bluuebunny/crossref_metadata_2025_split huggingface dataset:
Prevalence and Risk Factors of Postpartum Depression Among Women in Low‐Income Developing Rural Areas: A Cross‐Sectional Study in China
Authors: Sun Mei , Cao Fanfan , Peng Jiayuan , Tang Jingfei , He Yuqing , Zeng Yi , Tan Xiangmin , Zhao Qian 
Published: October 2024

Background: Postpartum depression (PPD) significantly affects the welfare of mothers, infants, families, and communities. Mothers in rural areas often face low incomes, poor social security, low education levels, and inadequate medical services. These specific cultural, social, and economic aspects have led to a worsening of PPD in rural areas. However, the current situation of PPD among women in rural areas of China is still insufficiently explored.Aim: This study aims to explore the prevalence and risk factors of PPD among women in low‐income developing rural areas of China.Methods: A cross‐sectional design was used in this study. Edinburgh Postnatal Depression Scale (EPDS) was applied to evaluate PPD symptoms. General demographic questionnaire, obstetrics‐/pediatrics‐related questionnaire, and psychosocial‐related questionnaire were adopted. Abuse Assessment Screen (AAS) was utilized to assess experienced intimate partner violence during pregnancy and postpartum. Social Support Rating Scale (SSRS) was utilized to measure their levels of social support.Results: Of the 467 participants, the overall prevalence of PPD among women in rural areas of China was 16.5%, and the average EPDS score was 8.35 (SD = 4.50). PPD occurred most frequently at 7–9 months postpartum (33.8%). Six factors associated with PPD were whether the sex of the baby was in line with the family’s expectations, monthly income of partners, social support, IPV during pregnancy and childbirth, and negative life events in the last 1 year, as well as physical and mental exhaustion from caring for a baby.Conclusions: This study sheds light on the prevalence and various risk factors associated with PPD among women residing in low‐income developing rural areas of China. The findings highlighted the need for targeted interventions and support systems designed to address the specific socioeconomic and cultural difficulties encountered by rural mothers.
Competitive Peacekeeping Interventions, State Factionalisation and the Escalation of Organised Violence: the Case of Syria
Authors: Alkhayer Talip , Kivimäki Timo 
Published: October 2024

Abstract
This study investigates the paradox of peacekeeping interventions exacerbating conflict intensity, particularly when executed by various competing powers rather than the UN, through the lens of the Syrian conflict. By tracing the causal pathway from intervention to state factionalisation and subsequent violence escalation, we utilise novel data highlighting the impact of corruptive state factionalism on conflict dynamics in Syria. Through qualitative and quantitative analyses, we show that competitive interventions create credible threats and mobilise violence, thus intensifying the conflict. This research underscores the necessity for non-partisan, UN-led peacekeeping efforts to mitigate the adverse effects of competitive interventions in fragile states.
Evaluating the performance of six 1970s off-gas deep retrofit bungalows
Authors: Perisoglou Emmanouil , Patterson Joanne , Ionas Miltiadis 
Published: October 2024

