bluuebunny/crossref_metadata_2025_split huggingface dataset:
Process evaluation of an mHealth-based school education program to reduce salt intake scaling up in China (EduSaltS): A mixed methods study using the RE-AIM framework
Authors: Guo Haijun , Li Yuan , Li Li , Luo Rong , Wang Lanlan , Yi Guangming , Zhang Gang , He Fengjun , Wang Changqiong , Wang Naibo , Li Lihuang , Mao Tao , Lin Jiajin , Li Yinghua , Zhang Puhong 
Published: April 2024

Abstract

Background
An mHealth-based school health education program (EduSaltS) has been implemented in China for reducing salt intake among children, but the scaling up is challenging, and the effectiveness could be jeopardized by deviations in its implementation. This study aims to explore the implementation process and the factors that impact its implementation in the real world.
Methods
Mixed methods RE-AIM framework were employed for the process evaluation. The quantitative data were retrieved from the management website that monitoring 54435 participants from the third-grade students in two cities. Before-after questionnaire surveys were conducted to evaluate the education effectiveness. Analysis of variance and Chi square-test were used to examine differences for numerical data and category data respectively, and statistical significance was set at p < 0.05. Qualitative methods were used to identify the facilitators and barriers by conducting individual interviews (n = 23) and eight focus-groups (n = 80). Qualitative data analysis followed the thematical protocol. The findings from the mixed methods were triangulated for integration.
Results
The percentage of students who registered with the EduSaltS was significantly high (97.7%) due to the participants’ strong preferences and school support. Knowledge and behaviour related to salt reduction improved, and the standard score of knowledge and practice increased from 75.1 to 80.9 out of 100. All 208 invited schools adopted the program and hosted 3999 class activities and 1800 school activities during the two-term program. The completion rates of the 20 health cloud courses fluctuated between 79.4% and 93.4%, with an average of 84.9%. Qualitative interviews showed that the implementation of the EduSaltS was strongly facilitated by policy support from the education sector as well as app-aided auto delivered courses, home-school cooperation, proper incentives, real-time monitoring and management, but hindered by parents' lack of smartphone skills at the initial stage, competing school health priorities and unhealthy off-campus environments.
Conclusions
mHealth-based innovative school health education is scalable given the wide coverage, high acceptability and expected implementation effects of the EduSaltS. The findings regarding the barriers and facilitators can be used to enrich further scaling-up of EduSaltS and similar strategies in larger populations and various settings.
In vitro model of vascular remodeling under microfluidic perfusion
Authors: Nishikata Kotaro , Doi Kimisato , Kaneoya Nobuyoshi , Futai Nobuyuki 
Published: April 2024

Abstract
We developed a portable microfluidic system that combines spontaneous lumen formation from human umbilical endothelial cells (HUVECs) in fibrin-collagen hydrogels with active perfusion controlled by a braille actuator. Adaptive interstitial flow and feedthrough perfusion switching enabled successful culture of spontaneously formed naturally branched lumens for more than one month. We obtained many large-area (2 mm × 3 mm) long-term (more than 30 days per run) time-lapse image datasets of the in vitro luminal network using this microfluidic system. We also developed an automatic image analysis pipeline to extract the morphology of the lumen network and node-edge network structure weighted with segmentwise flow parameters. Automatic lumen area measurements revealed that almost all lumens were successfully cultured in this system for approximately 50 days, following the meshwork, sprouting, remodeling, stability, and erosion stages. We found that the optimization of the lumen network during the remodeling stage can be explained by the decrease in the betweenness centrality of the WSS-weighted network and the increase in the strength centrality of the flow rate-weighted network.
Network-based time series modeling for COVID-19 incidence in the Republic of Ireland
Authors: Armbruster Stephanie , Reinert Gesine 
Published: April 2024

