bluuebunny/crossref_metadata_2025_split huggingface dataset:
Spatial Disparities and Determinants of Modern Contraceptive Use Among Reproductive Age Women in Ethiopia: Application of Multilevel Spatial Analysis
Authors: Fenta Wondaya , Muchie Bisrategebrial Tesfay , Kassie Maru Zewdu , Asfaw Muluhabet Alene 
Published: July 2024

Abstract

Background
Contraception involves the intentional prevention of conception or pregnancy during sexual activity. Globally, unintended pregnancies can occur due to the non-use, misuse, or failure of modern contraceptive methods. Non-use of modern contraceptives is a significant contributor to maternal and infant mortality rates in Sub-Saharan Africa, including Ethiopia. Hence, the main purpose of this study was to determine the factors of modern contraceptive use among reproductive-age women in Ethiopia.
Method
The 2019 Ethiopia Mini Demographic and Health Survey (EMDHS) dataset with 8,196 weighted samples of reproductive women aged 15 to 49 was used. Data management was done using STATA version 17 software, R version 4.2.2, and Arc GIS 10.8 software was used for mapping. To investigate the determinants factor, we used both multilevel and spatial analysis.
Results
In this study, 26% of women used modern contraceptives, with significant spatial clustering (Global Moran’s Index = 0.237776, p < 0.001). Hot spot areas were observed in Benishangul gumuz, Gambela, SNNP, and Eastern parts of the Oromia region. The model that includes individual-level, community-level variables, and spatial auto covariate variables was the best-fitted model for the data based on lower AIC and BIC fit statistics compared to the other models. The estimated intra-class correlation coefficient (ICC) indicates that 15.57% of the total variability for modern contraceptive use was due to the difference between clusters, leaving 84.43% of the variability to be accounted for the women or other unknown factors. The estimated odds of women at a higher educational level using modern contraceptives were 91.9% higher than the estimated odds of women with no education.
Conclusions
This study revealed that the use of a modern contraceptive method among women varies across the clusters. There is a low magnitude of modern contraceptive use among women in Ethiopia. Based on the result of the selected model, Women’s Aged (25–34), educated, married, living in Amhara Region, having higher community education, and having higher community wealth index were positively associated with the use of modern contraceptive methods. While the women aged 35–49, having 3 or more children, living in Somali Region were negatively associated with the use of contraceptive methods. The intervention measures should be undertaken by the concerned body at the community level to enhance the use of modern contraceptive methods among women across the clusters.
Tuning Vision Foundation Models for Rectal Cancer Segmentation from CT Scans: Development and Validation of U-SAM
Authors: Wan Shouhong , zhang hantao , Guo Weidong , Zou Bingbing , Wang Wanqin , Qiu Chenyang , Liu Kaige , Jin Peiquan , yang jiancheng 
Published: July 2024

Abstract

Background: Rectal cancer segmentation in CT is crucial for timely diagnosis. Despite promising methods, challenges remain due to the rectum's complex anatomy and the lack of a comprehensive annotated dataset.
Methods: A total of 33,024 slice pairs from 398 rectal cancer patients in a new source center are enrolled into our dataset, named CARE Dataset, with pixel-level annotations for both normal and cancerous rectum tissue. We split it into 317 cases for training and 81 for testing. Additionally, we introduce a novel segmentation model, U-SAM, designed to handle the complex anatomy of the rectum by incorporating prompt information. Segmentation performance for normal and cancerous rectum is evaluated using Intersection-over-Union (IoU) and Dice Coefficient (Dice). With the assistance of 46 clinical practitioners, an observer study is conducted to benchmark the U-SAM with human performance and evaluate its clinical applicability. The original new source 398 CT scans and our code are openly available for research.
Findings: Our method achieves Dice of 71.23% for normal rectum and 76.38% for rectal tumor, with IoU of 55.32% and 61.78%, respectively, surpassing state-of-the-art methods. The observer study validates that U-SAM can produce diagnostic results comparable to those of highly experienced doctors in just 3 seconds of inference time in clinical settings.
Conclusions: The proposed U-SAM offers an efficient and reliable method for segmenting rectal cancer and normal tissue, significantly reducing time in clinical settings and effectively assisting radiologists. We believe this initial exploration in CT-based rectal cancer segmentation will be instrumental for future diagnosis.
I-RANT: Training Session on Novel, Scripted, Bystander Microaggression Intervention Tool for Medical Students
Authors: Grass Emily , Astemborski Caroline , Lewis James 
Published: July 2024