This paper presents the energy and environmental performance of whole house energy systems implemented in six 1970s bungalows in South Wales, owned by Swansea Council. The objective was to reduce energy demand and carbon emissions, maximise renewable supply whilst ensuring a comfortable and affordable home for the residents. The whole house energy system for each home involved the installation of a combination of passive and active low carbon solutions. Detailed monitoring was carried out for a year before and for more than 2 years after the work, annual figures have been validated and normalised for weather. Analysis of monitored data confirms that Standard Assessment Performance ratings improved from 12 to 95. The average annual energy consumption across the six bungalows was reduced from 16,117 to 4560 kWh. 2418 kWh was provided by the PV panels and battery, with 1963 kWh of excess electricity that could be sold back to the grid. Real-life average Ground Source Heat Pump CoP was monitored at 3.3. Embodied carbon for retrofitting each house is estimated at 22,980 KgCO2e +/−20%, approximately 5-years carbon payback. Indoor conditions have been improved with internal temperature and relative humidity achieving standards with residents reporting levels of improved comfort satisfaction. Practical Application: A whole house energy system demonstrates the benefits of a holistic, fabric and systems retrofit approach. The work informs how gathering data using appropriate methods assists modelling predictions and decisions throughout the retrofit stages. The study demonstrates extensive monitoring as a vital tool to evaluate the performance of the individual components and the whole system within the home, as used by the residents. Performance evaluation is critical in identifying issues, allowing resolutions to be made both immediately on-site as well for longer term, follow on retrofit programmes. Real-life performance evaluation and visualisation methods are transferable across global building industry.
Machine learning and radiomics for ventricular tachyarrhythmia prediction in hypertrophic cardiomyopathy: insights from an MRI-based analysis
Authors: Durmaz Emine Sebnem , Karabacak Mert , Ozkara Burak Berksu , Kargın Osman Aykan , Demir Bilal , Raimoglou Damla , Aygun Ahmet Atil , Adaletli Ibrahim , Bas Ahmet , Durmaz Eser 
Published: October 2024

Background Myocardial fibrosis is often detected in patients with hypertrophic cardiomyopathy (HCM), which causes left ventricular (LV) dysfunction and tachyarrhythmias. Purpose To evaluate the potential value of a machine learning (ML) approach that uses radiomic features from late gadolinium enhancement (LGE) and cine images for the prediction of ventricular tachyarrhythmia (VT) in patients with HCM. Material and Methods Hyperenhancing areas of LV myocardium on LGE images were manually segmented, and the segmentation was propagated to corresponding areas on cine images. Radiomic features were extracted using the PyRadiomics library. The least absolute shrinkage and selection operator (LASSO) method was employed for radiomic feature selection. Our model development employed the TabPFN algorithm, an adapted Prior-Data Fitted Network design. Model performance was evaluated graphically and numerically over five-repeat fivefold cross-validation. SHapley Additive exPlanations (SHAP) were employed to determine the relative importance of selected radiomic features. Results Our cohort consisted of 60 patients with HCM (73.3% male; median age = 51.5 years), among whom 17 had documented VT during the follow-up. A total of 1612 radiomic features were extracted for each patient. The LASSO algorithm led to a final selection of 18 radiomic features. The model achieved a mean area under the receiver operating characteristic curve of 0.877, demonstrating good discrimination, and a mean Brier score of 0.119, demonstrating good calibration. Conclusion Radiomics-based ML models are promising for predicting VT in patients with HCM during the follow-up period. Developing predictive models as clinically useful decision-making tools may significantly improve risk assessment and prognosis.
Personality in Alcohol and Opioid Use Disorder:  A Multiphasic Personality Questionnaire Study
Authors: Rana Devender Kumar , Malhotra Anil , Kumar Krishan , Verma Abhishek , Basu Debasish , Mattoo Surendra K. , Malhotra Rama , Sharma Rajni 
Published: October 2024

Background This study explored the relationship between personality attributes and substance use disorder (SUD). Research has identified specific personality dimensions, such as neuroticism, psychoticism, antisocial personality traits, paranoia, and anxiety, as contributing factors on the way to the initiation, continuation, and relapse of SUD. Purpose To explore this connection, we examined the personality profiles of subjects with alcohol use disorder (AUD) and opioid use disorder (OUD). Methods A total of 928 subjects, 320 with AUD, 490 with OUD and 118 healthy controls (HC), in the age range of 16–65 years were recruited in the study. The Clinical Profile Sheet and the Multiphasic Personality Questionnaire (MPQ) were administered to HC and patients who fulfil the diagnostic criteria for substance dependence as defined by ICD-10 (WHO-1992). Results We found significant differences in personality profiles between individuals with OUD and AUD. Patients with AUD scored higher than OUD on the MPQ subscales for depression, mania, paranoia, and antisocial personality traits. All subscales of the MPQ showed elevated scores in subjects with SUD compared to HC. Conclusion Elevated scores on the MPQ subscales suggest that personality factors may contribute to the pattern of substance use and misuse in this cohort.
Recycling of PVC Supermarket Trays into Rigid Foam Extrusions
Authors: Thomas N.L. , Quirk J.P. , Cretney H. 
Published: October 2024

