bluuebunny/crossref_metadata_2025_split huggingface dataset:
Seeking information and services associated with reproductive health among rural Peruvian young adults: exploratory qualitative research from Amazonas, Peru
Authors: McGuire Molly F. , Ortega Emma , Patel Radha , Paz-Soldán Valerie A. , Riley-Powell Amy R. 
Published: March 2024

Abstract
Background
Sexual and reproductive health (SRH) literacy allows young adults to make informed decisions about health outcomes. In Peru, roughly one fifth of the population lives in rural areas, and little is known about where young adults in rural areas get their SRH information. The aim of this study was to identify what motivates and influences young adults to seek information and care related to SRH in three rural communities in the highlands of Northern Peru.

Methods
Five gender-stratified focus group discussions with a total of 24 participants, and nine follow-up interviews were conducted to generate in-depth narrative data and triangulate data from the target group. Participants were women and men aged 18–24. The focus group discussions and interviews explored sources of reproductive health information, the role of informal social networks, barriers to care, and primary health concerns of the target population.

Results
Main findings include: (1) The two greatest perceived SRH risks were unwanted pregnancy and abnormal discharge; (2) There appears to be limited concern about HIV or other sexually transmitted infections in the narratives; (3) There is a low quality of information concerning SRH, with discrepancies between the genders; (4) A broad spectrum of sources for SRH information were cited, including Internet, traditional healers, and specialized care; and varied by gender and life experience; (5) Having trust in the information source was the primary variable associated with uptake of services and/or access to information for both men and women. However, men reported more embarrassment around seeking services and information, whereas women faced more physical barriers.

Conclusions
There is a lack of SRH information among young adults in some communities in the northern highlands of Peru. Both schools and health centers were noted as being trusted and established information sources for all genders so could be a key resource to explore as a way to disseminate information.
Median quartet tree search algorithms using optimal subtree prune and regraft
Authors: Arasti Shayesteh , Mirarab Siavash 
Published: March 2024

AbstractGene trees can be different from the species tree due to biological processes and inference errors. One way to obtain a species tree is to find one that maximizes some measure of similarity to a set of gene trees. The number of shared quartets between a potential species tree and gene trees provides a statistically justifiable score; if maximized properly, it could result in a statistically consistent estimator of the species tree under several statistical models of discordance. However, finding the median quartet score tree, one that maximizes this score, is NP-Hard, motivating several existing heuristic algorithms. These heuristics do not follow the hill-climbing paradigm used extensively in phylogenetics. In this paper, we make theoretical contributions that enable an efficient hill-climbing approach. Specifically, we show that a subtree of size m can be placed optimally on a tree of size n in quasi-linear time with respect to n and (almost) independently of m. This result enables us to perform subtree prune and regraft (SPR) rearrangements as part of a hill-climbing search. We show that this approach can slightly improve upon the results of widely-used methods such as ASTRAL in terms of the optimization score but not necessarily accuracy.
The association of regional block with intraoperative opioid consumption in patients undergoing video-assisted thoracoscopic surgery: a single-center, retrospective study
Authors: Xiang Yan , Chen Liang , Jia Jiang , Yili Fu , Changwei Wei 
Published: March 2024

Abstract
Background
Regional block, such as thoracic epidural analgesia (TEA), thoracic paravertebral block (TPVB), or serratus anterior plane block (SAPB) has been recommended to reduce postoperative opioid use in recent guidelines, but the optimal options for intraoperative opioid minimization remain unclear. The aim of this study was to evaluate the intraoperative opioids-sparing effects of three regional blocks (TEA, TPVB, and SAPB) in patients undergoing video-assisted thoracoscopic surgery (VATs).