Abstract

Background: Microaggressions, subtle and often unintentional acts of hostility, have been recognized as a significant issue in healthcare, adversely affecting learners’ emotional and physical well-being. Current strategies for addressing microaggressions are broad frameworks without empirical substantiation that leave learners without a clear direction for intervention. This study introduces a novel scripted, succinct, bystander intervention tool to combat microaggressions. The intervention tool, named I-RANT, follows the script of introduction, role naming, affirming the target, negating the microaggression, and transitioning. The study goal was to assess the ability of a training session to impact learners’ recognition of microaggressions, confidence in intervening, and competency in applying the I-RANT tool.
Methods: A pre-experimental study was conducted in November 2023 with 97 second-year medical students at a large academic center in the Southeast United States. The I-RANT tool was taught through a 90-minute training session. The session included an introduction lecture, small group discussions, and role-play scenarios. Pre- and post-intervention surveys assessed microaggression recognition via a multiple-choice questionnaire (MCQ) and self-reported confidence in intervening on a Likert scale. Differences were compared via paired T-test. Role-play scenarios were observed by trained faculty and graded for competence using a rubric.
Results: Participants showed significant improvement in microaggression identification with increase in MCQ score from 4.17 pre-intervention to 4.74 post-intervention (p < 0.001) and increased self-reported confidence from 3.2 to 4.2 (p < 0.001). Trained faculty evaluated a random sampling of students’ role-play scenarios (n=30) revealing that 97% of sampled students demonstrated competence in utilizing the I-RANT tool.
Discussion: The I-RANT training session empowered learners to address microaggressions, fostering inclusive learning environments and enhancing well-being. Learners demonstrated a statistically significant improvement in recognition of microaggressions and confidence in intervening. The majority of learners demonstrated competency in utilizing the I-RANT tool by the end of the training session.
Conclusions: This study supports the effectiveness of our training session in enhancing medical students’ ability to recognize and address microaggressions. I-RANT empowers learners with a tool to intervene against microaggressions contributing to more inclusive and supportive healthcare environments, ultimately promoting cultural empathy, and improving the well-being of all healthcare team members.
APOE4 and sedentary lifestyle synergistically impair neurovascular function in the visual cortex of awake mice
Authors: Hall Catherine , Anderle Silvia , Bonnar Orla , Henderson Joseph , Shaw Kira , Chagas Andre , McMullan Letitia , Webber Alexandra , Mcgowan Kirsty , King Sarah 
Published: July 2024

Abstract

Reduced cerebral blood flow occurs early in the development of Alzheimer’s disease (AD), suggesting an impairment in how the brain maintains its energy supply may contribute to disease onset. The ε4 allele of the Apolipoprotein (APOE) gene, the strongest risk factor for late onset AD, alters cerebrovascular function, increasing blood-brain barrier permeability. However, reports are mixed as to whether it affects cerebral blood flow regulation, and therefore could contribute to the altered cerebral blood flow observed early in disease. We hypothesised that APOE4 genotype increases risk of vascular dysfunction but requires additional factors to generate a significant reduction in the brain’s regulation of its blood supply that could promote dementia.
To test this, we asked whether a modifiable lifestyle factor, physical activity, affected cerebrovascular and neuronal function in APOE3 and 4 targeted replacement (TR) mice. We used in vivo two-photon microscopy and haemodynamic measures to record neurovascular function from the visual cortex of APOE3 and APOE4-TR mice that were physically active or sedentary.