Recycled poly(vinyl chloride) (PVC) supermarket trays have been used successfully in production-scale trials to make the foamed layer in co-extruded cladding. The extruded product had satisfactory foam density, foam structure and colour. Impact properties were better than those of the control made from virgin PVC: this is attributed to the high levels of impact modifier used in tray formulations. These trials have demonstrated that PVC straight-on trays can be recycled into foamed extrusions for wood replacement products.
The Los Angeles motor scale (LAMS) and ASPECTS score are independently associated with DSA ASITN collateral score
Authors: Wang Richard , Lakhani Dhairya A , Balar Aneri B , Sepehri Sadra , Hyson Nathan , Luna Licia P , Cho Andrew , Hillis Argye E , Koneru Manisha , Hoseinyazdi Meisam , Lu Hanzhang , Mei Janet , Xu Risheng , Nabi Mehreen , Mazumdar Ishan , Urrutia Victor C , Chen Kevin , Huang Judy , Nael Kambiz , Yedavalli Vivek S 
Published: October 2024

Background Mechanical thrombectomy (MT) is the treatment standard in eligible patients with acute ischemic stroke (AIS) secondary to large vessel occlusions (LVO). Studies have shown that good collateral status is a strong predictor of MT efficacy, thus making collateral status important to quickly assess. The Los Angeles Motor Scale is a clinically validated tool for identifying LVO in the field. The aim of this study is to investigate whether admission LAMS score is also associated with the American Society of Interventional and Therapeutic Neuroradiology (ASITN) collateral score on digital subtraction angiography (DSA). Methods We conducted a retrospective multicenter cohort study of consecutive patients presenting with AIS caused by LVO from 9/1/2017 to 10/1/2023 with diagnostically adequate DSA imaging. Demographic, clinical, and imaging data was collected through manual chart review. Both univariate and multivariate analysis were applied to assess associations. A p-value <0.05 was considered significant. Results A total of 308 patients (median age: 68, IQR: 57.5–77) were included in the study. On multivariate logistic regression analysis, we found that lower admission LAMS score (adjusted OR: 0.82, 95% CI: 0.68–0.98, p < 0.05) and higher ASPECTS score (adjusted OR: 1.21, 95% CI: 1.02–1.42, p < 0.05) were independently associated with good DSA ASITN collateral score of 3-4. Conclusions Admission LAMS and ASPECTS score are both independently associated with DSA ASITN collateral score. This demonstrates the capability of LAMS to act as a surrogate marker of CS in the field.
Technology acceptance of the video game-based swallowing function training system among healthcare providers and dysphagia patients: A qualitative study
Authors: Zhang Bohan , Ding Ping , Hui Vivian , Wong Ka Po , Liu Yue , Liu Zihan , Xiao Qian , Qin Jing 
Published: October 2024

Objective Dysphagia is highly prevalent worldwide, causing serious complications. Video-game based rehabilitation training can increase dysphagia patient motivation and adherence. However, the acceptance of video game systems by patients and healthcare providers is still not fully explored. This study aimed to explore the acceptance of the video game swallowing training system among potential users. Methods The in-depth interviews were conducted face-to-face between July and October 2023 at a rehabilitation center in China, with a sample size based on the principle of information saturation. Interviews were audio-recorded and transcribed verbatim, and the data were analyzed using theory-driven thematic analysis methods based on the technology acceptance model. Results A total of 19 participants participated in the interviews, which included 11 hospitalized dysphagia patients, three rehabilitation therapists, one doctor, and four nurses. Three themes and seven subthemes were identified. Sufficient training content, interesting interaction between the game and the rehabilitation training, intuitive page design, and efficient training modes were related to the usefulness of the system; user-friendly page design and simple interface could make it easier for participants to use the system. Overall, the availability of the video game system for use without geographical or time limitations led to a high level of participant intention to use the system, but it is still challenging to use it in the real world. Conclusions The results of the study showed that participants were generally accepted and willing to use the video game system for dysphagia rehabilitation training. The video game-based swallowing function training system can be helpful in assisting with dysphagia rehabilitation.
Learning Curve of Endoscopic Lumbar Discectomy – A Systematic Review and Meta-Analysis of Individual Participant and Aggregated Data
Authors: Koh Chan Hee , Booker James , Choi David , Khan Danyal Zaman , Layard Horsfall Hugo , Sayal Parag , Marcus Hani J , Prezerakos George 
Published: October 2024

