bluuebunny/crossref_metadata_2025_split huggingface dataset:
Evaluating effects of Community-based Social Healing Model on Ubuntu, mental health and psychosocial functioning in post-genocide Rwanda: Protocol for Cluster Randomized Control Trial
Authors: Jansen Stefan , Niyonzima Jean Bosco Bosco , Gerbarg Patricia , Brown Richard P. , Nsengiyumva Alice , Niyonsenga Japhet , Nsabimana Epaphrodite 
Published: October 2024

Abstract

Background: The Community-Based Social Healing (CBSH) model by Ubuntu Centre for Peace aims to help those with traumatic experiences and mental health issues achieve better mental health. CBSH integrates BREATH-BODY-MIND™ (BBM) practices with collective narrative and rituals through Community Healing Assistants in therapeutic groups. An earlier pilot study showed significant mental health improvements among1,889 Rwandans who participated in the CBSH, including reduced depression, anxiety, and PTSD, improved work productivity and decreased intimate partner violence. The trial focuses on CBSH’s impact on Ubuntu This trial focuses on CBSH's impact on Ubuntu—a philosophy of humanness, compassion, and interconnectedness deeply rooted in the African philosophy––and mental health.
Methods/Design: This cluster randomized controlled trial, This cluster randomized controlled trial involves 54 randomly selected villages in Kirehe district, with 1080 participants allocated equally to the CBSH intervention or a wait-list control group. Outcomes are measured at the person-level, with primary outcomes being Ubuntu and mental health. Ubuntu is assessed using a context-adapted Ubuntu measurement scale. Mental health measures include the Patient Health Questionnaire for depression (PHQ-9), Generalized Anxiety Disorder-7 (GAD-7), Posttraumatic Stress Disorder Checklist for DSM-5 (PCL-5), Warwick-Edinburgh Mental Wellbeing scale (WEMWS), 10-item Connor-Davidson Resilience scale (CD-RISK-10), and Patient Health Questionnaire 15-item Somatic Symptom Severity Scale (PHQ-15). Secondary outcomes include the Revised Conflict Tactics scale short form (CTS2S SHORT FORM) and the Adapted Social Capital Assessment Tool (SASCAT).
Conclusion
This Trial explores the CBSH model’s impacts on Ubuntu, mental health, and social functioning among trauma-affected Rwandans, including those impacted by the 1994 Genocide against the Tutsi, mass killings, sexual abuse, and domestic abuse. The results will be valuable for the Ubuntu Centre for Peace, policymakers, healthcare practitioners, and other stakeholders, highlighting the significance of promoting Ubuntu in addressing mental health and psychosocial trauma consequences.Top of Form
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Trial registration: ISRCTN with ID: ISRCTN17659369. It was registered on February 09, 2024.
The indispensability of non-instrumental strategy in surgical operation teaching
Authors: Zhu Xiuling , Sun Shuping , Xiong Qianying , Wang Fengge , Zhao Yingdi , Zong Yongli 
Published: October 2024

Abstract

This study aims to investigate the influence of ‘non-instrumental strategies’ and demonstrate their effect and educational value for basic surgical teaching. In addition, it seeks to establish the insufficiency of educational technology using an ‘instrumental strategy’, to determine the effect of ‘Four Tips’ on surgical operation, and to ultimately reform surgical teaching.Undergraduates majoring in medical sciences at a local medical school in 2016 were randomly divided into experimental and control groups (30 students per group). Both groups received identical surgical training and operation instructions. Four additional tips were incorporated into training the experimental group. Thereafter, participants were examined and surveyed to evaluate their operation fatigue and satisfaction with team collaboration, communication, and technical operation quality. The data were evaluated by a T test, which provided a result of α = 0.05.The experimental group performed significantly better than the control group on the following: communication satisfaction (P = 0.012), operation quality (P = 0.001), teamwork (P = 0.000), and low operation fatigue (P = 0.004).This ‘non-instrumental strategy’ featuring ‘Four Tips’ contributes significantly to promoting students’ technical grasp and increases their satisfaction with learning effects, thus achieving an irreplaceable educational value.
Effect of Early-onset Posterior Capsule Opacification on Visual Outcomes in Trifocal Diffractive Pseudophakic Eyes: A Multicenter Prospective Study
Authors: Yang Jin , Zhang Limei , Shi Runhan , Chen Xuanzhu , Gu Xuefen , Shen Jiying , Wang Aijun , Ni Shuang , Cai Lei , Guo Haike 
Published: October 2024

