bluuebunny/crossref_metadata_2025_split huggingface dataset:
“I don’t know if we’ll ever live in harmony”: a mixed-methods exploration of the unmet needs of Syrian adolescent girls in protracted displacement in Lebanon
Authors: Davison Colleen M. , Watt Hayley , Michael Saja , Bartels Susan A. 
Published: October 2021

Abstract
Background
The current crisis in Syria has led to unprecedented displacement, with neighbouring Lebanon now hosting more than 1.5 million conflict-affected migrants from Syria. In many situations of displacement, adolescent girls are a vulnerable sub-group. This study explores and describes the self-reported unmet needs of Syrian adolescent girls who migrated to Lebanon between 2011 and 2016.

Methods
This mixed-methods study focusing on the unmet needs of adolescent girls was part of a larger research project on child marriage among Syrian migrants in Lebanon. Participants were recruited using purposive sampling in three field locations in Lebanon by locally trained research assistants. One hundred eighty-eight Syrian adolescent girls chose to tell qualitative stories about their own experiences. Using handheld tablets and an application called “Sensemaker” stories were audio-recorded and later transcribed. Participants were asked to then self-interpret their stories by answering specific quantitative survey-type questions. Demographic information was also collected. NVivo was used to undertake deductive coding of the qualitative data using Maslow’s Hierarchy of Needs as an analytic frame.

Results
Among the 188 self-reported stories from adolescent girls, more than half mentioned some form of unmet need. These needs ranged across the five levels of Maslow’s Hierarchy from physiological, safety, belonging, esteem and self-actualization. Nearly two thirds of girls mentioned more than one unmet need and the girls’ expressed needs varied by marital status and time since migration. Unmet esteem needs were expressed in 22% of married, and 72% of unmarried girls. Belongingness needs were expressed by 13% of girls who migrated in the last 1–3 years and 31% of those who migrated in the previous 4–5 years.

Conclusion
Many needs of displaced Syrian adolescent girls remain unmet in this situation of now protracted displacement. Girls most commonly expressed needs for love and belonging followed closely by needs for safety and basic resources. The level and type of unmet need differed by marital status and time since displacement. Unmet needs have been associated elsewhere with physical illness, life dissatisfaction, post-traumatic stress, depression, anxiety and even death. These results can inform integrated interventions and services specifically targeting adolescent girls and their families in the protracted migration situation now facing Lebanon.
Association between thyroid-stimulating hormone (TSH) and proteinuria in relation to thyroid cyst in a euthyroid general population
Authors: Shimizu Yuji , Nabeshima-Kimura Yuko , Kawashiri Shin-Ya , Noguchi Yuko , Minami Shigeki , Nagata Yasuhiro , Maeda Takahiro , Hayashida Naomi 
Published: October 2021

AbstractBackgroundHigh normal levels of thyroid-stimulating hormone (TSH) have been reported to be associated with chronic kidney disease (CKD) among euthyroid individuals. However, there has been only limited research on the association between TSH and proteinuria, a major risk factor for the progression of renal disease.MethodsA cross-sectional study of 1595 euthyroid individuals was conducted. All participants were within the normal range for free triiodothyronine (T3), free thyroxine (T4), and TSH. Analyses were stratified by thyroid cyst status to test the hypothesis that the absence of thyroid cysts, an indicator of latent thyroid damage, is associated with declining ability to synthesis thyroid hormone.ResultsFor participants with thyroid cysts, a significant inverse association between TSH and proteinuria was observed (adjusted odds ratio (95% confidence intervals) of log-transformed TSH for proteinuria 0.40 (0.18, 0.89)). In participants without thyroid cysts, a significant positive association between those two factors was observed (2.06 (1.09, 3.90)).ConclusionsAmong euthyroid individuals in the general population, being in the normal range of TSH was found to have an ambivalent association with proteinuria. Thyroid cyst status could be an effect modifier for those associations.
A victim-centred cost–benefit analysis of a stalking prevention programme
Authors: Tompson Lisa , Belur Jyoti , Jerath Kritika 
Published: October 2021

