bluuebunny/crossref_metadata_2025_split huggingface dataset:
Population-based age- and type-specific prevalence of human papillomavirus among non-vaccinated women aged 30 years and above in Germany
Authors: Liang Linda A. , Tanaka Luana F. , Radde Kathrin , Bussas Ulrike , Ikenberg Hans , Heideman Daniëlle A. M. , Meijer Chris J. L. M. , Blettner Maria , Klug Stefanie J. 
Published: September 2024

Abstract
Background
A persisting high-risk human papillomavirus (HR-HPV) infection is causal for cervical cancer; however, there is limited population-based data on the prevalence of HPV infections in Germany. We assessed the age and type-specific HPV prevalence, and associated risk factors in HPV unvaccinated women aged 30 and above.

Methods
The MARZY prospective population-based cohort study was conducted between 2005 and 2012 in Mainz and Mainz-Bingen, Germany. Eligible women were randomly recruited from population registries and invited for cervical cancer screening (n = 5,275). A study swab (liquid-based cytology) was taken and HPV testing was performed with GP5+/6 + polymerase chain reaction (PCR) followed by genotyping. We assessed HPV types as HR-HPV, ‘moderate’ risk and low-risk (LR-HPV). Logistic regression was performed to identify factors associated with HPV infection, stratified by HPV types.

Results
2,520 women were screened with a valid PCR result. Overall HPV prevalence was 10.6% (n = 266), with 6.5% HR-HPV positive (n = 165), 1.5% ’moderate’ risk type (n = 38) and 3.3% LR-HPV type (n = 84) positive. 8.9% had a single infection (n = 225) and 1.6% had multiple types (n = 41). The most common HR-HPV types were 16, 56, 52 and 31 and LR-HPV 90 and 42. Of 187 HR-HPV infections detected (among 165 women), 55.1% (n = 103) were with HPV types not covered by available bivalent or quadrivalent HPV vaccines. About 23% (n = 43) were of types not covered by the nonavalent vaccine (HPV 35, 39, 51, 56, 59). The HR and LR-HPV prevalence were highest in the age group 30–34 years (HR 9.8%, ‘moderate’ risk 3.0% and LR 5.6%), decreasing with increasing age. HR-HPV prevalence in women with normal cytology was 5.5%. In women with a high-grade squamous intraepithelial lesion (HSIL), prevalence was 66.7%. Women currently not living with a partner and current smokers had increased chances of an HR-HPV infection.

Conclusion
The overall population-based HPV prevalence was relatively high. An important share of prevalent HR-HPV infections constituted types not covered by current HPV vaccines. With the advent of HPV screening and younger vaccinated cohorts joining screening, HPV types should be monitored closely, also in older women who were not eligible for HPV vaccination.
The German version of the Pregnancy Physical Activity Questionnaire: a translation, cross-cultural adaptation, reliability and validity assessment
Authors: Spiller Mark , Ferrari Nina , Joisten Christine 
Published: September 2024

Abstract
Background
Validated and internationally standardised measurement instruments are a prerequisite for ensuring that physical activity during pregnancy is comparable and for deriving physical activity recommendations. In Germany, there has been no adapted version of the internationally used Pregnancy Physical Activity Questionnaire (PPAQ) until now. This study’s aim centred around translating the original English version into German (PPAQ-G) and determining its reliability as well as validity in a German population.

Methods
The PPAQ was translated into German using the forward-backwards technique. Its reliability and validity were tested. Thirty-four correctly completed questionnaires were analysed. The test–retest reliability was presented using the intraclass correlation coefficient (ICC) and Spearman correlation coefficient. Validity was tested by using accelerometer (n = 23) and determined by Spearman correlation coefficient.

Results
In the transcultural adjustment, two questions were amended to describe intensity more precisely, and two other questions were adapted to reflect the units of measurement used in Germany. The ICC indicated a reliability of r = 0.79 for total activity (without sitting), and the intensity subcategories ranged from r = 0.70 (moderate-intensity activities) to r = 0.90 (sitting). Although, validity assessment showed no significant correlation for sedentary, moderate or vigorous intensity, there were significant correlations for total activity (light and above; r = 0.49; p < 0.05) and for light activity (r = 0.65; p < 0.01).