Methods
This was a retrospective study of the adults undergoing VATs at a tertiary medical center between January 2020 and February 2022. According to the type of regional block used, patients were classified into 4 groups: GA group (general anesthesia without any regional block), TEA group (general anesthesia combined with TEA), TPVB group (general anesthesia combined with TPVB), and SAPB group (general anesthesia combined with SAPB). Cases were matched with a 1:1:1:1 ratio for analysis by age, sex, ASA physical status, and operation duration. The primary outcome was the total intraoperative opioid consumption standardized to Oral Morphine Equivalents (OME). Multivariable linear regression was used to estimate the association of the three regional blocks with the OME.

Results
A total of 2159 cases met the eligibility criteria. After matching, 168 cases (42 in each group) were included in analysis. Compared with GA without any reginal block, the use of TEA, TPVB, and SAPB reduced the median of intraoperative OME by 78.45 mg (95% confidence interval [CI], -141.34 to -15.56; P = 0.014), 94.92 mg (95% CI, -154.48 to -35.36; P = 0.020), and 11.47 mg (95% CI, -72.07 to 49.14; P = 0.711), respectively.

Conclusions
The use of TEA or TPVB was associated with an intraoperative opioid-sparing effect in adults undergoing VATs, whereas the intraoperative opioid-sparing effect of SAPB was not yet clear.
Acute type a aortic intramural hematoma complicated with preoperative hemopericardium: early and late surgical outcome analyses
Authors: Lin Chun-Yu , Kao Ming-Chang , Lee Hsin-Fu , Wu Meng-Yu , Tseng Chi-Nan 
Published: March 2024

Abstract
Background
Acute type A aortic intramural hematoma (ATAIMH) is a variant of acute type A aortic dissection (ATAAD), exhibiting an increased risk of hemopericardium and cardiac tamponade. It can be life-threatening without emergency treatment. However, comprehensive studies of the clinical features and surgical outcomes of preoperative hemopericardium in patients with ATAIMH remain scarce. This retrospective study aims to investigate the clinical features and early and late outcomes of patients who underwent aortic repair surgery for ATAIMH complicated with preoperative hemopericardium.

Methods
We investigated 132 consecutive patients who underwent emergency ATAIMH repair at this institution between February 2007 and August 2020. These patients were dichotomized into the hemopericardium (n = 58; 43.9%) and non-hemopericardium groups (n = 74; 56.1%). We compared the clinical demographics, surgical information, postoperative complications, 5-year cumulative survival rates, and freedom from reoperation rates. Furthermore, multivariable logistic regression analysis was utilized to identify independent risk factors for patients who underwent re-exploration for bleeding.

Results
In the hemopericardium group, 36.2% of patients presented with cardiac tamponade before surgery. Moreover, the hemopericardium group showed higher rates of preoperative shock and endotracheal intubation and was associated with an elevated incidence of intractable perioperative bleeding, necessitating delayed sternal closure for hemostasis. The hemopericardium group exhibited higher blood transfusion volumes and rates of re-exploration for bleeding following surgery. However, the 5-year survival (59.5% vs. 75.0%; P = 0.077) and freedom from reoperation rates (93.3% vs. 85.5%; P = 0.416) were comparable between both groups. Multivariable analysis revealed that hemopericardium, cardiopulmonary bypass time, and delayed sternal closure were the risk factors for bleeding re-exploration.

Conclusions
The presence of hemopericardium in patients with ATAIMH is associated with an elevated incidence of cardiac tamponade and unstable preoperative hemodynamics, which could lead to perioperative bleeding tendencies and high complication rates. However, patients of ATAIMH complicated with hemopericardium undergoing aggressive surgical intervention exhibited long-term surgical outcomes comparable to those without hemopericardium.
The effectiveness of a web-based information-knowledge-attitude-practice continuous intervention on the psychological status, medical compliance, and quality of life of patients after coronary artery bypass grafting surgery: a parallel randomized clinical trial
Authors: Li Jin , Deng Yueli , Jiang Yan 
Published: March 2024

Abstract
Background
Coronary artery disease (CAD) patients who have undergone coronary artery bypass grafting (CABG) often experience a severe psychological burden for a long period of time, which can adversely affect their post-operative prognosis. Therefore, this study aimed to evaluate the effect of a web-based Information-Knowledge-Attitude-Practice (WIKAP) continuous intervention on the psychological status, medical compliance, and quality of life (QoL) in patients with CAD after CABG surgery.