Abstract

Network-based time series models have experienced a surge in popularity over the past years due to their ability to model temporal and spatial dependencies, arising from the spread of infectious disease.The generalised network autoregressive (GNAR) model conceptualises time series on the vertices of a network; it has an autoregressive component for temporal dependence and a spatial autoregressive component for dependence between neighbouring vertices in the network. Consequently, the choice of underlying network is essential.This paper assesses the performance of GNAR models on different networks in predicting COVID-19 cases for the 26 counties in the Republic of Ireland, over two distinct pandemic phases (restricted and unrestricted), characterised by inter-county movement restrictions.Ten static networks are constructed, in which vertices represent counties, and edges are built upon neighbourhood relations, such as railway lines. We find that a GNAR model based on the fairly sparse Queen's contiguity network explains the data best for the restricted pandemic phase while the fairly dense 21-nearest neighbour network performs best for the unrestricted phase.Across phases, GNAR models have higher predictive accuracy than standard ARIMA models which ignore the network structure. For county-specific predictions, in pandemic phases with more lenient or no COVID-19 regulation, the network effect is not quite as pronounced. The results indicate some robustness to the precise network architecture as long as the densities of the networks are similar.An analysis of the residuals justifies the model assumptions for the restricted phase but raises questions regarding their validity for the unrestricted phase.While outperforming ARIMA models which ignore network effects, the GNAR model warrants further development to better model complex infectious diseases, including COVID-19.
2020 Mathematics Subject Classification: 62M10, 05C82, 91D30 Network-based time series, COVID-19, spatial models, networks
Primary school teachers' attitudes and knowledge regarding pupils' hearing loss and the challenges they encounter while teaching in central Tanzania
Authors: Abraham Zephania Saitabau , Masunga Haruni , Kahinga Aveline 
Published: April 2024

Abstract

Background
Primary school teachers are early educators who encounter pupils with disabilities earlier than other educators at different levels. Hearing loss tends to impair cognitive development and academic performance pupils. This study aimed to address such an existing gap in Tanzania since there is no any study that has been conducted in our country on similar topic despite being of public health significance.
Methods
A community based cross-sectional study design was used where 405 primary school teachers in Manyoni district were recruited using multistage cluster sampling technique. Data was collected using Swahili translated semi-structured questionnaires and analysis was done using Statistical Package for Social Sciences (SPSS) version 23. A p-value < 0.05 was considered to be statistically significant
Results
In this study 70.9% of primary school teachers had poor knowledge toward hearing loss among pupils and only 8.1% of teachers expressed good level of knowledge about hearing loss. This study has found a significant association between the overall knowledge of teachers and age as the only socio-demographic characteristic of the study participants (P-value = 0.000) though no association was found between marital status, education level, having children and sex (p-values being 0.534, 0.28, 0.261 and 0.934 respectively). Pertaining attitude of teachers toward hearing loss among pupils, this study found 44.8% to have negative attitude, 48.1% had intermediate attitude and only 3.5% had positive attitude. On the other hand, 75% of teachers agreed that hearing impaired students would achieve better academically in special schools. The association between socio-demographic and professional characteristics and the overall attitude of teachers towards pupils’ hearing loss was not statistically significant. This study has found a statistically significant association between the overall knowledge and overall attitude of primary school teachers towards pupils’ hearing loss (p-value = 0.024).
Conclusions
Primary school teachers' attitudes and knowledge regarding pupils' hearing loss was found to be mostly poor to intermediate. Most teachers had limited knowledge of hearing loss especially on the causes, risk factors and symptoms of hearing loss. Educational campaigns to improve knowledge and attitude of primary teachers toward pupils’ hearing loss for excellence academically, socially and emotionally should be spearheaded in Manyoni district.
Trends and predictors of severe and moderate anaemia among children aged 6-59 months in India: An analysis of three rounds of National Family Health Survey (NFHS) data
Authors: Preethi Vegi , Hemalatha Vegi , Arlappa N. , M Benson Thomas , Jaleel Abdul 
Published: April 2024