AbstractResearch suggests that stalking inflicts great psychological and financial costs on victims. Yet costs of victimisation are notoriously difficult to estimate and include as intangible costs in cost–benefit analysis. This study reports an innovative cost–benefit analysis that used focus groups with multi-agency teams to collect detailed data on operational resources used to manage stalking cases. This method is illustrated through the presentation of one case study. Best- and worst-case counterfactual scenarios were generated using the risk assessment scores and practitioner expertise. The findings suggest that intervening in high-risk stalking cases was cost-beneficial to the state in all the case studies we analysed (even if it incurs some institutional costs borne by the criminal justice system or health) and was often cost-beneficial to the victims too. We believe that this method might be useful in other fields where a victim- or client-centred approach is fundamental.
A novel sensitivity-based method for feature selection
Authors: Naik Dayakar L. , kiran Ravi 
Published: October 2021

AbstractSensitivity analysis is a popular feature selection approach employed to identify the important features in a dataset. In sensitivity analysis, each input feature is perturbed one-at-a-time and the response of the machine learning model is examined to determine the feature's rank. Note that the existing perturbation techniques may lead to inaccurate feature ranking due to their sensitivity to perturbation parameters. This study proposes a novel approach that involves the perturbation of input features using a complex-step. The implementation of complex-step perturbation in the framework of deep neural networks as a feature selection method is provided in this paper, and its efficacy in determining important features for real-world datasets is demonstrated. Furthermore, the filter-based feature selection methods are employed, and the results obtained from the proposed method are compared. While the results obtained for the classification task indicated that the proposed method outperformed other feature ranking methods, in the case of the regression task, it was found to perform more or less similar to that of other feature ranking methods.
Quantitative Effect of Metal Artefact Reduction on CT-based attenuation correction in FDG PET/CT in patients with hip prosthesis
Authors: Haemels Maarten , Vandendriessche Delphine , De Geeter Jeroen , Velghe James , Vandekerckhove Maxence , De Geeter Frank 
Published: October 2021

Abstract
Background
Metal artefact reduction (MAR) techniques still are in limited use in positron emission tomography/computed tomography (PET/CT). This study aimed to investigate the effect of Smart MAR on quantitative PET analysis in the vicinity of hip prostheses.

Materials and methods
Activities were measured on PET/CT images in 6 sources with tenfold activity concentration contrast to background, attached to the head, neck and the major trochanter of a human cadaveric femur, and in the same sources in similar locations after a hip prosthesis (titanium cup, ceramic head, chrome-cobalt stem) had been inserted into the femur. Measurements were compared between PET attenuation corrected using either conventional or MAR CT. In 38 patients harbouring 49 hip prostheses, standardized uptake values (SUV) in 6 periprosthetic regions and the bladder were compared between PET attenuation corrected with either conventional or MAR CT.

Results
Using conventional CT, measured activity decreased with 2 to 13% when the prosthesis was inserted. Use of MAR CT increased measured activity by up to 11% compared with conventional CT and reduced the relative difference with the reference values to under 5% in all sources. In all regions, to the exception of the prosthesis shaft, SUVmean increased significantly (p < 0.001) by use of MAR CT. Median (interquartile range) percentual increases of SUVmean were 1.4 (0.0–4.2), 4.0 (1.8–7.8), 7.8 (4.1–12.4), 1.5 (0.0–3.2), 1.4 (0.8–2.8) in acetabulum, lateral neck, medial neck, lateral diaphysis and medial diaphysis, respectively. Except for the shaft, the coefficient of variation did not increase significantly. Except for the erratic changes in the prosthesis shaft, decreases in SUVmean were rare and small. Bladder SUVmean increased by 0.9% in patients with unilateral prosthesis and by 4.1% in patients with bilateral prosthesis.

Conclusions
In a realistic hip prosthesis phantom, Smart MAR restores quantitative accuracy by recovering counts in underestimated sources. In patient studies, Smart MAR increases SUV in all areas surrounding the prosthesis, most markedly in the femoral neck region. This proves that underestimation of activity in the PET image is the most prevalent effect due to metal artefacts in the CT image in patients with hip prostheses. Smart MAR increases SUV in the urinary bladder, indicating effects at a distance from the prosthesis.
Performance evaluation of a PET insert for preclinical MRI in stand-alone PET and simultaneous PET–MRI modes
Authors: Emvalomenos Gaelle , Trajanovska Sofie , Pham Binh T. T. , Doughty Peter , Burnet Jerome , Smith Isabelle , Garipov Ruslan , Gregoire Marie-Claude , Sunn Nana , McGrath John , Meikle Steven R. 
Published: October 2021

Abstract
Background
This study aimed to evaluate the performance of a preclinical PET insert in three configurations: as a stand-alone unit outside the MRI bore, inside the bore of a cryogen-free 3T MRI and, finally, while performing simultaneous PET/MRI studies.