Abstract

Objective To elucidate the impact of early-onset PCO on the visual outcomes in patients with hydrophilic trifocal IOLs, and to ascertain the optimal timing for the application of Nd:YAG laser capsulotomy.Methods This is a prospective observational study. 189 patients implanted trifocal IOL who underwent Nd:YAG laser posterior capsulotomy were recruited. Patients were classified into four grades according to PCO morphology. The distance, intermediate, and near visual acuity (VA), dysfunction lens index (DLI), contrast sensitivity(CS) and visual function (VF-14) scores were measured before and 1 month after Nd:YAG laser capsulotomy.Results Before Nd:YAG laser capsulotomy, a significant correlation was observed between PCO grading and uncorrected distance (UDVA), intermediate (UIVA), near (UNVA) visual acuity, corrected distance VA (CDVA), DLI, and VF-14 scores (All P < 0.001). However, in patients with PCO grade 1 (early-onset), post-capsulotomy UNVA, DLI, medium and high spatial frequency contrast sensitivity under photopic condition and VF-14 scores were significantly improved compared with pre-capsulotomy values (all P < 0.05). The area under the receiver operating characteristic curve for DLI was 0.833 (P < 0.001), with a corresponding cut-off value of 7.28, indicating its usefulness in assessing the need for Nd:YAG laser capsulotomy in cases of early-onset PCO.Conclusions Early-onset PCO initially impairs near visual acuity in patients with trifocal IOLs and concurrently diminishes both subjective and objective of visual quality. DLI can effectively assess the severity of PCO, particularly in cases of early-onset PCO, and further determine the optimal timing for Nd:YAG laser capsulotomy.
Assessing the feasibility of using GPT models for clinical decision support in patients suspected of prostate cancer: a comparative study
Authors: Liang Xuan , Wang Xiaoyi , Li Yuanyuan , Liao Wenfeng , Zhang Zhenting , Zhu Guohui , Wei Xi 
Published: October 2024

Abstract

Background
Large Language Models (LLMs), such as the GPT model, leverage supervised learning and reinforcement learning with human labels for fine-tuning. Despite showing promise in various medical fields, the feasibility and safety of using GPT models for clinical decision support (CDS) in prostate cancer remain unverified. This study aims to evaluate the feasibility of GPT models in providing CDS for patients suspected of prostate cancer by comparing the recommendations generated by GPT models with those provided by real-world urologists.
Methods
Patient data were collected from March 2022 to December 2023 from Tianjin Medical University Cancer Institute and Hospital and Tianjin Medical University Second Hospital. A total of 113 cases with comprehensive clinical and imaging data were selected. Clinical recommendations were generated by GPT models (ChatGPT and GPT-3.5) and compared with those provided by a non-oncology specialized urologist. The recommendations were evaluated by three prostate cancer experts for coherence, factual consistency, comprehensiveness, and potential medical harm using a 5-point Likert scale. Mann-Whitney U tests were employed to determine significant differences.
Results
The GPT models demonstrated high factual consistency (98.1% in high consistency group) and coherence in generating clinical recommendations. In terms of medical harm, no significant difference was observed overall between GPT models and the non-oncology urologist (p ≥ 0.05). However, in cases rated neutral (score = 3), the non-oncology urologist showed higher rates of ambiguous recommendations (10.5%) compared to GPT models (2.8%, p < 0.05). The GPT models' response time was significantly faster, averaging 5–15 seconds per case versus approximately 1 minute for the urologist.
Conclusion
GPT models show promise in providing clinical decision support for patients suspected of prostate cancer, with high factual consistency and efficient response times. However, challenges such as comprehensiveness and potential medical harm need to be addressed before widespread clinical application. Further research is warranted to validate the empowering effect of GPT models on non-specialist clinicians in clinical decision-making.
Muscle Strength at Discharge as Predictor of Functional Outcome in Ischemic Stroke Patients Following Endovascular Therapy: Observational Study in Two Comprehensive Stroke Centers
Authors: Zhou Sijie , Chen Zhikai , Tang Jinyan , Chen Gan , Ouyang Ziqi , Wang Jian , Luo Senrong , Su Minyi , Huang Jianhui , Dmytriw Adam A , Carvallo José Fidel Baizabal , Liao Xuxing 
Published: October 2024

