bluuebunny/crossref_metadata_2025_split huggingface dataset:
Physical Activity and Chronic Diseases: A Cross-sectional Study of 19,084 Middle-aged and Elderly Chinese
Authors: Huang Yongyu , Lu Zuosheng 
Published: April 2024

Abstract

Background: Regular physical activity is beneficial for both physical and mental health, yet studies on the levels of physical activity among the elderly in China are relatively scarce, and the health benefits of different levels of physical activity remain unclear.
Objective: To investigate the levels of physical activity among the elderly in China and to analyze the association between different levels of physical activity and 15 chronic diseases using multinomial logistic regression.
Methods: The participants (N=19084) were drawn from the China Health and Retirement Longitudinal Study data, a nationally representative survey designed to collect high-quality microdata on households and individuals aged 45 and over, covering 28 provinces in China. We used the latest survey data from 2020 to describe the participation in physical activity among the middle-aged and elderly population in China using frequencies and percentages, and to explore the differences in the prevalence of chronic diseases among different levels of physical activity using multinomial logistic regression.
Results: Of the 19084 participants, 8750 (45.8%) met the recommended levels of physical activity guidelines（level3）, 8159 (42.8%) did not meet the recommended levels（level2）, and 2175 (11.4%) did not participate in any form of physical activity（level1）. Compared to those who did not participate in physical activity（level1）, those who participated but did not meet the guidelines（level2） had a reduced risk of 8 types of chronic diseases, including hypertension (OR=0.92, CI: 0.83-1.01) and stroke (OR=0.70, CI: 0.61-0.82). Among those who met the guidelines（level3）, compared to those who did not participate in physical activity（level1）, there was a reduced risk of 11 types of chronic diseases, including hypertension (OR=0.73, CI: 0.66-0.80) and stroke (OR=0.42, CI: 0.36-0.50). Compared to those who did not meet the physical activity guidelines（level1+level2）, those who met the guidelines（level3） had a reduced risk of 10 types of chronic diseases, including hypertension (OR=0.78, CI: 0.73-0.83) and stroke (OR=0.55, CI: 0.48-0.62).
Discussion: More than half of the elderly in China (54.2%) do not meet the physical activity guidelines. Participating in physical activity, even if not meeting the guidelines, can reduce the risk of chronic diseases, but adhering to the guidelines for physical activity offers greater health benefits. It is recommended that the Chinese government create favorable conditions for the elderly to participate in physical activities to further increase the proportion of the elderly population meeting the physical activity guidelines.
Ensemble Machine Learning Approach to Bankruptcy Prediction
Authors: Olatunji Sunday O. , Musleh Dhiaa , Rahman Atta-ur , Salih Ilyas A. , Salem Abdlrhman M. , Dash Sujata , Fares Mahmoud O. , Bokir Ahmed S. , Al-Qahtani Osama , Mallik Saurav , Shah Mohd Asif 
Published: April 2024

Abstract

Bankruptcy is among the biggest threats every company has in terms of its reputation. It can be explained as a situation in which a company is unable to pay back the outstanding debts to banks, lenders, and/or suppliers. An accurate and timely prediction could help the companies avoid and prevent this situation by incorporating remedial actions beforehand. In this regard, current research aims to investigate a combination of techniques to accurately predict bankruptcy. This is achieved by investigating different ensemble techniques to combine the best methods for accuracy enhancement. Comparative analysis has been carried out on the proposed ensemble models using the original but imbalanced dataset as well as the balanced dataset using the oversampling technique. The proposed method of using the balanced dataset on the proposed ensemble models outperformed the models using the original dataset in terms of accuracy and other performance metrics. As an outcome, Balance Bagging exhibits the highest accuracy at 98.77% followed by Random Forest at 98.68% and AdaBoost at 96.9%, respectively. This is considerable in contrast to the state-of-the-art techniques.
“Why shouldn’t I expect a lot from life?” – a qualitative study of what facilitates long-term recovery in first-episode psychosis
Authors: Åsbø Gina , Haavind Hanne , Kruse Sindre Hembre , Wold Kristin Fjelnseth , Hegelstad Wenche ten Velden , Romm Kristin Lie , Slade Mike , Ueland Torill , Melle Ingrid , Simonsen Carmen 
Published: April 2024