Methods
The PET insert consists of two rings of six detectors, each detector comprising 8 × 12 SiPMs reading out dual offset layers of pixelated LYSO crystals with a 1.4-mm pitch. The inner diameter is 60 mm, transaxial field of view (FoV) 40 mm and axial FoV 98 mm. Evaluation was based on NEMA NU 4-2008 guidelines with appropriate modifications. Spatial resolution and sensitivity were measured inside and outside the MR bore. Image quality, count rate and quantitative performance were measured in all three configurations. The effect of temperature stability on PET sensitivity during fast spin echo sequences was also evaluated. B0 field homogeneity and T1 and T2 relaxation times were measured using a water-filled phantom, with and without simultaneous PET operation. Finally, PET and MRI scans of a mouse injected with 10 MBq [18F]NaF and a mouse injected with 16 MBq [18F]FDG were performed in sequential and simultaneous modes.

Results
Peak absolute sensitivity was 10.15% with an energy window of 250–750 keV. Absolute sensitivity values outside and inside the MR bore with MR idle agreed to within 0.1%. Outside the MR bore, spatial resolution was 1.21/1.59 mm FWHM (radial/tangential) 5 mm from the centre of the FoV which compared well with 1.19/1.26 mm FWHM inside the MR bore. There were no substantial differences between all three scan configurations in terms of peak NEC rate (175 kcps at 17 MBq), scatter or random fractions. Uniformity and recovery coefficients were also consistent between scanning modes. B0 field homogeneity and T1 and T2 relaxation times were unaltered by the presence of the PET insert. No significant differences were observed between sequential and simultaneous scans of the animals.

Conclusions
We conclude that the performance of the PET insert and MRI system is not significantly affected by the scanning mode.
Clinical effectiveness of implant support for distal extension removable partial dentures: functional evaluation using occlusal force measurement and masticatory efficiency
Authors: Murakami Kei , Ayukawa Yasunori , Ogino Yoichiro , Nakagawa Akinari , Horikawa Tadashi , Yamaguchi Eishi , Takaki Kimiyasu , Koyano Kiyoshi 
Published: October 2021

Abstract
Background
Implant-supported removable partial dentures (ISRPD) are supported at the free-end region with implant retainers. As implant retainers prevent denture settlement and facilitate denture retention, this is intended to improve masticatory performance in comparison with that of conventional removable dentures. In the present study, we evaluated the effect of implant retainers at the free-end region of removable dentures on occlusal force and masticatory efficiency using a pressure-sensitive sheet, and measured glucose concentration in saliva after mastication with gummy candy.

Methods
In the present study, the occlusal force and masticatory efficiency of 13 subjects were measured in the following three conditions: without dentures (Condition 1), wearing dentures but not supported by implants (Condition 2), and wearing dentures supported by implants (ISRPD) (Condition 3). All data were statistically compared.

Results
Regarding the occlusal force, Condition 3 showed significantly higher scores than the other conditions; however, there were no significant differences between Conditions 1 and 2. Regarding the masticatory efficiency, Condition 3 showed significantly higher scores than Condition 2.

Conclusions
With ISRPD, the occlusal force and masticatory efficiency were increased in comparison with those with conventional removable dentures.
Diagnosis of inflammatory peri-implant diseases using an immunochromatographic assay for calprotectin in peri-implant crevicular fluid
Authors: Kido Rie , Kido Jun-ichi , Nishikawa Yasufumi , Sakamoto Eijiro , Tomotake Yoritoki , Yumoto Hiromichi 
Published: October 2021