Conclusions
The PPAQ-G showed good reliability for use on pregnant German women and a moderately accurate measurement of physical activity. It can be used nationally for epidemiological studies, and it also enables international comparisons of physical activity during pregnancy.

Trial registration
DRKS00023426; Registration date 20 May 2021.
Trajectories of work disability among individuals with anxiety-, mood/affective-, or stress-related disorders in a primary healthcare setting
Authors: Helgesson Magnus , Pettersson Emma , Lindsäter Elin , Taipale Heidi , Tanskanen Antti , Mittendorfer-Rutz Ellenor , Cullen Alexis E. 
Published: September 2024

Abstract
Background
Anxiety-, mood/affective-, or stress-related disorders affect up to one-third of individuals during their lives and often impact their ability to work. This study aimed to delineate trajectories of work disability (WD) among individuals diagnosed with anxiety-, mood/affective-, or stress-related disorder in primary healthcare and to examine associations between trajectory group membership and sociodemographic, clinical, and clinical-related factors.

Methods
The study population included working-age individuals, aged 22–62 years, living in Stockholm County, Sweden, who experienced a new episode of any anxiety-, mood/affective, or stress-related disorder in primary healthcare in 2017 (N = 11,304). Data were obtained from Swedish national and regional registers and were linked using pseudonymised unique personal identification numbers. The primary outcome was days with WD (sum of sickness absence and disability pension days) during the three years before and three years after a diagnosis of anxiety-, mood/affective-, or stress-related disorders in primary healthcare. A zero-inflated Poisson group-based trajectory model was used to identify groups of individuals with similar patterns of WD over the study period, with a multinomial logistic regression used to examine associations of sociodemographic, clinical, and clinical-related factors with trajectory group membership.

Results
Four distinct trajectory groups were found, high increasing (5.1%), with high levels, from 16 to 80 days of WD in six-monthly intervals during follow-up, peak (11.1%), with a peak in WD, up to 32 days of WD, around the time of the diagnosis, low increasing (12.8%), with an increase in days of WD from 4 to 22 during the study period, and constant low (71.1%), with almost no WD over the study period. In multinomial regression models, diagnostic category, psychotropic medication use, a diagnosis of a psychiatric disorder within secondary healthcare, age at diagnosis, and occupation were associated with WD trajectory groups.

Conclusions
Around two-thirds of individuals treated for a new episode of any anxiety-, mood/affective-, or stress-related disorder in primary healthcare have an excellent prognosis regarding WD. Several sociodemographic and clinical characteristics were associated with group membership; these factors could identify individuals at risk of long-term welfare dependency and who might benefit from interventions to promote a return to work.
A simple modified technique for screw fixation of displaced intra-articular calcaneus fracture through a sinus tarsi approach: a comparison with plate fixation
Authors: Bahaeddini Mohammad Reza , Konjkav Arian Rahimi , Aminian Amir , Tabrizian Pouria , Gravand Sajad Noori , Amiri Shayan , Mirjalily Mohammad Sadegh , Tayyebi Hamed , Mazhar Farid Najd 
Published: September 2024

Abstract
Background
Plates and screws are frequently used for the fixation of displaced intra-articular calcaneus fracture (DIACF). In this study, we compared the outcomes of a modified screw fixation technique with plate fixation via a sinus tarsi approach (STA).

Methods
A series of 187 DIACF patients who were treated via an STA using a plate fixation (n = 81) or a screw fixation (n = 106) were included. Screw fixation was done with two 2.7 mm screws and two 6.5 mm cannulated screws. Outcomes were evaluated radiographically and clinically. Clinical evaluations included pain assessment by Visual Analogue Scale (VAS) and functional assessment by the American Orthopaedic Foot and Ankle Society (AOFAS) questionnaire and Foot Function Index (FFI).

Results
The mean final VAS was smaller in the screw group (P = 0.01). The mean AOFAS and FFI scores were not significantly different between the two groups (P = 0.17 and P = 0. 19, respectively). The mean improvement of Bohler’s angle, but not the Gissane’s angle, was significantly greater in the screw group (P = 0.014 and P = 0.09, respectively). The mean improvement of calcaneal length and height were not significantly different between the two groups (P = 0.78 and P = 0.22, respectively). The hardware removal rate was 14.8% in the plate group and 3.8% in the screw group (P = 0.007).

