bluuebunny/crossref_metadata_2025_split huggingface dataset:
Safety and efficacy of individual target transcranial magnetic stimulation to stimulate the most negative correlate of DLPFC-pgACC in the treatment of major depressive disorder: study protocol of a double-blind, randomised controlled trial
Authors: Liu Nian , Zhao Na , Tang Nailong , Cai Min , Zhang Yuyu , Lv Runxin , Zhang Yaochi , Han Tianle , Meng Yumeng , Zang Yufeng , Wang Huaning 
Published: November 2024

IntroductionMajor depressive disorder (MDD) is a common mental disorder that is characterised by high morbidity, high rates of relapse, high rates of disability and, in severe cases, suicide ideas or even behaviour causing significant distress and burden. Transcranial magnetic stimulation (TMS) is a non-invasive brain stimulation technique widely used in the clinical treatment of MDD. Nevertheless, due to the imprecise selection and positioning of stimulation targets, their response rate is not as satisfactory. This trial was designed to treat MDD based on functional connectivity with individual target-TMS (IT-TMS) to stimulate the dorsolateral prefrontal cortex (DLPFC) where it correlates most negatively with the pregenual anterior cingulate cortex (pgACC). We will validate the safety and efficacy of IT-TMS for MDD using pgACC as an effector target, analyse the underlying antidepressant mechanism of the DLPFC-ACC brain network and search for neuroimaging markers that predict the efficacy of TMS.Methods and analysisThis is a single-centre, randomised, double-blind and sham-stimulation-controlled clinical trial. We aim to recruit approximately 68 depressed patients with MDD aged 18–60 years. Eligible participants will be randomised into the DLPFC-pgACC localisation and sham stimulation groups. The IT-TMS treatment will last 10 days and will be combined with antidepressant medication. Assessments will be confirmed at baseline, on day 5 of treatment and at the end of treatment with follow-up at weeks 2, 4 and 8 after the end of treatment. The primary outcome measure is the difference in the Hamilton Depression Scale score between baseline and end of treatment.Ethics and disseminationThe Ethics Committee of the First Affiliated Hospital of the Air Force Medical University has approved this clinical trial (project code: XJLL-KY20222111). The trial’s results will be published in international peer-reviewed journals and presented at academic conferences.Trial registration numberClinicalTrials.gov PRS (ID:NCT05577481).
Acupuncture combined with Chinese herbal medicine for discogenic low back pain: protocol for a multicentre, randomised controlled trial
Authors: Lin Yi , Li Xinyi , Huang Liangqing , Xie Xiaoming , Luo Taoxu , Tian Guihua 
Published: November 2024

IntroductionDiscogenic low back pain is a common form of chronic low back pain. In traditional Chinese medicine, combinations of acupuncture and herbal medicine are frequently used to manage this condition. However, evidence for the efficacy of a combined approach remains scarce. To address this gap, we designed a multicentre, randomised controlled trial to compare the effects of the combined use of acupuncture and Chinese herbal medicine, and their separate applications along with non-steroidal anti-inflammatory drugs, in treating discogenic low back pain.Methods and analysisThis is a multicentre, prospective, randomised, four-arm, parallel-controlled trial involving patients with discogenic low back pain. Patients will be randomly divided into four groups (acupuncture combined with herbal medicine, acupuncture, herbal medicine and positive drug control) at a 1:1:1:1 ratio. All patients will undergo a 4-week treatment regimen consisting of acupuncture (active or sham acupuncture) and oral medication (herbal medicine or placebo granules and celecoxib or placebo capsules), as well as a 3-month follow-up assessment. The primary outcome measure will be pain intensity, measured using the Visual Analogue Scale after a 4-week treatment period. Secondary outcome measures will include the lumbar pressure pain threshold, pain-related disability measured using the Oswestry Disability Index, Hospital Anxiety and Depression Scale, Pittsburgh Sleep Quality Index, 36-Item Short-Form Health Survey and incidence of adverse events. Assuming an SD of 1.8, minimal clinically important difference of 1.5 and a 10% dropout rate, at least 97 participants per group are needed, totalling 388 participants.Ethics and disseminationThe study was approved by the Ethics Committee of Dongzhimen Hospital Affiliated with Beijing University of Chinese Medicine (approval number: 2024DZMEC-083-03) and the other seven participating subcentres. All participants will provide written informed consent. This trial will be conducted in accordance with the principles outlined in the Declaration of Helsinki and its amendments. This work will be disseminated through the publication of peer-reviewed manuscripts.Trial registration numberChiCTR2400082428.
Acceptability, barriers and facilitators of using dried blood spots-point-of-care testing for sickle cell disease in Africa: an implementation science protocol for a multinational qualitative study
Authors: Nnodu Obiageli Eunice , Munung Nchangwi Syntia , Chirande Lulu , Chunda-Liyoka Catherine , Kiguli Sarah , Sarfo Fred Stephen , Touré Boubacari Ali , Balandya Emmanuel , Guindo Aldiouma , Kuona Patience , Esoh Kevin , Jonas Mario , Nwegbu Maxwell , Masamu Upendo , Morrice Jack , Moru Patrick Ohiani , Bitoungui Valentina Ngo , Nembaware Victoria , Nkya Siana , Tshilolo Léon , Makani Julie , Wonkam Ambroise , Peprah Emmanuel 
Published: November 2024