AbstractBackgroundThe incidence rate of peri-implant diseases is increasing with implant placement. Early detection of peri-implant diseases is important to prevent and treat these diseases, and a simple and objective diagnostic method is expected. Immunochromatographic (IC) assays are used for rapid diagnostic methods for some diseases. The aim of this clinical study was to determine the amount of calprotectin, an inflammatory marker, in peri-implant crevicular fluid (PICF) using an IC chip, and estimate the possibility of this diagnostic system.MethodsForty-six individuals with dental implants participated in a pilot study. PICF samples were collected from the peri-implant sites with or without inflammation after clinical examinations including probing depth (PD), bleeding on probing (BOP) and gingival index (GI). Calprotectin in PICF was determined by an IC chip and enzyme-linked immunosorbent assay (ELISA) for calprotectin. The density of calprotectin line on the IC chip was measured using an IC reader (IC reader value). The relationship between IC reader value and ELISA value or clinical parameters was investigated. A receiver operating characteristic (ROC) curve analysis of IC reader value of calprotectin was performed to predict inflammation in peri-implant diseases.ResultsIC reader value of calprotectin was significantly correlated with its ELISA value and PD. IC reader values of calprotectin in PICF samples from periodontal sites with GI-1 and GI-2, and with BOP-positive sites were significantly higher than those of PICF samples from GI-0 sites, and BOP-negative sites, respectively. The IC reader value for calprotectin in PICF samples from inflammatory diseased sites was significantly higher than that of non-diseased sites. ROC analysis suggested that the IC reader value of PICF calprotectin was useful for predicting inflammatory peri-implant diseases.ConclusionIC assay for PICF calprotectin may be a possible system for diagnosing the inflammatory peri-implant diseases.
Association between serum zinc levels and basic physical functioning: secondary data analysis of NHANES 2011–14
Authors: Gau Jen-Tzer , Chavan Bhakti , Li Yang , Clark Brian C. , Haile Zelalem T. 
Published: October 2021

Abstract
Background
Serum zinc (Zn) levels have been shown to be associated with functional status; however, it is not clear whether this association differs by other sociodemographic characteristics. We examined the association between serum Zn levels and physical functioning difficulty in a representative sample of older adults in the US.

Design and methods
A cross-sectional study was conducted on participants 50 years and older from the 2011–12 and 2013–14 National Health and Nutrition Examination Surveys (n = 1136). Serum Zn levels were analyzed as tertiles. The main outcome of interest was physical functioning difficulty, defined as self-reported difficulty of basic physical functioning that included walking, transferring, dressing, and feeding.

Results
Mean Zn levels (SE) were 0.67(0.1), 0.81(0.1), and 0.98(0.1) μg/mL in the low, middle, and high Zn groups, respectively. Approximately 24.9% participants reported physical functioning difficulty. In the multivariable model, we found a significant multiplicative interaction between sex and serum Zn (P for interaction =0.028) and between education and serum Zn (P for interaction = 0.001) on basic physical functioning difficulty. The stratified analysis revealed that among men, compared to those with low serum Zn, the odds of having physical functioning difficulty were lower in men who had high serum Zn [aOR 0.43 (95% CI: 0.25–0.76)]. For women, compared to those with low serum Zn the odds of having physical functioning difficulty were higher in women who had middle serum Zn [aOR 2.67 (1.58–4.50)]. Among individuals with less than high school education, the odds of having physical functioning difficulty were lower in those who had middle serum Zn compared to those who had low serum Zn [aOR 0.48 (0.26–0.89)]. However, the odds of having physical functioning difficulty were higher in those who had middle serum Zn compared to those who had low serum Zn for individuals with high school [aOR 5.72 (1.92–17.00)] and beyond high school education [aOR 1.77 (1.05–2.97)], respectively.

Conclusion
Sex and educational attainment interact with serum Zn levels to influence basic physical functioning difficulty in older adults.
Evaluation of facial soft tissue thickness in asymmetric mandibular deformities after orthognathic surgery
Authors: Huang Luo , Li Zhicong , Yan Jing , Chen Lunqiu , Piao Zheng-guo 
Published: October 2021

Abstract
Objectives
The purpose of this study was to compare differences in facial soft tissue thickness in three-dimensional (3D) images before and after orthognathic surgery in patients with skeletal Class III malocclusion and to obtain a better understanding of the relationship between hard and soft tissue changes after surgery.