Abstract

Background: Qualitative research frequently characterises recovery, but more knowledge on subjective experiences of facilitators of long-termrecovery in psychosis is needed. This interview study aimed to explore what people with first-episode psychosis (FEP) highlight as important for their long-term recovery.
Methods: Interviews with 20 individuals in recovery (personal and/or clinical) participating in two follow-up studies, 10 and 20-years after treatment start for a first episode schizophrenia or bipolar spectrum disorder. Interviews were thematically analysed by the research team that included a peer researcher.
Results: The analysis generated that personal agency was experienced as the overarching facilitator of recovery, with five themes: 1. Doing recovery in everyday life, involving agency in daily life; 2. Re-evaluating risk, involving re-evaluating limitations and stress reduction; 3. Becoming a caregiver, involving development from being cared for to taking care of others; 4. Negotiating normality, involving identity and social inclusion; 5. Owning and sharing your story, involving accepting lived experience and overcoming stigma.
Discussion: All participants described themselves as the main facilitators of their own recovery, and treatment as secondary to their efforts. Gradually testing limitations and taking risks, providing social support to others, as well as owning and sharing your story were crucial for promoting long-term recovery in FEP. Clinical implications include supporting service users’ agency with strength- based interventions and shared-decision making, and refining stress reduction psychoeducation in a long-term perspective.
Evaluation of a youth-focused suicide prevention HOPE aftercare service: protocol for a non-randomized hybrid effectiveness-implementation type 1 design
Authors: Kartal Dzenana , Jaeger Tess , Lamblin Michelle , Richards Hannah , Witt Katrina , Occhipinti Jo-An , Mihalopoulos Cathrine , Chatterton Mary Lou , Chanen Andrew , McGorry Patrick , Skinner Adam , Zbukvic Isabel , Thompson Andrew , Knott Jonathan , Flego Anna , Hamilton Craig , Webb Marianne , Mullen Eddie , Swingler Natasha , Robinson Jo 
Published: April 2024

Abstract

Background: Suicide is the fourth leading cause of death among young people aged 15–29 worldwide. Young people often present to emergency departments (EDs) with self-harm and suicide related behaviors. The period following discharge from the ED is recognized as one of elevated risk for both repeated self-harm and suicide. During this critical time, suicide prevention aftercare services are recommended. Despite their increased popularity, evidence demonstrating the effectiveness of these models is very limited.
Methods: Using a hybrid effectiveness-implementation type I design, this evaluation will assess the effectiveness and implementation of a suicide prevention aftercare (Hospital Outreach Post-suicidal Engagement; HOPE) service designed to reduce risk of self-harm and suicide in young people aged 12–25 who are referred to the service following an ED presentation for self-harm or suicide attempt. Two complementing theoretical frameworks will guide this evaluation, specifically the design, data collection, analysis, and interpretation of results. The RE-AIM evaluation framework will be used to assess Reach, Effectiveness (including cost-effectiveness), Adoption, Implementation and Maintenance of the HOPE aftercare service. The PRISM implementation framework will be used to assess multi-level contextual factors hypothesized to affect the RE-AIM outcomes. Several data sources will be used to assess the changes in primary and secondary outcomes from baseline to post–intervention, and at follow-up, including user and provider self-report surveys, semi-structured interviews, and routinely collected hospital data. An historical control study will also be conducted using data from the Self-Harm Monitoring System for Victoria to examine the impact of the service on rates of self-harm and suicide-related presentations to ED, and compare trends prior to and following commencement of the HOPE aftercare service. In addition, dynamic systems modelling will be used to assess the future scalability of the service.
Discussion: Findings from this evaluation will determine the effectiveness, including cost-effectiveness, of the HOPE aftercare service and describe the implementation context. They will inform the future development and sustainability of this and other similar services across Australia and internationally.
Trial registration: ACTRN12623001332617
The impact of temporal hydrogen regulation on hydrogen exporters and their domestic energy transition
Authors: Schumm Leon , Abdel-Khalek Hazem , Brown Tom , Ueckerdt Falko , Sterner Michael , Fioriti Davide , Parzen Max 
Published: April 2024