BackgroundSickle cell disease (SCD) is a prevalent inherited blood disorder. Globally, approximately 515 000 babies are born with SCD annually, with 75% of these births occurring in Africa. Integrating newborn screening (NBS) for SCD into primary healthcare structures, such as immunisation programmes, holds significant promise, with dried blood spots (DBS)-point-of-care technologies (POCT) like HaemoTypeSC offering cost-effective screening solutions. However, scaling up DBS-POCT for NBS of SCD in Africa remains challenging.ObjectiveThis study aims to explore individual, organisational and external factors that may influence the reliability, feasibility, acceptability, adoption and sustainability of using DBS-POCT with HaemoTypeSC for NBS of SCD at primary healthcare centres in African countries.MethodThis qualitative study will be conducted in seven African countries that are part of the SickleInAfrica consortium sites. The study design is informed by the Consolidated Framework for Implementation Research (CFIR) and the Implementation Outcome Model. Participants will be mothers whose babies have been diagnosed with SCD, healthcare professionals and policy-makers. In-depth interviews and focus group discussions will be used for data collection. Data analysis will be through thematic analysis.Ethics and disseminationResearch ethics approvals have been obtained from the seven countries. Written informed consent will be obtained from all participants. The study results will be disseminated in peer-reviewed scientific journals, scientific conferences, reports to national ministries of public health and webinars.
Scoping review of countries’ practices missed by health emergency preparedness and response quantitative tools: COVID-19 and Ebola response experiences
Authors: Ssenkusu John Mbaziira , Kiwanuka Julius , Ninsiima Mackline , Bell Jessica , Nuzzo Jennifer B 
Published: November 2024