Abstract

Background
Despite attempts to tackle malnutrition, childhood anaemia remains a significant public health concern impacting both child development and overall health in India. This study aims to analyse the prevalence rates and identify time-independent (unchanging) predictors associated with anaemia severity among children in India.
Methods
Data analysis was conducted using NFHS datasets from three survey rounds. The final analytical sample for this study comprised 40,331 children in NFHS-3 (2005–2006), 200,093 in NFHS-4 (2015–2016) and 178,909 in NFHS-5 (2019–2021). Descriptive, multivariable and binary logistic regression was used to determine the factors associated with severe and moderate anaemia among children aged 6–59 months. All statistical analyses were conducted using Stata-14, a software package developed by Stata Corp.
Results
There has been an increase in the prevalence of severe anaemia among children from NFHS-4 to NFHS-5. Among all three rounds of NFHS, the highest prevalence of severe anaemia was observed among children aged 12–23 months, particularly among males compared to females. Urban children and those belonging to SC/ST communities experienced higher rates of severe/moderate anaemia. Moreover, children born to mothers with 4–5 children (OR 1.1, p < 0.05) and 6 or more children (OR 1.2, p < 0.05) demonstrated an increased likelihood of severe/moderate anaemia. Additionally, children whose mothers had no education were found to be 1.4 times more susceptible to severe/moderate anaemia. These factors consistently predict severe/moderate anaemia among children aged 6–59 months in India, suggesting they are predictors of anaemia independent of time in the country.
Conclusion
This study highlights the trends and predictors of severe/moderate anaemia among Indian children which is vital for designing effective public health interventions. Targeted approaches like nutritional supplementation, maternal education programs, improving household diet diversity, and community-based interventions are essential to combat anaemia effectively to improve the overall health and well-being of children.
Life Cycle Assessment of Single versus Multiple Use Medical Products: A Case Study of Steam Sterilization Packaging
Authors: Ramos Tiffany M , Eriksen Ofir , Cimpan Ciprian , Khoshnevisan Benyamin , Christensen Thomas Budde , Hooge Asta , Syberg Kristian 
Published: April 2024

Abstract

Plastic pollution has emerged as a critical global environmental challenge, exacerbated by the extensive use of plastics in the healthcare industry. This study examines the environmental impacts of single-use plastic sterilization wraps versus reusable sterilization cases (RSCs) commonly used in operating theaters (OTs). We employ Life Cycle Assessment (LCA) methodologies to compare their life cycles, considering raw materials, production, use, and disposal phases. Our findings indicate that RSCs result in substantially lower environmental burdens compared to single-use wraps. Furthermore, we explore three circumstances: current practices, a future circumstance with renewable energy transitions, and an ideal "best case" circumstance integrating renewable energy and increased recycling potential of polypropylene (PP) fractions. Additionally, we assess practical implications for medical staff and facilities during product transitions, alongside considerations for expanding sorting practices for single-use medical PP products. This research addresses a gap in comparative analysis within the European context, offering insights to guide decision-makers in reducing plastic consumption in healthcare settings. Further studies of this nature are imperative to inform sustainable practices and policies in the healthcare sector.
Surviving aluminum phosphide poisoning induced cardiotoxicity- a case report
Authors: Gebray Habtamu Mesele , Chekol Addisu Liknaw 
Published: April 2024