Abstract

As global demand for green hydrogen rises, potential hydrogen exporters move into the spotlight. However, the large-scale installation of on-grid hydrogen electrolysis for export can have profound impacts on domestic energy prices and energy-related emissions. Our investigation explores the interplay of hydrogen exports, domestic energy transition and temporal hydrogen regulation, employing a sector-coupled energy model in Morocco. We find substantial co-benets of domestic climate change mitigation and hydrogen exports, whereby exports can reduce domestic electricity prices while mitigation reduces hydrogen export prices. However, increasing hydrogen exports quickly in a system that is still dominated by fossil fuels can substantially raise domestic electricity prices, if green hydrogen production is not regulated. Surprisingly, temporal matching of hydrogen production lowers domestic electricity cost by up to 31% while the effect on exporters is minimal. This policy instrument can steer the welfare (re-)distribution between hydrogen exporting firms, hydrogen importers, and domestic electricity consumers and hereby increases acceptance among actors.
Blockage of BAG2-CHIP Axis Combats Gastric Cancer by Inducing HSP70 Ubiquitination-mediated Apoptosis
Authors: Liu Qian , Wei Hong , Tang Baoyuan , Tian Binbin , Ma Zhijian , Gu Qianlin , Su Xiaolu , Yu Zeyuan , Dong Yuman , Shi Wengui , Luo Changjiang 
Published: April 2024

Abstract

The acquired resistance of cells to apoptosis is strongly correlated with the development of gastric cancer. Bcl-2-associated athanogene 2 (BAG2) functions as an oncogene in numerous tumours by regulating cell apoptosis. However, its functional, clinical importance and underlying mechanism in gastric cancer (GC) remain unclear. Here, we reported BAG2 as a therapeutic target to regulate GC apoptosis through BAG2-CHIP-HSP70-Apaf1-Cytc axis. BAG2 is highly overexpressed in GC and negatively correlated with prognosis of patients with GC. Knockout of BAG2 inhibits GC growth and induces cell apoptosis in vitro and in vivo. Mechanistically, BAG2 interacts with C-terminus of HSP70-inteacting protein (CHIP) to inhibit the ubiquitination degradation of HSP70, resulting in an increase in the binding of HSP70 and Apoptotic protease activating factor (Apaf1), and in turn reduction of mitochondrial Cytochrome C (Cytc) release to block cell apoptosis. In addition, we identified FIIN-2 as an inhibitor of the BAG2-CHIP complex, which induces apoptosis to inhibit GC growth in GC cell lines, organoids and CDX mice models. In conclusion, we characterize that BAG2 drive the GC growth by regulating cell apoptosis through BAG2-CHIP-HSP70-Apaf1-Cytc axis, and blockage of BAG2-CHIP using FIIN-2 as a potential strategy to combat GC.
Enhanced Stress-Resilience Training (ESRT) for Graduate-Entry Medical Students: A Mixed-Method Investigation
Authors: Sanders Luke , Budd Georgie , Carter Lebares , Dave Umakant , Kemp Andrew H. 
Published: April 2024

Abstract

Background
Medical students face demanding academic requirements, fierce competition, self-doubt and financial concerns contributing to high rates of depression, anxiety, stress, sleep problems and burnout, highlighting a need for effective interventions. We explored a promising intervention known as Enhanced Stress-Resilience Training (ESRT), a modified form of mindfulness training adapted for clinicians, that was applied to medical students for the first time.
Methods
A randomised controlled trial was conducted to examine the effectiveness of ESRT for graduate-entry medical students (N = 98). Group (ESRT, active control) by time (pre-intervention, post-intervention, 6-month follow-up assessment) analyses of variance (ANOVAs) were conducted on psychological flexibility, resilience and stress reactivity. Student experience and perception of ESRT were investigated via exit evaluations (n = 25), one-on-one semi-structured interviews (n = 12), and end-of-study focus groups (n = 11) which underwent reflexive thematic analysis.
Results
ESRT users demonstrated increased psychological flexibility scores at post-intervention (p = .001, d = 0.62) and six-months follow-up (p = < .001, d = 0.96), and these findings were confirmed in intention-to-treat analysis. Those with low baseline resilience who underwent ESRT displayed increased resilience (p = < .001, d = 1.86) and decreased stress reactivity (p = < .001, d = 1.58) at the six-month follow-up. Reflexive thematic analysis revealed a strong demand for ESRT, which improved capacity for coping. Feedback from ESRT participants demonstrated overwhelmingly positive experiences and a demand for integrating ESRT into the medical curriculum.
Conclusions
ESRT is an effective intervention for enhancing psychological flexibility, while also increasing resilience and decreasing stress reactivity in the most vulnerable students. While students felt subjectively better across multiple domains, engagement in ESRT was challenged by time constraints and conflicting priorities. To overcome these barriers, we advocate for further implementation efforts which would benefit from institutional support to integrate ESRT into the formal medical curriculum.
Assessment and exploratory analysis of Indicator Based Surveillance (IBS) system in Rwanda
Authors: Nizeyimana Pacifique , Nsekuye Olivier , Ruyange Laurent , Twahirwa Solange , Manariyo Marcel , Zimulinda Alain , Kayirangwa Marie Rose , Uwamahoro Sandrine , Itanga Ines , Kabeja Adeline , Rwagasore Edson , Muvunyi Claude Mambo 
Published: April 2024