Energy supply and demand were mismatched in APOE4 mice, with smaller increases in cerebral blood flow, blood volume and blood oxygenation observed during neuronal activation as blood vessels failed to adequately respond to increased neuronal energy needs. Exercise dose-dependently overall improved neurovascular function, with an increased impact of exercise apparent at later ages. Several haemodynamic measures showed a larger beneficial effect of exercise in APOE4 vs. APOE3 mice.
Thus, APOE4 genotype in conjunction with sedentary behaviour produced the worst neurovascular function, which was improved by physical activity. Our results support the requirement for APOE4 genotype to combine with other factors to produce large deficits in cerebrovascular function and suggest that promotion of physical activity may be particularly important to improve cerebrovascular function and potentially to reduce dementia risk in APOE4 carriers.
Clinical effect analysis of plate fixation and screw fixation via tarsal sinus approach in the treatment of Sander Ⅱ Ⅲand Ⅳ calcaneal fracture
Authors: Zhao Hongxian , Wang Zijia , Yang Mingming , Liang Anlin , Gao Shichang 
Published: July 2024

Abstract

Objective
The aim of this study is to compare the efficacy of plate fixation via the tarsal sinus approach with screw fixation alone in treating Sander type II, III, and IV fractures.
Method
Between 2016 and 2023, a comprehensive study encompassing 73 patients and 78 feet with calcaneus fractures was conducted. The investigation compared the efficacy of open reduction plate fixation (ORPF) (18 cases) against open reduction screw fixation (ORSF) (60 cases). Parameters such as operation duration, intraoperative blood loss, hospital stay duration, postoperative imaging metrics (including calcaneal length, width, height, Bohler Angle, Gissane Angle, and Angle of calcaneus varus), postoperative complications, and the AOFAS score one year post-surgery were meticulously analyzed and compared across both treatment groups.
Results
No significant discrepancies were observed between the two groups concerning calcaneal dimensions, including length, width, height, Bohler Angle, Gissane Angle, and Angle of calcaneus varus post-operation (p > 0.05). Moreover, throughout the long-term postoperative monitoring period, no notable distinctions were evident in these parameters between the two groups. Notably, the ORSF group exhibited reduced intraoperative hemorrhage (p = 0.026), shorter procedural duration (p = 0.028), and fewer occurrences of postoperative complications such as pain or superficial infections. However, the incidence of long-term postoperative complications did not demonstrate statistical significance. Furthermore, there were no discernible variations in AOFAS scores between the groups at the latest follow-up assessment.
Conclusion
Both open reduction screw internal fixation and open reduction plate internal fixation have been shown to be effective methods for clinically treating calcaneal fractures, with both techniques yielding positive postoperative imaging results. However, internal fixation with open reduction screws has been found to have several advantages over open reduction plate internal fixation, including less bleeding, shorter operation time, and fewer short-term complications.
Upper-Gastrointestinal Tract Metabolite Profile Regulates Glycaemic and Satiety Responses to Meals with Contrasting Structure
Authors: Frost Gary , Cai Mingzhu , Tejpal Shilpa , Tashkova Martina , Ryden Peter , Moral Natalia Perez , Saha Shikha , Garcia-Perez Isabel , Contreras Jose Ivan Serrano , Wist Julien , Holmes Elaine , Bernal Andres , Dou Bowen , Becker Georgia , Edwards Cathrina 
Published: July 2024

Abstract

Dietary interventions to combat non-communicable diseases focus on optimising food intake but overlook the influence of food structure. Food processing often causes the loss of foodstructure, but how this influences human gastrointestinal digestion and the signals it generates, such as gut hormones that affect homeostatic mechanisms is unclear. In this randomised cross-over study, 10 healthy participantsconsumed iso-nutrient chickpea meals with contrasting cellular structures and underwent gastric, duodenal, and blood sampling. Here, we reported that the ‘Broken’ and ‘Intact’ cell structures of meals resulted in different digestive and metabolomic profiles, leading to distinct postprandial glycaemia, gut hormones, and satiety responses. ‘Broken' meal resulted in high starch digestibility and a sharp rise in gastric maltose within 30 minutes, which acutely elicited higher blood glycaemia, GIP, and GLP-1. ‘Intact’ meal produced a prolonged release of appetite-suppressing hormones GLP-1 and PYY, elevated duodenal amino acids, and undigested starch at 120 minutes. This work highlights how plant food structure alters upper gastrointestinal-nutrient-sensing hormones, providing insights into the adverse effects of modern diets on obesity and type 2 diabetes.
Engineering Properties of Expansive Clay Soils with Sustainable Stabilization Methods
Authors: Navagire Omkar Prakash , V. Srinivasan , Sharma Shashi Kant 
Published: July 2024