Study Design A systematic review and meta-analysis of individual participant and aggregated data. Objectives To define the learning curves of endoscopic discectomies using unified statistical methodologies. Methods Searches returned 913 records, with 118 full-text articles screened. Studies of endoscopic lumbar spine surgery reporting outcomes by case order were included. Mixed-effects nonlinear, logistic, and beta meta-regressions prdwere conducted to define the learning curves. Results 13 studies involving 864 patients among 15 surgeons were included in total. For transforaminal endoscopic discectomy, the estimated operating time for the first case was 95 min [CI: 87-104], and the estimated plateau was 66 minutes [CI: 51-81]. An estimated 21 cases [CI: 18-25] were required to overcome 80% of this deficit, but near-plateau performance was expected only after 59 cases [CI: 51-70]. The estimated risk of surgical complications on the first case was 25% [CI: 11%-46%], with an 80% reduction in relative risk requiring an estimated 41 cases. The expected postoperative VAS leg pain score after the first case was 2.7 [CI: 1.8-3.8], with an 80% improvement requiring an estimated 96 cases. Similar numbers were required to overcome the learning curves in interlaminar and biportal endoscopic discectomies. Conclusions Approximately 60 cases are required to achieve proficiency in endoscopic lumbar spine surgery, although the greatest part of the learning curve can be overcome with 20 cases. This should be considered when designing implementation programmes for surgeons and service providers that wish to incorporate endoscopic spinal surgery into their practice.
FOUNTAIN: a modular research platform for integrated real-world evidence generation
Authors: Oberprieler Nikolaus G. , Pladevall-Vila Manel , Johannes Catherine , Layton J. Bradley , Golozar Asieh , Lavallee Martin , Liu Fangfang , Kubin Maria , Vizcaya David 
Published: October 2024

Abstract
Background
Real-world evidence (RWE) plays a key role in regulatory and healthcare decision-making, but the potentially fragmentated nature of generated evidence may limit its utility for clinical decision-making. Heterogeneity and a lack of reproducibility in RWE resulting from inconsistent application of methodologies across data sources should be minimized through harmonization.

Methods
This paper’s aim is to describe and reflect upon a multidisciplinary research platform (FOUNTAIN; FinerenOne mUlti-database NeTwork for evidence generAtIoN) with coordinated studies using diverse RWE generation approaches and explore the platform’s strengths and limitations. With guidance from an executive advisory committee of multidisciplinary experts and patient representatives, the goal of the FOUNTAIN platform is to harmonize RWE generation across a portfolio of research projects, including research partner collaborations and a common data model (CDM)–based program. FOUNTAIN’s overarching objectives as a research platform are to establish long-term collaborations among pharmacoepidemiology research partners and experts and to integrate diverse approaches for RWE generation, including global protocol execution by research partners in local data sources and common protocol execution in multiple data sources through federated data networks, while ensuring harmonization of medical definitions, methodology, and reproducible artifacts across all studies. Specifically, the aim of the multiple studies run within the frame of FOUNTAIN is to provide insight into the real-world utilization, effectiveness, and safety of finerenone across its life-cycle.

Results
Currently, the FOUNTAIN platform includes 9 research partner collaborations and 8 CDM-mapped data sources from 7 countries (United States, United Kingdom, China, Japan, The Netherlands, Spain, and Denmark). These databases and research partners were selected after a feasibility fit-for-purpose evaluation. Six multicountry, multidatabase, cohort studies are ongoing to describe patient populations, current standard of care, comorbidity profiles, healthcare resource use, and treatment effectiveness and safety in different patient populations with chronic kidney disease and type 2 diabetes. Strengths and potential limitations of FOUNTAIN are described in the context of valid RWE generation.