IntroductionAfter the COVID-19 pandemic and previous disease outbreaks, it is critical to continuously examine the preparedness measurement tools and level of country preparedness for future health emergencies. Existing preparedness quantitative tools, such as the 2021 Global Health Security Index (GHSI) and Joint External Evaluation (JEE) second edition, may not fully reflect the country’s actual practices during an outbreak. This scoping review profiles countries’ practices, actions and experiences during Ebola and COVID-19 pandemics missed by these tools but critical to a successful response.MethodsUsing the PRISMA checklist for scoping reviews, we documented country practices during health emergence responses. Our search strategy keywords included “actions/practices,” “preparedness/response,” “Ebola/COVID-19,” and “successes/experiences/challenges,” across PubMed, Medline, CINAHL, Embase, Google Scholar and WHO IRIS. English peer-reviewed articles published between January 2004 and October 2020 for Ebola and between January 2020 and December 2022 for COVID-19 were included. Articles were independently assessed for inclusion and discordant decisions were agreed on by consensus. A qualitative thematic analysis was conducted and findings were presented by a disease outbreak.ResultsOut of 1913 studies screened, 36 were included. The COVID-19 and Ebola response practices, actions, and experiences not included in the GHSI 2021 and JEE second edition tools included; use of previous outbreaks lessons, cushioning the populations and putting in place mechanisms to support businesses, protection of vulnerable populations, leveraging the trust in leadership and role models, and innovative ways of engaging the public through use of technology.ConclusionCountries’ outbreak response strategies depend on the available resources, the outbreak characteristics, its effects and how other countries are responding. This study suggests incorporating capacities of these response actions into existing tools and countries should make detailed plans on how they can leverage existing trust, protect the vulnerable, cushion citizens and businesses from epidemic effects, and innovatively use technology to engage the public in epidemic responses.
High prevalence of STIs among men engaged in transactional sex and alcohol use in western Kenya: important implications for STI prevention interventions
Authors: Napierala Sue , Bair Elizabeth F , Omollo Ouma Dan , Egbe Teniola I , Wesonga Julius Oduor , Rajaratnam Anisha , Celum Connie , Thirumurthy Harsha , Agot Kawango 
Published: November 2024

ObjectivesBetter data on aetiological prevalence of sexually transmitted infections (STIs) among African men could greatly strengthen STI prevention efforts and convey benefits to women as well. In an ongoing study among men in Kenya, we analysed baseline STI prevalence and individual characteristics associated with STI.MethodsIn Siaya County, Kenya, we recruited men aged 18–39 years who self-reported engagement in transactional sex and alcohol use. We administered a baseline questionnaire to participants and conducted testing for HIV, herpes simplex virus type 2 (HSV-2),Chlamydia trachomatis(CT) andNeisseria gonorrhoeae(NG) infection. Characteristics associated with bacterial STIs were analysed using logistic regression and we estimated the positive and negative predictive values (PPV/NPV) of syndromic management of these infections.ResultsWe enrolled 1500 participants from July 2022 to March 2023. Participant mean age was 27.9 years, 62.2% were married/cohabitating and 53.5% were heavy alcohol users (Alcohol Use Disorders Identification Test-Consumption≥4). Participants reported a mean of 4.2 sexual partners and 3.5 transactional sex partners in the past 3 months. HIV prevalence was 9.5%, HSV-2 was 38.7%, CT was 14.3% and NG was 2.5%. Combined CT and/or NG infection was detected in 16.1% of participants.Compared with participants uninfected, those testing positive for CT and/or NG were younger (p=0.001), had more sexual partners (p=0.027) and transactional sex partners (p=0.039), were less likely to have used a condom at last sex (p=0.015) and were more likely to self-report having an STI besides HIV in the past 12 months (p=0.002). The PPV and NPV for currently experiencing CT and/or NG symptoms were 33.3% and 84.4%, respectively.ConclusionsAmong Kenyan men engaged in transactional sex and alcohol use, STI prevalence was high. These data fill an important gap about STI prevalence and risk factors in African men highlighting the risk of ongoing transmission and the need for targeted prevention programmes and expanded access to testing and treatment.
Changing role of water table and weather conditions in diameter growth of Scots pine in drained peatlands
Authors: Hökkä Hannu , Palviainen Marjo , Stenberg Leena , Heikkinen Juha , Laurén Annamari 
Published: November 2024

We investigated the impact of water table (WT), monthly temperature, and precipitation of current and previous growing seasons on annual diameter growth of Scots pine in boreal drained peatlands. The data were collected from six sites across Finland. WT was monitored during 5–8 growing seasons depending on site during 2007–2014. The sites contained altogether 19 sample plots, where diameter growth from 339 trees was measured, resulting in 1599 growth observations. Tree-level diameter growth was analysed using mixed linear models, including variables describing tree size, competition, and environment. The higher precipitation in June of the previous year and May of the current year increased diameter growth, whereas the higher temperature in July of the current year and the deeper WT in August of the previous year decreased growth. The results suggest that Scots pine grows better at shallow than deep WT in drained peatlands. This contradicts earlier findings that a deep WT is needed to support tree growth in drained peatlands. We suggest that the development of a mor layer on the peat is changing nutrient cycling and hydrology. The results encourage the avoidance of intensive drainage in forested peatlands, which may also diminish the adverse environmental impacts of peatland forestry.
AAC McMurphy field pea
Authors: Bing Deng-Jin , Beauchesne Don , Miller Michelle , Mollison Brett , Kim Yong Min , Liu Kui , Cuthbert Richard , Naeem Hamid 
Published: November 2024