Abstract

Introduction: Rwanda, like other countries, is facing emerging and re-emerging infectious diseases. Since 2002, Rwanda has implemented indicator-based surveillance through the Integrated Disease Surveillance and Response (IDSR) framework. This study aimed to explore the completeness and timeliness of reporting and use of the tool in Rwanda. Method: In this study, we used a cross-sectional descriptive approach using a structured questionnaire for IDSR focal persons and data managers in 46 public hospitals accompanied by a secondary data analysis of monthly records from the national HMIS for the period 2018–2021 from 564 public health facilities (HFs) and 283 private HFs. Exploratory analysis and correlation assessments complemented dataset analysis. Results: This study reveals that public HF consistently achieves or surpasses the 80% completeness (96.7%) and timeliness (80.8%) targets. In contrast, private HF demonstrates 42.8% and 25.3%, completeness and timeliness, respectively. Eight-seven percent (87%) of interviewees reported to have received feedback from the central level, with varying frequencies. Hospitals provide feedback to HFs in their catchment area (91%), but frequencies differ. Regarding data accuracy, 95.7% possess standard case definitions, and 87% regularly refer to them. Two-thirds (67.6%) report they monitor weekly trends, but only 34.9% produce and share weekly reports promptly. Challenges identified include internet issues (30%), other competing duties (30%), and forgetting to report (26%). 84.8% of HFs used the system to detect outbreaks in their catchment areas; 71.7% of these were responded to according to national guidelines. Furthermore, 92.3% of all HFs have used the eIDSR system for planning purposes. Conclusion: The IDSR system was highly useful by providing evidence for decision-making in early detection and response to outbreaks as well as for hospital program planning. Maintaining timely reporting, enhancing data quality and timely use, and improving health workers' knowledge and practices are vital for a surveillance system user to detect outbreaks early. More focus should be put on Private Health Facilities.
Recurrence with isolated vaginal metastasis after comprehensive treatment of ulcerated moderately differentiated carcinoma of the lower rectum: A case report
Authors: Zhang LIxia , Jiang Xiaoling , Wu Maoyuan , Zhang Wenwen , Wang Guanyan , Yang Wei , Li Tingchao , He Lianli , Wang Gangcheng 
Published: April 2024

Abstract

Locally recurrent rectal cancer (LRRC) refers to the lesions that appear in the pelvic cavity and perineum with the same pathological type as the primary tumor after radical operation of rectal cancer, excluding other distant metastases such as liver, lung, and bone. Radical surgical resection in such patients is a central element in improving quality of life and survival. In this paper, we report the case of a patient who was admitted to our hospital with a recurrence of ulcerated moderately differentiated carcinoma of the lower rectum with vaginal involvement after comprehensive treatment. After discussion by a multidisciplinary team, surgical treatment was selected to be performed through a longitudinal incision approach in the prone position of the sacrum, with complete resection of the tumor tissues, which improved the patient's quality of life and increased her survival rate.
Endovascular electrothrombosis treatment for carotid cavernous fistula caused by ruptured primitive trigeminal artery aneurysm: a case report and literature review
Authors: Wan Yuhui , Cheng Zengjing , Lu Ziyan , Yang Dehong , Li Zhaoliang , Yang Kai , Chen Binglin , Chen Ailin , Zhu Qing 
Published: April 2024