Abstract

The production of Industrial waste is increasing day by day in many countries around the world. One of the industrial wastes is Coal Bottom Ash (CBA) which is a coal combustion by-product of thermal power plants, which is categorized as creating environmental pollution if it is not disposed of properly. The objective of the present study is to evaluate the compressive strength and bearing capacity of Black Cotton (BC) soil/Subgrade soil by conducting the Unconfined Compressive Strength (UCS) test and California Bearing Ratio (CBR) test. In the present study, a total of 20 combinations of mix proportions were prepared using the following materials: BC soil, Coal Bottom Ash (CBA), and Wollastonite Microfiber (WMF). The mix proportions involved replacing BC soil with (10%, 20%, 30%, and 40%) CBA and (5%, 10%, and 15%) WMF. Samples were prepared by following the curing process for up to 28 days for UCS testing. The results of standard Proctor tests reveal that the addition of CBA and WMF leads to a decrease in the Optimum Moisture Content (OMC) and an increase in the Maximum Dry Density (MDD). It is also observed that the swelling of the soil reduces drastically with the addition of CBA and WMF mixture. Engineering behaviour delineates the corresponding increase in UCS and CBR values with the increase in mix proportions of CBA-WMF mixes. Assessment of the UCS and CBR values confirms that the utilisation of the CBA and the WMF in Subgrade soil stabilisation provides improved engineering behaviour to deploy in several construction applications.
The perceptions of Dutch General Practitioners on the implementation of a Proactive Integrated Care Approach for Hotspotters
Authors: Leming Kimberley A. , Gestel Laurens C. , Bruijnzeels Marc A. , Vos Rimke C. , Adriaanse Marieke A. 
Published: July 2024

Abstract

Background.
For a subgroup of patients with complex health problems called “Hotspotters”, a new proactive and integrated care (PIC) approach in the primary care setting is being developed to stimulate health improvement among these patients. To ensure sustainable implementation of this approach it is important to study implementation outcomes in preliminary implementation phase. In this study, we explore whether general practitioners (GPs) recognise Hotspotters patients, their needs, and how they perceive the acceptability, appropriateness, and feasibility of the PIC approach.
Methods. GPs were recruited in the regions of Utrecht and The Hague in the Netherlands. They filled in a questionnaire on recognition of Hotspotters, Hotspotters’ needs, acceptability, appropriateness, and feasibility.
Results. Most GPs (90.90%) recognise Hotspotters as a patient group, but only 42.90% are aware of their needs. Also, most GPs (80.90%) agreed that care change is needed. Furthermore, only 4.50% of GPs did not find the PIC approach acceptable, while a larger percentage reported to disagree on the appropriateness (22.70%) and feasibility (22.70%). Conclusions. Most of the GPs recognise Hotspotters, are somewhat aware of their needs, open for care change and would consider adopting the PIC approach if it was made to be more feasible.
The characteristics of coronary arteries in angiography of women; a national-based registry in Iran
Authors: Kermani-Alghoraishi Mohammad , Arani Hamid Reza Bandshahi , Mansouri Asieh , Taheri Marzieh , Safaei Ali , Farshidi Hossein , Kazemi Tooba , Assareh Ahmadreza , Kojuri Javad , Khaledifar Arsalan , Sadrnia Saeed , Ghaffari Samad , Khosravi Alireza 
Published: July 2024

Abstract

Introduction:The current study aims to investigate the characteristics of coronary artery angiography (CAG) and the contributed factors to coronary artery disease (CAD) in women.Methods:The current cross-sectional study is derived from a national registry on cardiovascular disease known as the Persian cardiovascular disease registry (PCVDR). The demographic, medical, clinical and angiographic data of 39207 women underwent CAG have been retrieved.Results:Traditional CVD risk factors and the past medical history of cardiovascular events were statistically higher among those who aged over 50 years old (P-value<0.05) except smoking (P-value<0.001) and obesity (P-value<0.001) that were remarkably higher among younger subjects. Normal epicardial coronary artery was remarkably higher among younger women (49.1%) compared to those aging more than 50 years old (20.1%) (P-value<0.001). Regardless of age, LAD, RCA and LCX territories were involved with severe stenosis accounting for 58.8%, 37.7% and 36.2% of the individuals, respectively. Ectasia, aneurysm, calcified artery, thrombus formation and ostial lesion were remarkably higher among older individuals (P-value<0.05), but dissection was statistically higher in young women (P-value=0.012). The severity of coronary arteries involvement was associated with advanced age, diabetes mellitus, hypertension, dyslipidemia and smoking (P-value<0.05); while obesity had an inverse association (P-value<0.001).Conclusion:Based on the findings of this study, women aging more than 50 years old are prone to be hospitalized for CVDs, require more intensive cardiac intervention and have more severe CAD involvements found in CAG. Age, diabetes mellitus, hypertension, dyslipidemia and smoking were remarkably associated with more severe CAD; however, obesity had paradoxically an inverse association.
Multimorbidity and tooth loss: Data from Chilean National Health Survey 2016-2017
Authors: Santos-López Matías , Gómez Priscila , Margozzini Paula , Ortuño Duniel 
Published: July 2024