AAC McMurphy is a semi-leafless, yellow cotyledonary field pea ( Pisum sativum L.) cultivar developed at Agriculture and Agri-Food Canada Lacombe Research and Development Centre, Lacombe, Alberta, Canada. It has a maturity of 90 days, one-thousand-seed weight of 246 g, and a lodging score of 2.9 on the scale of 1–9. The seed crude protein content of AAC McMurphy is 24.2%. AAC McMurphy is resistant to powdery mildew (caused by Erysiphe pisi) and moderately susceptible to mycosphaerella blight (caused by Mycosphaerella pinodes) and fusarium root rot (caused by Fusarium avenaceum).
Scalar/Spinor cosmological model and covariant formalism
Authors: Ribas M. O. , Bonato H. O. , Devecchi F. P. , Constantinidis C. P. 
Published: November 2024

We investigate a cosmological model using the covariant formalism proposed by Canuto et al., considering bosonic and fermionic fields as sources, including both self-interacting potentials. Following that path, it is possible to determine, first, a family of symmetries using the Noether procedure. That permits to obtain the conformal function [Formula: see text], part of the covariant formalism, that maps the physics between descriptions. In gravitational units (old universe) it is verified that the bosonic/fermionic combination behaves as a dark constituent. In atomic units what emerges is an initially accelerated universe, followed a decelerated period, that would correspond to a primordial era considered as an analog of inflation.
Unveiling Parkinson’s: Handwriting Symptoms with Explainable and Interpretable CNN Model
Authors: zemmar Ammar , Bennour Akram , Tahar Mekhaznia , Ghabban Fahad , Al-Sarem Mohammed 
Published: November 2024

Parkinson’s disease (PD), the second most prevalent neurodegenerative disorder globally, afflicting approximately 10 million individuals, necessitates early detection for optimal management. In this paper, we propose deep learning models to discern Parkinson’s disease through the nuanced analysis of handwriting with the overall objective of achieving transparency and trustworthiness through the integration of Explainable and Interpretable AI. Leveraging transfer learning from well-established VGG16 and VGG19 architectures and introducing two bespoke CNN models (PD-Detect1 and PD-Detect2), we meticulously scrutinize diverse datasets (HandPD, NewhandPD, Parkinson Drawing) to ascertain the efficacy of our approach. LIME and SHAP Explainable AI techniques are employed to pinpoint specific regions of the spiral drawings that significantly influence the predictions made by the VGG16 and PD-Detect2 models. Additionally, Convolutional Filter Visualization and Grad-CAM are utilized to illustrate how the convolutional layers of the PD-Detect2 model function. Finally, LIME is applied to the PD-Detect2 model to identify visual markers of handwriting symptoms in the spiral drawing. Remarkable results underscore our reliance on VGG16 and VGG19 for precise identification, achieving an outstanding 100% accuracy in the waves drawing dataset. PD-Detect1 exhibits commendable performance with an accuracy of 94.44% in the meander of NewhandPD dataset, while VGG16 achieves an accuracy of 95%. VGG16 records 95% accuracy while PD-Detect2 achieves 85% accuracy in the spiral drawing dataset. Both results further bolstered to 100% with the application of classic data augmentation techniques. The Positive/Negative superpixels from LIME and SHAP highlight the key regions used by VGG16 and PD-Detect2 for predictions, while PD-Detect2 places more emphasis on disease-related features. Visualizing convolutional filters provided insight into the functionality of each layer within the PD-Detect2 model, while the Class Activation Maps produced by Grad-CAM highlighted the image regions most influential to the model’s decision. Ultimately, LIME’s superpixels identified visual markers of handwriting symptoms associated with Parkinson’s disease. Explainable AI and Interpretable AI enhance the quality of CNN models and support the decision-making process, enabling healthcare professionals to more accurately assess disease probability and monitor treatment responses. This leads to a more effective system for the early diagnosis of Parkinson’s disease through prediction and visual monitoring of handwriting symptoms.
From Viral Content to Real-Life Cuisine and Beyond: Examining Teenagers' Interactions with TikTok Food Videos and the Influence on their Food Practices
Authors: Wang Chun-Han Ariel , Sher Stephen Tsung-Han , Chung Chia-Fang 
Published: November 2024