Methods
A parallel randomized clinical trial enrolled 174 CAD patients who underwent CABG at our hospital between January 2018 and December 2019. The participants were randomly divided into the Control and WIKAP group and received intervention for 12 months. The scores for anxiety, depression, medical compliance, and QoL were assessed on the first day (M0), 3rd month (M3), 6th month (M6), 9th month (M9) and 12th month (M12) after discharge. Furthermore, the occurrence of major adverse cardiac and cerebrovascular events (MACCE) was analyzed using the Kaplan-Meier curve and Cox proportional regression models for an additional 24-month follow-up period without any intervention.

Results
After the 12-month intervention, the scores of anxiety and depression were significantly reduced in the WIKAP group at M9 and M12 compared to those in the Control group (all P < 0.05). Additionally, the scores of medical compliance in the WIKAP group were remarkably elevated at M6, M9, and M12 compared with those scores in the Control group (all P < 0.05). Furthermore, the QoL scores were lower in the WIKAP group at M6, M9, and M12 compared to the Control group (all P < 0.05). However, the MACCE-free survival showed no significant difference between the two groups (P > 0.05). Cox proportional regression analysis also showed that the nursing intervention (Control vs. WKIAP) was not associated with the incidence of MACCE.

Conclusion
WIKAP nursing intervention effectively improved the psychological health, medical compliance, and QoL in CAD patients who underwent CABG operation, but it did not prolong MACCE-free survival.

Trail registration
The study is registered in isrctn.org: ISRCTN13653455.
The impact of amplification on quality of life in women with Turner syndrome
Authors: Mann Lauren , VanLooy Lindsey 
Published: March 2024

Abstract
Background
Individuals with Turner syndrome (TS, ORPHA 881) experience barriers in communication throughout life as they navigate both early conductive, and progressive sensorineural hearing loss amid other healthcare needs. Hearing loss is self-identified as one of the largest unmet healthcare needs.

Purpose
The purpose of this study was to investigate the impact of treatment for hearing loss on communication confidence and quality of life measures for individuals with TS.

Research design
We employed a prospective cross-sectional study design that included both online survey data and audiometric data for a subset of participants.

Study sample
We recruited 179 adults with TS at the Turner Syndrome Society of the United States (TSSUS) Conference, and through a variety of regional TS organizations’ social media platforms. Audiological data was collected onsite at the conference for a subset of 67 participants; 8 of which who were followed after receiving subsequent treatment with hearing aids.

Data collection and analysis
The online survey design included demographic questions, the Communication Confidence Profile (CCP), and the RAND 36-Item Health Survey 1.0. Audiometric data included tympanometry, puretone air, and puretone bone conduction thresholds. Descriptive statistics, parametric, and non-parametric tests were used to analyze both survey and audiometric data.

Results
74% of participants had a self-reported diagnosis of hearing loss, of which 61% were previously recommended amplification. Only 38% of participants reported using hearing aids. For those participants who wore hearing aids, Total CCP Score, ‘Confidence in Ability to Hear Under Various Conditions’, and ‘Energy/Vitality’ metrics were significantly greater than those with untreated hearing loss warranting a hearing aid. Collectively, Total CCP Score and ‘Confidence in Ability to Hear Under Various Conditions’ increased significantly when participants were fit with hearing aids.

