable changes is due to the independent variables. The main indices of the model based on factor analyses were supported (0.9<), which indicated goodness of fit of the model (χ2/df = 1.76, CFI, NFI, TLI = 0.98 GFI = 0.91, RMSEA = 0.043, R-square = 0.99). The significance level for correlation coefficient was below 0.05. Reliability of the tool was supported based on internal correlation (Cronbach’s alpha) equal to 0.943 for the whole tool and in 0.89–0.97 range for the subscales.

Conclusion
In general, the results showed that the Farsi version of QSDI (eight factors and 39 items) had acceptable and applicable indices and it can be used as a valid tool in different fields for higher education students of medical sciences.
The Annual costs of treating genital warts in the Public Healthcare Sector in Peru
Authors: Saldarriaga Enrique M , Cárcamo Cesar P. , Babigumira Joseph B. , García Patricia J. 
Published: October 2021

Abstract
Objectives
To estimate the cost of six different techniques used to treat Genital Warts and the annual average cost of treating a typical GW patient in Peru. To estimate the annual economic burden diagnosing and treating GW in the Peruvian public healthcare system.

Methods
We developed a prevalence-based, cost-of-illness study from the provider’s perspective, the healthcare facilities under the purview of Peruvian Ministry of Health. We used an activity-based costing approach. We conducted primary data collection in three regions in Peru and supplemented it with governmental data. Uncertainty of the costing estimates was assessed via Monte Carlo simulations. We estimated the average cost and associated confidence intervals for six treatment options – three topical and three surgical – and the overall cost per patient.

Results
The average treatment cost per patient was 59.9USD (95 %CI 45.5, 77.6). Given a population of 18.4 million adults between 18 and 60 years of age and a GW prevalence of 2.28 %, the annual cost of treating GW was 25.1 million USD (uncertainty interval 16.9, 36.6).

Conclusions
This study provides the first quantification of the economic burden of treating genital warts in Peru and one of the few in Latin America. The costing data did not include other healthcare providers or out-of-pocket expenditures, and hence we present a conservative estimate of the COI of GW in Peru. Our findings bring attention to the financial burden of treating GW, a vaccine-preventable disease.
Salivary cortisol and eye temperature changes during endurance competitions
Authors: de Mira Monica C. , Lamy Elsa , Santos Rute , Williams Jane , Pinto Mafalda Vaz , Martins Pedro S. , Rodrigues Patrícia , Marlin David 
Published: October 2021

Abstract
Background
The purpose of this study was to investigate the usefulness of salivary cortisol (SC) and eye temperature measured by infrared thermography (IRTET) as biomarkers to manage competitions more effectively and monitor horse welfare in endurance competitions. Based on previous studies, it was hypothesised that pre-exercise baseline SC and IRTET would be higher in younger or less experienced horses, and that post-exercise variation from baseline would be higher in the top finishers.

Results
Salivary cortisol measured in 61 competing at qualifier 40 km and 80 km rides showed an abrupt variation (93–256% rise) of the baseline SC levels [median ± interquartile range (IQR) = 0.27 ng/dl ± 0.36] obtained at the Pre-Inspection (PI) into Vet Gate (VG)1 independently of the covered distance, but modest or even lower in the subsequent Vet Gates, e.g. VG2 or VG3. The IRTET measured concomitantly in 16 horses showed significant (p < 0.05) higher levels at the PI in less experienced horses participating in the 40 km ride (median ± IQR = 35.7 °C ± 1.4) than their counterparts in the 80 km ride (median ± IQR = 35.0 °C ± 1.5), but not SC. Baseline SC levels at the PI of horses classifying in the Top5 in the 40 km ride category were significantly (p < 0.05) higher median ± IQR = 0.90 ng/ml ±0.61) when compared to horses positioned from 10th position on (median ± IQR = 0.16 ng/ml ±0.40). A lower IRTET in the PI was correlated with better placement (p < 0.05) and those in the Top5 (median ± IQR = 33.9 °C ± 0.0) had a significantly (p < 0.5) higher variation (+ 10.65%) into the last VG.

Conclusion
Pre-exercise baseline IRTET levels, but not SC, were higher in less experienced horses in the 40 compared to their counterparts in the 80 km ride competitions. SC and IRTET showed different indications according to the competition. In the40 km ride competition, higher baseline pre-exercise SC levels seemed to be linked to a better classification outcome. In contrast, in the 80 km ride horses, the higher IRTET variation from pre-exercise into final Vet Gate was the parameter associated with a better performance. A more controlled environment and a larger sample are needed to confirm these results and monitor horse welfare in competitions.
Evaluation of deep learning-based autosegmentation in breast cancer radiotherapy
Authors: Byun Hwa Kyung , Chang Jee Suk , Choi Min Seo , Chun Jaehee , Jung Jinhong , Jeong Chiyoung , Kim Jin Sung , Chang Yongjin , Chung Seung Yeun , Lee Seungryul , Kim Yong Bae 
Published: October 2021