TikTok has gained immense popularity among teenagers, offering access to numerous user-generated content. Notably, food videos have emerged as a prominent theme on this short-form video social platform. The casual and enjoyable nature of short food videos on TikTok belies their potential influence on one of teenagers' most immediate and regular health practices--eating. Understanding how teenagers interact with these videos, their subsequent actions, and the resulting impact on their food practices and eating habits have the potential to provide insight into their broader lifestyle choices and their interactions within their social circles, including parents, friends, and other people online. By examining how teenagers use TikTok food videos online and offline, we gain a deeper understanding of the intricate relationship between social media, teenage lifestyle, and social dynamics surrounding food practices.
In this research, we conducted 15 semi-structured interviews with teenagers aged 13 to 19, investigating their consumption of TikTok food videos and the actions inspired by them. By examining the multifaceted influence of TikTok food videos from a temporal perspective, this study contributes to the reflections of teens' use of TikTok food videos and their inspired food practices in the short and long term, online and offline. We propose design and theoretical implications to support teenagers' health. These insights have the potential to extend to various contexts, helping educators, policymakers, and designers in fostering healthy lifestyles among teenagers.
Perceptions of Empathy Among Nursing Assistants in Long‐Term Care Facilities
Authors: Hu Hsiao-Ling , Kuo Chien-Lin , Wang Shou-Yu , Chuang Yeu-Hui 
Published: November 2024

Background:​ Empathy is a fundamental component of the therapeutic relationship between healthcare providers and patients and has the potential to yield significant benefits, including heightened care satisfaction, enhanced care quality, and improved mental well‐being for patients. As nursing assistants (NAs) are primary direct care providers in long‐term care facilities (LTCFs), it is necessary to understand NAs’ views on empathy in their care provision for residents, but a gap exists in the literature regarding NAs’ perspectives on empathy in this context.Aim: In this study, we aimed to explore perceptions of empathy among NAs in LTCFs.Research Design: A qualitative approach was applied in this study.Participants and Research Context: Through purposive and snowball sampling, 18 NAs who provided care for residents in six LTCFs in Taiwan were recruited. Face‐to‐face in‐depth interviews were conducted using a semistructured interview guide, and data were analyzed using a content analysis.Ethical Considerations: Ethical approval was obtained from the Institutional Review Board. All participants signed a written informed consent form prior to the interview.Results: Four themes encompassing 11 categories were generated including “being fundamental to caregiving to establish trust and enhance quality care,” “practicing altruistic behavior in the pursuit of ethical caregiving,” “cycling empathic flow in care,” and “facing challenges in delivering empathetic care.”Conclusions: NAs in LTCFs viewed empathy as an essential element of the caregiving process. They saw empathy as selfless care, assistance to others, and alleviation of residents’ suffering. Understanding residents’ emotions, thoughts, and needs, active listening and compassionate engagement were vital to expressing empathy. However, NAs faced challenges in expressing empathy due to demanding tasks, time limitations, and insufficient knowledge and communication skills. In addition, emotional desensitization further complicated the provision of empathic care. The findings of this study can provide information for nurse managers and directors to understand NAs’ perspectives on empathy and difficulties when providing empathic care in the long‐term care context.