Abstract

Background: Oral diseases are a significant global public health challenge. Current evidence indicates that several chronic conditions are individually associated with tooth loss. Currently, people are living with more than one chronic condition, known as multimorbidity. This study aimed to evaluate the association between multimorbidity and tooth loss in the Chilean population, considering the common risk factors for oral and chronic diseases.
Methods: Cross-sectional study with secondary data from the latest Chilean National Health Survey (ENS 2016-17). The number of remaining teeth was classified into four groups: functional dentition (≥20 remaining teeth), moderate tooth loss (10 to 19 remaining teeth), severe tooth loss (1 to 9 remaining teeth), and edentulism if there were no remaining teeth. Multimorbidity was defined based on the number of chronic conditions present as a binary variable (MMC≥2) and as a 4-level categorical variable (MMCG0-G3). The sample was divided into <65 and ≥65 years for statistical analysis. Mean and SD were calculated for crude and adjusted remaining teeth. Poisson regression models with robust variance, crude and adjusted for sex, age, geographic area, and educational level, were fitted to calculate the prevalence ratio between multimorbidity and tooth loss.
Results: The study sample was 4,151 individuals between the ages of 18 and 98. Adults aged <65 years with multimorbidity have a 1.07 times higher prevalence of moderate tooth loss (95% CI 0.84; 1.36), 1.12 times higher prevalence of severe tooth loss (95% CI 0.67; 1.89), and a 0.92 times lower prevalence of edentulism (95% CI 0.39; 2.20). Adults aged ≥65 years with multimorbidity have 1.13 times higher prevalence of moderate tooth loss (95% CI 0.94; 1.37), 1.66 times higher prevalence of severe tooth loss (95% CI 1.04; 2.66), and 1.26 times higher prevalence of edentulism (95% CI 0.76; 2.08).
Conclusions: There was an association between multimorbidity and tooth loss in the Chilean population, resulting in a higher prevalence of moderate tooth loss, severe tooth loss and edentulism in those with higher number of chronic diseases. This association was more robust in adults aged ≥65 years.
Automated Structural Integrity Assessment of Bridges: A Deep Learning Fusion Methodology
Authors: Alseid Bara , Seo Hyungjoon 
Published: July 2024

Abstract

This study presents a detailed evaluation of two advanced deep learning methodologies, Sequential Feature Isolation (SFI) and Filtration-Based Structuring (FBS), for classifying and analysing structural elements such as cracks, bricks, and joints in Silver Jubilee Bridge models. The SFI method employs successive stages of CANUPO analysis followed by dip angle filtration, whereas the FBS method begins with dip angle filtration before proceeding with CANUPO analysis. A critical aspect of this research is optimizing the Local Neighbour Radius (LNR) for dip angle filtration. By testing LNR values ranging from 0.01m to 0.025m, the study identified 0.01m, paired with an 80-degree dip angle, as the optimal setting, significantly enhancing filtration precision. The application of these methods on large-scale models demonstrated their scalability and effectiveness. The SFI and FBS method effectively reduced the number of brick points by an average of 99% and joint points by 90%, while retaining 28% of crack points crucial for shaping crack configurations. The comparative analysis revealed that the SFI method is ideal for projects requiring high precision and detailed feature isolation, whereas the FBS method is better suited for tasks needing a broader retention of structural details. The study underscores the importance of selecting the appropriate method based on specific research objectives and provides clear guidelines for method selection and structural feature analysis. This comprehensive approach enhances the precision and reliability of structural assessments, offering significant contributions to the field of geological and structural analysis.