Abstract

Background
Endovascular thrombectomy (EVT) has emerged within the last few years as a safe and efficacious method to achieve arterial recanalization in patients with acute ischemic stroke (AIS). However, there are few clinical methods to predict functional outcome. We aimed to investigate whether the muscle strength (MS) at discharge assessed by the Medical Research Council (MRC) scale for muscle strength/weakness predicted functional outcome in patients with AIS undergoing EVT.
Methods
We enrolled 264 consecutive patients from two large comprehensive stroke centers in China from 2018 to 2022. A total of 248 patients were analyzed. We measured and analyzed muscle strength by means of the MRC scale at discharge. Patients were divided in two groups: normal to mildly abnormal muscle strength (MRC ≥ 4), and markedly decreased muscle strength (MRC < 4). A poor outcome was defined as a modified Ranking Score (mRS) of 3–6 at 90-days.
Results
Logistic regression showed that older age (p = 0.014), higher pre-EVT NIHSS score (p = 0.006), greater ASPECTS (p = 0.052), longer door-to-recanalization time (p = 0.016) and post-EVT revascularization ≥ 2b (p = 0.025), were independently associated with MRC < 4. Patients with poor muscle strength at discharge (MRC < 4) had a significantly higher frequency of poor outcome at 90-days: 91.37% vs. 13.76% (p < 0.001). Both lower and upper limb strength in the most paretic side showed high accuracy in predicting the functional outcome at 90 days: area under the curve: 0.924 and 0.874, respectively. An MRC of 0 (plegia or complete paralysis), was associated with a 70% mortality rate within 3 months of AIS.
Conclusion
Muscle strength is a reliable, easy to assess and reproducible clinical method to predict functional outcome and mortality at 90-days in patients treated with EVT and it is influenced by age, NIHSS score, extend of tissue involvement and time for recanalization.
Evaluation of Cadaver- and Manikin-Based Surgical Airway Simulation Training in Emergency Medicine Resident Doctors
Authors: Altintas Emel , Beser Ceren Gunenc , Abbasoglu Tugce Taskindere 
Published: October 2024

Abstract

Introduction:
Endotracheal intubation may not always be possible. Therefore, in rare cases where endotracheal intubation is not possible, surgical airway interventions may be needed. In this context, we aimed to evaluate and compare manikin- and cadaver-based surgical airway simulation training programs developed using the ADDIE (Analyze, Design, Develop, Implement, and Evaluate) model for emergency medicine resident doctors (EMRDs).
Materials & Methods
Thirty-one EMRDs included in the study were first administered a pretest and they were divided into a manikin-based surgical airway simulation training group (group M) and a cadaver-based surgical airway simulation training group (group C), depending on whether they had less or more than two years of experience and based on their pretest scores.16 EMRDs practiced the skill on the whole body cadaver and 15 EMRDs practiced the skill on the 3D printed cricothyrotomy model. An evaluation was made based on the first two levels of the Kirkpatrick model.1stLevel - Reaction: EMRDs’ reactions were evaluated with a 5-point Likert-type surgical airway simulation training program satisfaction survey. 2ndLevel- Learning: EMRDs’ learning levels were evaluated via the cricothyrotomy skill assessment guide at baseline and one month later. 5 participants in each group left the study during the skill assessment 1 month later.
Results
The average of the satisfaction survey scores of the Group C was 4.85 ± 0.16, and the average of the satisfaction survey scores of the Group M was 4.82 ± 0.20. There was no statistical difference between the average satisfaction survey scores of both groups (p = 0.623). More than half of the EMRDs in both groups successfully performed the cricothyrotomy procedure at first application (Group C success rate %56.3, Group M success rate %73.3).Yet, the EMRDs in group M were significantly more successful than those in group C (p < 0.01). One month later, all EMRDs in both groups completed the procedure successfully.
Conclusions
The average of the satisfaction survey scores of the Group C was 4.85 ± 0.16, Group M was 4.82 ± 0.20. In the first application of cricothyrotomy, the success rate of Group C was 56.3%, the success rate of Group M was 73.3%, and in the application 1 month later, the success rate of both groups was determined as 100.
WITHDRAWN: Techniques for Building Internal Target Volumes (ITV) in CT Imaging Through Calibration, Artifact Management, Image Registration, and 4DCT Incorporating Motion-Encompassing Methods
Authors: Solomon Girma Biniyam , Kide Kinfe Gebremedhin , Cavedon Carlo 
Published: October 2024