Conclusion
The results support previous data where hearing loss is a self-identified healthcare concern among women with Turner syndrome, yet many fail to receive appropriate hearing evaluation or treatment. Additionally, the use of hearing aids may improve communication confidence and quality of life in women with Turner syndrome. Furthermore, this study confirms the need for long-term audiological care and monitoring in women with Turner syndrome.
Heartworm disease in domestic dogs in Estonia: indication of local circulation of the zoonotic parasite Dirofilaria immitis farther north than previously reported
Authors: Mõttus Maare , Mõtsküla Paul F. , Jokelainen Pikka 
Published: March 2024

Abstract
Background
The mosquito-borne zoonotic parasite Dirofilaria immitis continues to spread northwards in Europe. This parasite can cause potentially life-threatening heartworm disease in dogs and pulmonary dirofilariasis in humans and is, therefore, a major health concern in both the veterinary medicine and human medical fields. This is the first report of D. immitis infections and heartworm disease in the Baltic country Estonia.

Methods
Data on canine D. immitis infections and heartworm disease were collected from the electronic patient records database of the Small Animal Clinic of Estonian University of Life Sciences, the only university clinic in Estonia. The patient records of dogs with confirmed diagnosis of D. immitis infection or heartworm disease were reviewed and summarised.

Results
Six dogs had been diagnosed with confirmed D. immitis infection or heartworm disease at the university clinic in 2021–2022. The confirmed diagnoses had been reached following international guidelines, based on a combination of different tests. Molecular confirmation of the parasite species had not been performed. Two of the dogs had been imported while four had no travel history outside of the country.

Conclusions
Four of the dogs with a confirmed D. immitis infection or heartworm disease had no history of being imported or travelling outside of the country, indicating autochthonous infections and, consequently, local circulation of the parasite in Estonia. These findings represent the new northernmost autochthonous cases of D. immitis infection and canine heartworm disease reported in the European Union.

Graphical Abstract
Bayesian EM approach for GNSS parameters of interest estimation under constant modulus interference
Authors: Lesouple Julien , Ortega Lorenzo 
Published: March 2024

AbstractInterferences pose a significant risk to applications that rely on global navigation satellite systems (GNSSs). They have the potential to degrade GNSS performance and even result in service disruptions. The most notable type of intentional interference is characterized by a constant modulus, such as chirp and tone interferences. These interferences have a straightforward structure, leading to the creation of complex circles when attempting to identify their contribution. To address the interference and improve the situation, we calculate the maximum likelihood estimator for the relevant parameters (time delay and Doppler shift) while considering the presence of these latent variables. To achieve this, we employ the expectation–maximization algorithm, which has previously demonstrated its effectiveness in similar scenarios. Experiments conducted using synthetic signals confirm the efficiency of the proposed algorithm.
Mapping the widespread distribution and transmission dynamics of linezolid resistance in humans, animals, and the environment
Authors: Shen Weiyi , Cai Chang , Dong Ning , Chen Jiawei , Zhang Rong , Cai Jiachang 
Published: March 2024

Abstract
Background
The rise of linezolid resistance has been widely observed both in clinical and non-clinical settings. However, there were still data gaps regarding the comprehensive prevalence and interconnections of linezolid resistance genes across various niches.

Results
We screened for potential linezolid resistance gene reservoirs in the intestines of both humans and animals, in meat samples, as well as in water sources. A total of 796 bacteria strains out of 1538 non-duplicated samples were identified to be positive for at least one linezolid resistance gene, optrA, poxtA, cfr, and cfr(D). The prevalence of optrA reached 100% (95% CI 96.3–100%) in the intestines of pigs, followed by fish, ducks, and chicken at 77.5% (95% CI 67.2–85.3%), 62.0% (95% CI 52.2–70.9%), and 61.0% (95% CI 51.2–70.0%), respectively. The meat and water samples presented prevalences of 80.0% (95% CI 70.6–87.0%) and 38.0% (95% CI 25.9–51.9%), respectively. The unreported prevalence of the cfr(D) gene was also relatively higher at 13.0% (95% CI 7.8–21.0%) and 19.0% (95% CI 10.9–25.6%) for the feces samples of ducks and pigs, respectively. Enterococci were the predominant hosts for all genes, while several non-enterococcal species were also identified. Phylogenetic analysis revealed a significant genetic distance among linezolid resistance gene reservoirs, with polyclonal structures observed in strains within the same niche. Similar genetic arrays harboring assorted insertion sequences or transposons were shared by reservoirs displaying heterogeneous backgrounds, though large diversity in the genetic environment of linezolid resistance genes was also observed.