Abstract
Introduction
Aluminum phosphide which is a cheap and commonly used rodenticide is also an effective solid fumigant that is frequently used for grain preservation. The pill contains around 44% inert elements to avoid disintegration of the tablet, ammonium carbonate, while the rest (about 56%) is aluminum phosphide. Because it is freely available in the market and accessibility is not controlled in developing countries, it is one of the commonly used agents for self-poisoning in different parts of the developing world
Case presentation
We presented a 48 years old female patient who was taken to private clinic after 6 hours of intentional ingestion of two tablets of Aluminum phosphide. She was presented with restlessness of 03 hours duration with confusion. She had 06 episodes of vomiting of ingested matter. Upon examination, the patient was drowsy, pale, cold and clammy. She had non-recordable blood pressure and radial pulsation. Glasgow Coma Scale was 14/15. Routine lab investigations and initial Electrocardiogram were normal. Six hours after Intensive Care Unit admission, the Electrocardiogram showed atrial fibrillation with fast ventricular response, ST segment elevation and inverted T-waves. Cardiac troponin level was elevated. Hospital based protocol for a hypotensive patient with aluminum phosphide poisoning was administered and medical treatment of myocardial infarction was given. These measures ultimately resulted in a complete resolution of clinical findings and laboratory derangements.
Conclusion
Exposure to phosphine gas released from ALP fumigants increases the risk of major morbidity and mortality. The mortality due to ALP poisoning is very high and variable. The use of Magnesium sulphate to reduce cardiac arrhythmias and mortality is well documented but there is no uniformity in dose and frequency of its administration worldwide.
Ductal carcinoma in-situ arising within benign phyllodes tumours: review of the literature and case presentation
Authors: Giulia Deguidi , Alessia Nottegar , Marco Barillari , Denise Fiorini , Alessandra Invento , Mirandola Sara , Caldana Marina , Tombolan Valeria , Bertoldi Lorenzo , Bosio Giacomo , Pellini Francesca 
Published: April 2024

Abstract

INTRODUCTION: Phyllodes tumor (PT) is a rare benign tumor of the breast with a propensity to recur and metastasize. Ductal carcinoma in situ (DCIS) within PT is an extremely rare finding and is usually diagnosed postoperatively.
CASE PRESENTATION: We present a case of a 24-year-old female with bilateral multiple fibroadenomatosis and a growing lump in her right breast diagnosed as a atypical lobular hyperplasia. Preoperatively, surgical biopsy revealed DCIS within benign PT.
DISCUSSION: Phyllodes tumors are rare and ones with a coexisting carcinoma are even less frequently encountered. No standard management protocol exists for such cases, but when detected by histopathology, the clinical management and prognosis have to undergo a complete change. Treatment should be guided by the type and stage of carcinoma detected and proper individualized management by a multidisciplinary team play a crucial role.
CONCLUSION: Phyllodes tumors are rare and ones with a coexisting carcinoma are even less frequently encountered. No standard management protocol exists for such cases, but when detected by histopathology, the clinical management and prognosis have to undergo a complete change. Preoperative diagnosis and proper individualized management by a multidisciplinary team that ensures clear surgical margins and planned adjuvant therapy or close follow up play a crucial role in preventing the recurrence of DCIS within PT.
Hypomagnesemia and Fractional Excretion of Magnesium (FeMg) in Children with Nephrotic Syndrome
Authors: Garg Neha , Mahajan Akanksha , Mantan Mukta , Goswami Binita 
Published: April 2024

Abstract
Background- Hypomagnesemia and increased FeMg have been identified in patients with tubular damage; we explore the possibility of using these parameters to identify tubular damage in children with nephrotic syndrome especially those with steroid resistant disease.
Methods: This cross-sectional study was done from July 2021-July 2022 (n= 50); itsprimary objective was to estimate FeMg and serum magnesium levels in children and adolescents (2-18 years) with nephrotic syndrome (both steroid sensitive and steroid resistant), currently in remission. Those with CKD stage 3 or more, receiving drugs like diuretics, aminoglycosides, proton pump inhibitors, secondary and congenital nephrotic syndrome were excluded. Clinical details were elicited and biochemical investigations including urinary estimations of magnesium and creatinine were done.
Results- 50 (31M: 19F) children (25 SSNS and25 SRNS) with median (IQR) age 10 years (7;11) were enrolled. Hypomagnesemia (S. magnesium<1.8 mg/dl)was seen in 36% and 52% (p=0.45) and FeMg was 1.76% and 1.39% in the SSNS and SRNS groups respectively (p= 0.25); none of the patients had symptoms of hypomagnesemia and increased FeMg (>2.2%) was similar (28%) in both groups.
Conclusion- Hypomagnesemia appears to be a common electrolyte abnormality in children with nephrotic syndrome in disease remission especially in SRNS and underlying tubular damage may be contributory both in SSNS and SRNS.
Influence of improvement in frontal lobe hemodynamics on neurocognitive function in adult patients with moyamoya disease
Authors: Tsunoda Sho , Inoue Tomohiro , Ohwaki Kazuhiro , Takeuchi Naoko , Shinkai Takako , Fukuda Akira , Segawa Masafumi , Kawashima Mariko , Akabane Atsuya , Miyawaki Satoru , Saito Nobuhito 
Published: April 2024