Abstract

The full text of this preprint has been withdrawn by the authors as it was submitted and made public without the full consent of all the authors. Therefore, the authors do not wish this work to be cited as a reference. Questions should be directed to the corresponding author.
Family formation among adolescent Rohingya refugees; Trajectories into adolescent marriage and childbearing in Cox’s Bazaar Bangladesh
Authors: Zimmerman Linnea A , Elnakib Shatha , Ali Anam , Akter Rumana , Hossain Tofajjel , Traill Tom , Mieth Kate , Hasan Tahia , Hasan Tanvir , Robinson W. Courtland 
Published: October 2024

Abstract

Background Although both marriage and childbearing are potentially influenced by humanitarian emergencies, and for many individuals are intrinsically linked life-course events, they are rarely explored together in the literature on humanitarian emergencies. Additionally, literature on child marriage focuses largely on females, neglecting the experiences of males.
Objective To understand how trajectories of family formation for adolescent females and males have been affected by mass displacement. We compare time to first marriage and time to first birth following marriage between age cohorts of 15-19 and 20-24 year-old female and male Forcibly Displaced Myanmar Nationals.
Methods We use data from 1,565 females and 722 males aged 15-24, collected within fifteen camps in Cox’s Bazaar, to estimate hazard of first marriage and of child marriage and data from 643 married females to estimate hazard from marriage to first birth.
Results Females aged 20-24 had a 31% increased hazard of marriage overall and 42% increased hazard of child marriage relative to females aged 15-19 (95% CI: 1.07-1.87) and an 84% higher incidence rate (95% CI: 1.46-2.33). For males, there was a higher hazard of marriage by age 25 amongst males aged 20-24 relative to age 15-19 (HR: 1.80, 95% CI: 1.10-2.94), but no statistically significant difference in the hazard of marriage by age 18. Approximately 20% of females gave birth within a year of marriage and 70-75% within three years post-marriage, across age cohort and age at marriage. There were no statistically significant differences in hazard of first birth by either age cohort or age at marriage.
Discussion Displacement may have increased risk of child marriage for adolescents, as evidenced by higher child marriage rates amongst males and females who were age 14-18 at the time of displacement. Displacement did not affect time to childbirth following marriage, which remains high amongst both age cohorts. Efforts to reduce child marriage and adolescent child marriage must address limited opportunities for adolescents in situations of displacement.
Investigation of melatonin effect on the outcome of moderate and severe diffuse axonal injury (DAI) - A randomized, placebo-controlled clinical trial
Authors: Ghaedamini Alireza , Karamoozian Saeed , Hadad Mohammad Khaksari , Ghaedamini Hossein , Soltani Zahra , Hojati Ali , Soleimani Amin , Karimabadi Reza , Mayel Masod , Sabet Nazanin , Ahmadinejad Mohammad Mehdi , Asadikorom Gholamreza , Mofid Behshad , Nakheie Nozar , Khazaeli Payam , Jafari Elham 
Published: October 2024