Conclusion
The establishment of the FOUNTAIN platform has allowed harmonized execution of multiple studies, promoting consistency both within individual studies that employ multiple data sources and across all studies run within the platform’s framework. FOUNTAIN presents a proposal to efficiently improve the consistency and generalizability of RWE on finerenone.
Association between different patterns of social participation and loneliness among the Chinese older people: is there a local-migrant gap?
Authors: Chen Rui , Liu Guangwen , Li Shixue , Kong Fanlei 
Published: October 2024

Abstract
Background
Little empirical evidences were provided on the disparity in the level of loneliness between the migrant older with children (MOC) and their local counterpart in China. This study aimed to explore the association between social participation and loneliness and verify whether there was a local-migrant difference in this association.

Methods
A total of 1332 older people (60 +) were included in this study with 656 MOC and 676 natives. Loneliness was assessed by the University of California Los Angeles Loneliness Scale with eight items (ULS-8). Social participation was evaluated by three kinds of social activities concerning sports activities, hobby activities and community resident interaction. Univariate analysis was conducted to compare the local-migrant disparity as well as the level of loneliness between different subgroups. Hierarchical multiple linear regression analysis was used to examine the proposed relationship and the moderating influence of migration status.

Results
The average ULS-8 scores were 11.73 ± 4.02 for local subjects and 12.82 ± 4.05 for MOC respectively, indicating a lower level of loneliness among local older people. Participating in hobby activities (β = -0.092, P = 0.003) and interacting with residents (β = -0.216, P = 0.001) more frequently were related to lower level of loneliness while participating in square dancing was related to higher level of loneliness (β = 0.087, P = 0.001). The negative relationships between hobby activities as well as resident interaction and loneliness were more profound in migrants than natives.

Conclusions
Only two types of social participation could help alleviate loneliness. More attention to older migrants’ loneliness and extending the scale and types of social activities were recommended for policymakers.
A preventive care approach for oral health in nursing homes: a qualitative study of healthcare workers’ experiences
Authors: Bellander Lisa , Angelini Eva , Andersson Pia , Hägglin Catharina , Wijk Helle 
Published: October 2024

Abstract
Background
Oral health problems are common among care-dependent older adults living in nursing homes. Developing strategies to prevent the deterioration of oral health is therefore crucial to avoid pain and tooth loss. A standardized work widely used in nursing homes in Sweden is the quality register Senior Alert (SA), which assesses age-related risks concerning e.g. pressure sores, falls, malnutrition and oral health. The oral health assessment is performed with the Revised Oral Assessment Guide-Jönköping (ROAG-J), which also includes planning and implementation of preventive oral care interventions with the goal of achieving good quality care. However, what facilitates and hinders healthcare workers in working with oral health in SA remains unexplored. The aim of this study was to describe healthcare workers’ experiences of assessing oral health with the ROAG-J, planning and performing preventive oral health care actions in accordance with SA in nursing homes.

Methods
Healthcare workers (n = 28) in nursing homes in two Swedish municipalities participated and data was collected through six focus group interviews. Reflexive thematic analysis was used to identify patterns of meaning in the data.

Results
Themes generated in the analysis were:

A structured process promotes communication and awareness and stresses the importance of oral health;

Oral care for frail older adults is challenging and triggers ethical dilemmas;

Unclear responsibilities, roles and routines in the organization put oral health at risk;

Differences in experience and competence among healthcare staff call for educational efforts.

Conclusions
The structured way of working increases staff awareness and prioritization of oral health in nursing homes. The main challenges for the healthcare workers were residents’ reluctance to participate in oral care activities and oral care being more complicated since most older adults today are dentate. Organizational challenges lay in creating good routines and clarifying staff roles and responsibilities, which will require continuous staff training and increased management involvement.