Conclusion
The modified screw fixation method provides lower pain, better radiographic outcome, and lower rate of hardware removal compared to plate fixation in the treatment of DIACF.
Guided biofilm therapy versus conventional protocol—clinical outcomes in non-surgical periodontal therapy
Authors: Cyris Miriam , Festerling Julia , Kahl Maren , Springer Claudia , Dörfer Christof E. , Graetz Christian 
Published: September 2024

Abstract
Background
The aim of the randomized controlled clinical trial study was to evaluate the effectiveness in reducing pathologically increased pocket probing depths (PPD > 3 mm) using the Guided Biofilm Therapy (GBT) protocol (adapted to the clinical conditions in non-surgical periodontal therapy (NSPT): staining, air-polishing, ultrasonic scaler, air-polishing) compared to conventional instrumentation (staining, hand curettes/sonic scaler, polishing with rotary instruments) both by less experienced practitioners (dental students).

Methods
All patients were treated according to a split-mouth design under supervision as diseased teeth of quadrants I/III and II/IV randomly assigned to GBT or conventional treatment. In addition to the treatment time, periodontal parameters such as PPD and bleeding on probing (BOP) before NSPT (T0) and after NSPT (T1: 5 ± 2 months after T0) were documented by two calibrated and blinded examiners (Ethics vote/ Trial-register: Kiel-D509-18/ DRKS00026041).

Results
Data of 60 patients were analyzed (stage III/IV: n = 36/ n = 24; grade A/ B/ C: n = 1/ n = 31/ n = 28). At T1, a PPD reduction of all diseased tooth surfaces was observed in 57.0% of the GBT group and 58.7% of the control group (p = 0.067). The target endpoint (PPD ≤ 4 mm without BOP) was achieved in 11.5% for GBT (conventional treatment: 11.2%; p = 0.714). With the exception for number of sites with BOP, which was at T1 15.9% in the GBT group and 14.3% in the control group (p < 0.05) no significant differences between the outcomes of the study were found. At 30.3(28.3) min, the treatment time was significantly shorter in GBT than in the control group at 34.6(24.5) min (p < 0.001).

Conclusions
With both protocols (GBT/ conventional instrumentation) comparably good clinical treatment results can be achieve in NSPT in stage III-IV periodontitis patients.

Trial registration
The study was registered before the start of the study and can be found under the number DRKS00026041 in the German Clinical Trials Register. The registration date was 19/08/2021.
What do suicide loss survivors think of physician-assisted suicide: a comparative analysis of suicide loss survivors and the general population in Germany
Authors: Hofmann Laura , Spieß Louisa , Wagner Birgit 
Published: September 2024

Abstract
Background
Physician-assisted suicide (PAS) and voluntary euthanasia remain highly debated topics in society, drawing attention due to their ethical, legal, and emotional complexities. Within this debate, the loss of a loved one through suicide may shape the attitudes of survivors, resulting in more or less favorable attitudes towards this topic.

Aims
This study aims to explore and compare the attitudes towards PAS and voluntary euthanasia in a population of suicide loss survivors and the general population, while also considering socio-demographic factors.

Methods
A total of 529 participants, 168 of whom were survivors of suicide loss, completed an online questionnaire on their attitudes (NOBAS) and opinions (open response format) towards PAS and voluntary euthanasia, as well as regarding their legalization in Germany. The analysis consisted of both quantitative and qualitative components.

Results
The entire sample showed positive attitudes towards PAS and voluntary euthanasia in terminally ill persons. Participants were more divided in their attitudes towards PAS in the case of a mental health disorder. Individuals without experienced suicide loss were more liberal regarding legalization in Germany and were more likely to understand the wish for PAS. Survivors of suicide loss were mainly concerned about the consequences for relatives. However, differences between both groups are small.