Abstract

Background
Adult moyamoya disease (MMD) often present with slight neurocognitive impairment. This impairment may result from frontal lobe hemodynamic insufficiency.
Methods
In current study, we performed revascularization surgery incorporating superficial temporal artery (STA)–anterior cerebral artery (ACA) direct bypass for 20 adults with MMD who had poor anterograde ACA flow (Group A), and pre- and postoperative results of neurocognitive tests were retrospectively analyzed. The comparative group (Group C) included 23 patients with unruptured aneurysms or brain tumors who underwent craniotomy and the same neurocognitive tests as patients with MMD. We calculated the compositive frontal lobe function index (CFFI) based on seven neurocognitive tests for each patient, and the difference between the pre- and postoperative CFFI values (CFFI Post − Pre) was compared between the two groups.
Results
Frontal perfusion was improved postoperatively in all cases of Group A. The CFFI Post − Pre was significantly higher in Group A than in Group C (0.23 ± 0.44 vs. −0.20 ± 0.32; p < 0.001). After adjusting for postoperative age, sex, preoperative non-verbal intelligence quotient and preoperative period of stress, Group A had a significantly higher CFFI Post − Pre than Group C in the multiple regression analysis (t value = 4.01; p < 0.001).
Conclusion
Improvement of frontal hemodynamics might be the key for improving neurocognitive dysfunction in adult MMD. The surgical indication and method should probably be considered not only from the perspective of stroke prevention, but also from the perspective of neurocognitive improvement or protection.
Effect of online peer support on mental health among patients of post-acute sequelae of SARS-CoV-2 infection: A systematic review
Authors: Kataoka Mayumi , Hazumi Megumi , Usuda Kentaro , Miyake Michi , Nishi Daisuke 
Published: April 2024

Abstract

Background
Psychosocial burdens of the post-acute sequelae of SARS-CoV-2 infection (PASC) are an emerging public health concern. Online peer support is expected to be effective in improving the mental health of PASC patients. However, the effectiveness of these treatments remains unclear. This study investigated the effectiveness of online peer support for improving the mental health of PASC patients.
Methods
We searched the MEDLINE, PsycINFO/PsycArticles, and Japan Medical Abstracts Society electronic databases for studies on June 12, 2023. The inclusion criteria for studies were as follows: 1) patients with post-COVID-19 conditions over 18 years of age; 2) conducted online peer support exposure or intervention; 3) measured mental health-related outcomes using quantity scales; and 4) peer-reviewed original articles written in English or Japanese. We excluded qualitative studies that did not use quantitative scales to measure outcomes and original peer-reviewed articles. We conducted risk of bias assessments with the Risk of Bias Assessment instrument designed for non-randomized studies (RoBANS).
Results
A total of 157 studies were retrieved, and two met the inclusion criteria. The total numbers of participants in the two studies were 239 and 47, respectively. One was a cohort study, and the other was a pre-post study; neither had a control group. Most participants in both studies were middle-aged women or female from high-income European countries. Exposure or intervention included sharing sources of support (e.g., experiences, knowledge, and expertise) and peer support combined with workshops for the self-management of physical and mental health facilitated by trained medical experts. The effectiveness of online peer support on mental health outcomes was also assessed. Two studies reported significant improvements in work productivity, functional status, quality of life, self-efficacy, and well-being. Both studies were rated as high or unclear in most risk-of-bias domains. No meta-analysis was performed because of the small number of included studies.
Conclusions
Few studies examine online peer support for improving mental health-related outcomes among PASC patients, and evidence of its effectiveness is unclear. Well-designed studies are required to conduct meta-analyses to evaluate the effectiveness of online peer support for PASC patients.