Abstract

Objective
The efficacy of melatonin in improving diffuse axonal injury has not been evaluated. This study investigated the melatonin effect on moderate and severe diffuse axonal injury outcomes.
Methods
This was a randomized clinical trial. The case group (N = 35) received 3mg of oral melatonin, and the control group (N = 35) received Placebo. extended-Glasgow Outcome Scale (e-GOS) and Functional Independence Measure (FIM) scores at baseline, 1 month, 3 months, and 6 months after injury were defined as primary outcomes, and Glasgow Coma Scale (GCS) at baseline, 24 hours, 48 hours, 1 week, 2week until discharge defined as secondary outcomes.
Results
A total of 70 patients were enrolled and were randomly allocated into the intervention (n = 35) and placebo (n = 35) groups. The results showed that there was no statistically significant difference between melatonin and placebo in GOS (P > 0.05) and FIM (P > 0.05) at 3 months and 6 months after hospitalization but the mean E-GOS (P = 0.001) and FIM (P = 0.001) at the first month was significantly higher in the melatonin group.
Conclusions
The use of melatonin as a low-cost and safe medicine complementary treatment in people with DAI can accelerates functional recovery.
Estimating the hole surface area of insecticide-treated nets using image analysis, manual hole counting and exact hole measurements
Authors: Mbuba Emmanuel , Chavernas Natalia Mañas , Moore Sarah J. , Ruzige Philipo David , Kobe Dickson , Moore Jason , Philipo Rose , Kisoka Noela , Pontiggia Gianpaolo , Chacky Frank , Mwalimu Charles Dismasi , Cattin Philippe Claude , Wolleb Julia , Sandkuehler Robin , Ross Amanda 
Published: October 2024

Abstract

Background
The physical integrity of insecticidal-treated nets (ITNs) is important for creating a barrier against host-seeking mosquitoes, and therefore influences people's perception of the net's effectiveness and their willingness to use it. Monitoring the physical integrity of ITNs over time, provides information for replenishment schedules and purchasing decisions. Currently, the assessment is conducted by manually counting holes and estimating their size to class the net as functional or not. This approach is laborious to routinely conduct during field surveys of ITNs. Automated image analysis may provide a rapid assessment of the physical integrity of ITNs but it is not known if the images can capture sufficient information. As a first step, this study aimed to determine the agreement between estimated hole surface areas derived from 1) manually segmented images, 2) manual hole counting compared to 3) ground truth obtained by calibrated close-up shots of individual holes.
Methods
The physical integrity of 75 ITNs was assessed by manual hole counting, image analysis and ground truth, and these methods were compared. For the image analysis, a graphical user interface was developed and used for the segmentation of holes visible in photographs taken from each side of the net. The hole surface area was then computed from this data. The agreement between the estimates from image analysis and manual hole counting was compared to the ground truth using the Bland-Altman method.
Results
There was substantial agreement between the manually segmented image analysis estimates and the ground truth hole surface areas. The overall bias was small, with a mean ratio of the hole surface area from image analysis to the ground truth of 0.70, and the 95% limits of agreement ranging from 0.35 to 1.38. Manual hole counting underestimated the hole surface area compared to the ground truth, particularly among nets with holes above 10 cm in diameter.
Conclusion
Images coupled with manual segmentation contain sufficient information to calculate hole surface area. This lays the groundwork for incorporating automatic hole detection, offering a fast and objective method for routine assessment of physical integrity of ITNs.
BRCA2 germline mutation carrier with five malignancies: a case study
Authors: Su Elena , Christinat Yann , McKee Thomas , Azzarello-Burri Silvia , Jochum Wolfram , Fischer Stefanie , Rothermundt Christian 
Published: October 2024

Abstract

Background
BRCA2 germline mutations are known to predispose carriers to various cancer types, including breast, ovarian, pancreatic and prostate cancer. An association with melanoma has also been reported. However, the full tumour spectrum associated with BRCA mutations, especially in patients with other concurrent pathogenetic mutations, is unexplored.
Case presentation:
We present a 70-year-old female patient with a pathogenic BRCA2 c.5946del variant. Over a period of 15 years, she has developed two independent breast cancers, well-differentiated liposarcoma, clear cell renal cell carcinoma and myeloproliferative neoplasia. This unusual tumour spectrum and the staggered occurrence of these tumours required multiple rounds of genetic testing and lead to a delayed diagnosis of the BRCA2-associated tumour predisposition. In addition to the BRCA2 mutation, extended germline testing revealed an APC c.3920T > A variant and variants of unknown significance in the BRIP1 and ATR genes. The molecular analysis of the tumours revealed distinct profiles with differences in HRD status and in copy number variations but no common origin.
Conclusions
Our case study revealed that the pathogenic BRCA2 c.5946del germline variant can be associated with an unusual tumour spectrum, which may lead to a delayed diagnosis of a hereditary tumour predisposition. Thus, upfront genetic testing using large multigene panels or whole-genome sequencing could be encouraged, especially in cases with a prominent family history.