Discussion
The experience of a loss by suicide influences attitudes towards PAS and voluntary euthanasia. Both groups showed an accepting attitude towards PAS and voluntary euthanasia, but also expressed concerns and fears regarding easy accessibility and consequences for grieving relatives.
Understanding the influences on hospital discharge decision-making from patient, carer and staff perspectives
Authors: Ward-Stockham Kristel , Omonaiye Olumuyiwa , Darzins Peteris , Kitt Clinton , Newnham Evan , Taylor Nicholas F. , Considine Julie 
Published: September 2024

Abstract
Background
Gaps in discharge planning are experienced by 41% of hospital patients in Australia. There is an established body of knowledge regarding the features of the discharge process that need to be improved to avoid subsequent hospital readmission and enhance the discharge experience. However, many of these studies have focused solely on factors related to unplanned hospital readmissions and there has been limited success in operationalising improvements to the discharge process. The aim of this study was to explore and describe the factors that influence the decision to discharge adult medical patients from hospital, from patient, carer and staff perspectives.

Methods
A qualitative descriptive study was conducted in one acute medical ward in Melbourne, Australia. The study data were collected by observations of clinical practice and semi-structured interviews with patients, carers and staff. Participants were: i) English-speaking adults identified for discharge home, ii) patient carers, and iii) staff involved in the discharge process. Observation data were analysed using content analysis and interviews data were analysed using thematic analysis.

Results
Twenty-one discharges were observed, and 65 participants were interviewed: 21 patients, two carers, and 42 staff. Most patients (76%) were identified as being ready for discharge during morning medical rounds, and 90% of discharge decisions were made collaboratively by the medical team and the patient. Carers were observed to be notified in 15 discharges by the patient (n = 8), doctors (n = 4), or nursing staff (n = 3). Five themes were constructed from thematic analysis of interviews: Readiness for Home, Fragmented Collaboration, Health Literacy, Unrealistic Expectations, and Care beyond Discharge. A collaborative team and supportive carers were considered to enhance risk assessment and discharge planning, however fragmented communication between clinicians, and between clinicians and patients/carers was a barrier to discharge decision-making.

Conclusions
Our study highlights the need for a more coordinated approach to discharge decision-making that optimises communication with patients and carers and multidisciplinary workflows and reduces fragmentation. The importance of patient-centred care and a personalised approach to care are well established. However, there is a need to design systems to customise the entirety of the patient journey, including the approach to discharge decision making.
Acetylsalicylic acid and dihydroartemisinin combined therapy on experimental malaria-associated acute lung injury: analysis of lung function and the inflammatory process
Authors: de Oliveira Helena D’Anunciação , Batista Camila Nunes , Lima Maiara Nascimento , Lima Ana Carolina , dos Passos Beatriz Amanda Barbosa Rangel , Freitas Rodrigo Jose Rocha Xavier , Silva Johnatas Dutra , Xisto Debora Gonçalves , Rangel-Ferreira Marcos Vinícius , Pelajo Marcelo , Rocco Patricia Rieken Macedo , Ribeiro-Gomes Flávia Lima , de Castro Faria-Neto Hugo Caire , Maron-Gutierrez Tatiana 
Published: September 2024

Abstract
Background
Severe malaria can cause respiratory symptoms, which may lead to malaria-acute lung injury (MA-ALI) due to inflammation and damage to the blood-gas barrier. Patients with severe malaria also often present thrombocytopenia, and the use of acetylsalicylic acid (ASA), a commonly used non-steroidal anti-inflammatory drug with immunomodulatory and antiplatelet effects, may pose a risk in regions where malaria is endemic. Thus, this study aimed to investigate the systemic impact of ASA and dihydroartemisinin (DHA) on ALI induced in mice by Plasmodium berghei NK65 (PbNK65).

Methods
C57BL/6 mice were randomly divided into control (C) and PbNK65 infected groups and were inoculated with uninfected or 104 infected erythrocytes, respectively. Then, the animals were treated with DHA (3 mg/kg) or vehicle (DMSO) at the 8-day post-infection (dpi) for 7 days and with ASA (100 mg/kg, single dose), and analyses were performed at 9 or 15 dpi. Lung mechanics were performed, and lungs were collected for oedema evaluation and histological analyses.

Results
PbNK65 infection led to lung oedema, as well as increased lung static elastance (Est, L), resistive (ΔP1, L) and viscoelastic (ΔP2, L) pressures, percentage of mononuclear cells, inflammatory infiltrate, hemorrhage, alveolar oedema, and alveolar thickening septum at 9 dpi. Mice that received DHA or DHA + ASA had an increase in Est, L, and CD36 expression on inflammatory monocytes and higher protein content on bronchoalveolar fluid (BALF). However, only the DHA-treated group presented a percentage of inflammatory monocytes similar to the control group and a decrease in ΔP1, L and ΔP2, L compared to Pb + DMSO. Also, combined treatment with DHA + ASA led to an impairment in diffuse alveolar damage score and lung function at 9 dpi.