AbstractPurposeTo study the performance of a proposed deep learning-based autocontouring system in delineating organs at risk (OARs) in breast radiotherapy with a group of experts.MethodsEleven experts from two institutions delineated nine OARs in 10 cases of adjuvant radiotherapy after breast-conserving surgery. Autocontours were then provided to the experts for correction. Overall, 110 manual contours, 110 corrected autocontours, and 10 autocontours of each type of OAR were analyzed. The Dice similarity coefficient (DSC) and Hausdorff distance (HD) were used to compare the degree of agreement between the best manual contour (chosen by an independent expert committee) and each autocontour, corrected autocontour, and manual contour. Higher DSCs and lower HDs indicated a better geometric overlap. The amount of time reduction using the autocontouring system was examined. User satisfaction was evaluated using a survey.ResultsManual contours, corrected autocontours, and autocontours had a similar accuracy in the average DSC value (0.88 vs. 0.90 vs. 0.90). The accuracy of autocontours ranked the second place, based on DSCs, and the first place, based on HDs among the manual contours. Interphysician variations among the experts were reduced in corrected autocontours, compared to variations in manual contours (DSC: 0.89–0.90 vs. 0.87–0.90; HD: 4.3–5.8 mm vs. 5.3–7.6 mm). Among the manual delineations, the breast contours had the largest variations, which improved most significantly with the autocontouring system. The total mean times for nine OARs were 37 min for manual contours and 6 min for corrected autocontours. The results of the survey revealed good user satisfaction.ConclusionsThe autocontouring system had a similar performance in OARs as that of the experts’ manual contouring. This system can be valuable in improving the quality of breast radiotherapy and reducing interphysician variability in clinical practice.
The biomechanical effect of the relevant segments after facet-disectomy in different diameters under posterior lumbar percutaneous endoscopes: a three-dimensional finite element analysis
Authors: Shi Yin , Xie Yi-Zhou , Zhou Qun , Yu Yang , Fan Xiao-Hong 
Published: October 2021

Abstract
Objective
To evaluate the biomechanical influence after percutaneous endoscopic lumbar facetectomy in different diameters on segmental range of motion (ROM) and intradiscal pressure (IDP) of the relevant segments by establishing three dimensional finite element (FE) model.

Methods
An intact L3–5 model was successfully constructed from the CT of a healthy volunteer as Model A (MA). The Model B (MB), Model C (MC) and Model D (MD) were obtained through facetectomy on L4 inferior facet in diameters 7.5 mm, 10 mm and 15 mm on MA for simulation. The ROM and IDP of L3/4 and L4/5 of four models were all compared in forward flexion, backward extension, left and right bending, left and right rotation.

Results
Compared with MA, the ROM of L4/5 of MB, MC and MD all increased. MD changed more significantly than MB and MC in backward extension, right bending and right rotation. But that of MB and MC on L3/4 had no prominent change, while MD had a slight increase in backward extension. The IDP of MB and MC on L4/5 in six states was similar to MA, yet MD increased obviously in backward extension, right bending, left and right rotation. The IDP on L3/4 of MB and MC was resemble to MA in six conditions, nevertheless MD increased slightly only in backward extension.

Conclusion
Compared with the facetectomy in diameters 7.5 mm and 10 mm, the mechanical effect brought by facetectomy in diameter 15 mm on the operating segment changed more significantly, and had a corresponding effect on the adjacent segments.
Comparative effectiveness of two methods for inducing osteoarthritis in a novel animal model, the Diannan small-ear pig
Authors: Jia Di , Zhang Ruixian , He Yinghong , Cai Guofeng , Zheng Jiali , Yang Yuye , Li Yanlin 
Published: October 2021

Abstract
Background
Varieties of animals were used to study osteoarthritis pathogenesis. The Diannan small-ear pig, which is native to Yunnan, China, is thought to have an articular anatomy similar to that of humans and is more likely to be a source of pathological tissues than other animals. The aim of this study was to determine whether this animal can serve as a more effective osteoarthritis model and explore the role of SDF-1/CXCR4 signaling pathway in the development of Osteoarthritis in animals.

Methods
Twenty-seven adult pigs were randomly divided into three groups and underwent the Hulth procedure, papain articular injection, and conventional breeding. After 4, 8, and 12 weeks, cartilage tissues from knee joint were extracted for general and histological observation, immunofluorescence, and biochemical analysis. Synovium was taken out for stromal cell-derived factor-1 analysis.

Results
Histopathological observation showed obvious cartilage loss in two experimental groups, this cartilage loss was more severe in the chemical groups. Synovial stromal cell-derived factor1 levels increased over time in all groups. mRNA and protein levels of matrix metalloproteinase-3 were much higher in the chemical groups than in the other groups, whereas levels of collagen type II and aggrecan were significantly lower in the chemical groups than in the other groups. Immunofluorescence assays of collagen type II revealed an apparent reduction in this marker in the chemical groups compared with the other groups.

Conclusions
These results indicated that the Diannan small-ear pig can be used as an effective osteoarthritis model. In addition, it is much more convenient and much faster to induce osteoarthritis by intra-articular injection of papain, which is a method worthy of being promoted.