Materials and method
The present retrospective study included 31 patients with skeletal Class III malocclusion with mandibular chin deviation greater than 4 mm who had undergone cone-beam computed tomography before and 6 months after surgery. Seven bilateral points were established. Measurements were taken from software-generated multiplanar reconstructions. The predictor variables were timing (pre- and postoperatively) and side (deviated vs. nondedicated). A regression model and correlation analysis were conducted for statistical analysis.

Results
The difference of bilateral facial soft tissue thickness was statistically significantly different between deviated and nondeviated sides (P < 0.05), with lower values observed on the deviated side. The soft tissue thickness has become nearly symmetric at local regions of the lower thirds of the face after orthognathic surgery. However, most measurements showed a negative correlation between changes in soft tissue thickness and changes in bone tissues.

Conclusions
Skeletal Class III malocclusion with facial asymmetry is accompanied by differences in soft tissue thickness when comparing Dev and N-Dev sides of the posterior region of the mandible, where soft tissues are thinner on the Dev side. Soft tissue thickness can compensate for or camouflage the underlying asymmetric mandible. In addition, the asymmetric soft tissue thickness on the lower third of the face can be partially improved by orthognathic surgery, but the amount of soft tissue thickness change is not consistent with that of hard tissue positional change.
Patients’ health outcomes after an implementation intervention targeting the physiotherapists’ clinical behaviour
Authors: Fritz Johanna , Almqvist Lena , Söderlund Anne , Wallin Lars , Sandborgh Maria 
Published: October 2021

Abstract
Background
A behavioural medicine approach in physiotherapy has shown positive effects on increased and sustained activities and participation, including reduced sick leave for patients with persistent musculoskeletal pain. The aim of this study was to explore the health outcomes of patients with persistent musculoskeletal pain treated by physiotherapists who had received active compared with passive support when implementing a behavioural medicine approach.

Methods
An explorative and comparative pre−/post-test trial was conducted. A total of 155 patients with musculoskeletal pain ≥4 weeks were consecutively recruited by physiotherapists in primary healthcare who had received active or passive support when implementing a behavioural medicine approach. Data concerning health outcomes for patients were collected using questionnaires before and after the physiotherapy treatment and at half-, one- and two-year follow-ups. Descriptive, non-parametric and parametric bi- and multivariate statistics were used.

Results
There were no differences over time between the patients treated by physiotherapists who had received active compared to passive implementation support regarding pain-related disability, pain intensity, self-rated health, self-efficacy in performing daily activities, catastrophic thinking related to pain, and fear of movement. Significant improvements over time were identified in both groups regarding all variables and the effect sizes were large. The percentage of patients on sick leave significantly decreased in the patient group treated by physiotherapists who had received active implementation support.

Conclusion
It is very important to include patient outcomes when evaluating the implementation of multicomponent interventions. It seems that the implementation method did not play a major role for the patients’ outcomes in this study. Most of the patients’ health outcomes improved regardless of whether they were treated by physiotherapists who had received active or passive support when implementing a behavioural medicine approach. This was likely because the active implementation support was not extensive enough to enable the physiotherapists to sustain the behavioural medicine approach.

Trial registration
The study protocol was retrospectively registered in ClinicalTrials.gov. ID NCT03118453, March 20, 2017.
Clonazepam for pain due to muscle spasm in a patient with vertebral compression fractures caused by multiple myeloma: a case report
Authors: Akita Kazuki , Kumakura Yasutomo , Nakajima Emi , Ishiguro Hiroki , Iijima Tetsuya 
Published: October 2021

Abstract
Background
Vertebral compression fractures can cause severe back pain. Although many types of analgesics and interventional treatments are available, they are sometimes ineffective in mitigating the pain. We encountered a case where clonazepam was effective for the management of severe low back pain caused by lumbar vertebral compression fractures.

Case presentation
A 44-year-old male was diagnosed with multiple myeloma and had vertebral compression fractures of the first and second lumbar vertebrae. He had been suffering from severe low back pain on movement with muscle spasm and pain-associated anxiety. We considered this breakthrough low back pain to be caused by facet joint pain; thus, we prescribed clonazepam as a muscle relaxant and anxiolytic. Following this treatment, the intractable breakthrough pain was dramatically relieved.

Conclusion
Clonazepam, which has both muscle relaxant and anxiolytic effects, might be helpful in mitigating pain, associated anxiety, and muscle spasms due to vertebral compression fractures.