Conclusions
Therapy with ASA maintained lung morpho-functional impairment triggered by PbNK65 infection, leading to a large influx of inflammatory monocytes to the lung tissue. Based on its deleterious effects in experimental MA-ALI, ASA administration or its treatment maintenance might be carefully reconsidered and further investigated in human malaria cases.
Harnessing UAVs and deep learning for accurate grass weed detection in wheat fields: a study on biomass and yield implications
Authors: Liu Tao , Zhao Yuanyuan , Wang Hui , Wu Wei , Yang Tianle , Zhang Weijun , Zhu Shaolong , Sun Chengming , Yao Zhaosheng 
Published: September 2024

AbstractWeeds are undesired plants competing with crops for light, nutrients, and water, negatively impacting crop growth. Identifying weeds in wheat fields accurately is important for precise pesticide spraying and targeted weed control. Grass weeds in their early growth stages look very similar to wheat seedlings, making them difficult to identify. In this study, we focused on wheat fields with varying levels of grass weed infestation and used unmanned aerial vehicles (UAVs) to obtain images. By utilizing deep learning algorithms and spectral analysis technology, the weeds were identified and extracted accurately from wheat fields. Our results showed that the precision of weed detection in scattered wheat fields was 91.27% and 87.51% in drilled wheat fields. Compared to areas without weeds, the increase in weed density led to a decrease in wheat biomass, with the maximum biomass decreasing by 71%. The effect of weed density on yield was similar, with the maximum yield decreasing by 4320 kg·ha− 1, a drop of 60%. In this study, a method for monitoring weed occurrence in wheat fields was established, and the effects of weeds on wheat growth in different growth periods and weed densities were studied by accurately extracting weeds from wheat fields. The results can provide a reference for weed control and hazard assessment research.
Automated classification of mixed populations of Aedes aegypti and Culex quinquefasciatus mosquitoes under field conditions
Authors: Njaime Fábio Castelo Branco Fontes Paes , Máspero Renato Cesar , Leandro André de Souza , Maciel-de-Freitas Rafael 
Published: September 2024

Abstract
Background
The recent rise in the transmission of mosquito-borne diseases such as dengue virus (DENV), Zika (ZIKV), chikungunya (CHIKV), Oropouche (OROV), and West Nile (WNV) is a major concern for public health managers worldwide. Emerging technologies for automated remote mosquito classification can be supplemented to improve surveillance systems and provide valuable information regarding mosquito vector catches in real time.

Methods
We coupled an optical sensor to the entrance of a standard mosquito suction trap (BG-Mosquitaire) to record 9151 insect flights in two Brazilian cities: Rio de Janeiro and Brasilia. The traps and sensors remained in the field for approximately 1 year. A total of 1383 mosquito flights were recorded from the target species: Aedes aegypti and Culex quinquefasciatus. Mosquito classification was based on previous models developed and trained using European populations of Aedes albopictus and Culex pipiens.

Results
The VECTRACK sensor was able to discriminate the target mosquitoes (Aedes and Culex genera) from non-target insects with an accuracy of 99.8%. Considering only mosquito vectors, the classification between Aedes and Culex achieved an accuracy of 93.7%. The sex classification worked better for Cx. quinquefasciatus (accuracy: 95%; specificity: 95.3%) than for Ae. aegypti (accuracy: 92.1%; specificity: 88.4%).

Conclusions
The data reported herein show high accuracy, sensitivity, specificity and precision of an automated optical sensor in classifying target mosquito species, genus and sex. Similar results were obtained in two different Brazilian cities, suggesting high reliability of our findings. Surprisingly, the model developed for European populations of Ae. albopictus worked well for Brazilian Ae. aegypti populations, and the model developed and trained for Cx. pipiens was able to classify Brazilian Cx. quinquefasciatus populations. Our findings suggest this optical sensor can be integrated into mosquito surveillance methods and generate accurate automatic real-time monitoring of medically relevant mosquito species.

Graphical Abstract