Abstract

Background and Importance: Persistent primitive trigeminal artery aneurysms are clinically rare, especially with carotid cavernous fistula caused by their rupture. At present, endovascular treatment is of choice for carotid cavernous fistula, including by detachable balloon / coil, coil combined with Onyx glue, covered stent and so on. We cured a patient harbored carotid cavernous fistula caused by a ruptured primitive trigeminal artery aneurysm by detachable coil combined with endovascular electrothrombosis with a good result.
Clinical Presentation: The patient was admitted with a history of head trauma over two months ago and had experienced right eye protrusion for the past three weeks. Physical examination revealed protrusion of the right eye, along with conjunctival congestion and swelling. Digital subtraction angiography (DSA) confirmed a diagnosis of an incomplete Cavernous Carotid Fistula (CCF) on the right side, associated with a Persistent Primitive Trigeminal Artery (PPTA) on the same side. We cured by a ruptured primitive trigeminal artery aneurysm by detachable coil combined with endovascular electrothrombosis with a good result. It effectively avoided the mass effect associated with excessive coil filling and mitigated the risk of unintended embolization.
Conclusion: The combination of mechanical detachable bare metal coil embolization and electrocoagulation presents a novel and innovative approach for addressing CCF resulting from a ruptured PPTA aneurysm. This approach brings several notable advantages, including cost-effectiveness, reduced mass effect from embolic materials, and avoidance of potential complications associated with the use of medical glue for embolization.
Inhomogeneity Enhanced Signatures of Electromagnetically Induced Transparency
Authors: Vaduganathan Ramesh Kumar , R Rajadurai , Ramaswamy Radha 
Published: April 2024

Abstract

We investigate the propagation of a weak probe and a strong couple(pump) beam in an inhomogenous medium exhibiting Electromagnetically Induced Trans-parency(EIT) described by the Maxwell-Bloch equation. Unlike the homogenous case, the density matrix elements vary with the direction of pulse propagation. Employing the Gauge transformation approach, we have generated bright soli-tons for the weak probe and strong pump. The collisional dynamics of bright solitons shows that the presence of inhomogeneity makes the signatures of EIT more pronounced unlike the homogeneous counterpart. In particular, the colli-sional dynamics shows that one can not only slow down the laser pulses, but also can stop them literally leading to better optical storage. In addition, one also witnesses probe pulse broadening arising by virtue of space dependent density matrix showing that the medium becomes transparent to the probe over a wide range of frequencies.
Association of Cancer Status with Persistent Opioid Use in Kentucky Medicaid Patients Undergoing Colorectal Surgery
Authors: Oyler Douglas , Delcher Chris , Shelton Brent , Bae Jungjun , Bhakta Avinash 
Published: April 2024

Abstract

Background: Opioid prescribing guidance primarily focuses on patients with non-cancer pain. Patients undergoing surgery for cancer may have a higher risk of persistent postoperative opioid use compared to patients undergoing similar procedures for other indications.
Methods: This was a retrospective analysis of Medicaid claims data for patients undergoing colorectal surgery between 2015-2018. Included patients were assigned to a cancer or non-cancer cohort based on International Classification of Disease 9 or 10 codes indicating cancer or other relevant disease (e.g., Crohn’s disease). Multivariable logistic regression was used to assess the rate of persistent postoperative opioid use, defined as an opioid prescription between 90 and 180 days after surgery.
Results: This analysis included 1,929 patients: 891 in the cancer cohort and 1,038 in the non-cancer cohort. Adjusting for other relevant variables, patients undergoing surgery for cancer were significantly more likely to develop persistent postoperative opioid use (OR 1.35, 95% CI 1.08 to 1.69). Other variables associated with increased likelihood of the primary endpoint were opioid use within 30 days prior to hospitalization (OR 3.00, 95% CI 2.34 to 3.85), laparoscopic proctocolectomy or open colectomy (OR 2.66, 95% CI 1.19 to 5.91 and OR 1.75, 95% CI 1.37 to 2.23 compared to laparoscopic colectomy, respectively), and hospital drive distance over 60 miles (OR 1.72, 95% CI 1.26 to 2.32).
Discussion: Persistent opioid use was more likely in patients undergoing surgery for cancer. Guidelines for opioid prescribing should be inclusive to cancer patients to prevent undesired outcomes.