Conclusions
The linezolid resistance genes were widespread among various niches. The horizontal transfer played a crucial role in driving the circulation of linezolid resistance reservoirs at the human-animal-environment interfaces.
A new approach for configuring modular floating cities: assessing modular floating platforms by means of analytic hierarchy process
Authors: EL-Shihy Ahmed A. 
Published: March 2024

AbstractFloating cities have emerged as an efficient long-term solution over unsustainable practiced solutions to combat the rising seas problem; nevertheless, the world lacks an international, official, and comprehensive framework regarding floating cities. Although previous research approached modular floating city design; however, resulted in configurations with various critical design restrictions mainly regarding interlocking capabilities and space utilization. The purpose of this paper is to offer a new systematic strategy for configuring modular and expandable floating cities without such restrictions. This paper explores Euclidean tilings as a strategy to offer numerous configurations based on regular, semi-regular, and demi-regular tilings. Selecting the ideal configuration is complicated; therefore, both quantitative and qualitative data methods were implemented to attain the objectives. Via an extensive literature review, this research derives key factors for configuring floating cities, then sets a brainstorming session with experts for group decision making before providing findings upon calculations via analytic hierarchy process, one of the most used quantitative data methods of multiple-criteria decision analysis. Through comprehensive literature review: seakeeping, modularity, zoning and circulation, and feasibility have been identified as the most significant criteria in floating city research. It explores the qualities and limitations of triangular, squared, hexagonal, octagonal, and dodecagonal platforms. Regarding criteria, seakeeping was the most significant criterion for platform selection by 53.6%. Regarding platforms, the hexagonal platform scored the highest with 25.31%. Relying on this method and the design considerations presented, numerous dynamic configurations can be offered and assessed through specific contexts without any of the past restrictions.
The use of computed tomography and X-ray fluorescence analysis in the research of printed book from the seventeenth century: book binding, tomographic reading of the text, dendrochronological dating, pigments analysis
Authors: Vavřík Daniel , Kazanskii Andrei , Neoralová Jitka , Kindlerová Rita Lyons , Novotná Dana , Vávrová Petra , Kumpová Ivana , Vopálenský Michal , Kyncl Tomáš 
Published: March 2024

Abstract
This paper presents the use of X-ray computed tomography and X-ray fluorescence in the analysis and expert research of the seventeenth century printed book "Eukhologīon albo Molitoslov, ili Trebnik" from Kiev. The main purpose of the survey was to confirm whether the book binding is original or whether it is a rebinding, and whether there are any fragments of the hidden older texts. Commonly used radiography is usually not able to provide sufficient information for these purposes. On the other hand, computed tomography allows a detailed and three-dimensional documentation of the bookbinding technology and the structure of the materials used, including the wooden boards. It will be presented that all elements of the weave are clearly visible, making it possible to show that there are no internal defects in the stitching and materials. It has also been convincingly shown that there are no fragments or layers of older texts in the binding, so no further invasive intervention will be necessary regarding this aspect. The paper also demonstrates the possibility of reading the text in a closed book utilising X-ray computed tomography data; this option may be advantageous for massively damaged manuscripts. It will also be shown, that thanks to detailed tomographic imaging of the wood structure of the boards, a dendrochronological survey can be successfully carried out without invasive intervention into their outer layers. From the CT data it was also found that the pigments of the letters have significantly different densities. Therefore, as part of the survey, elemental analysis of the writing was also carried out using a portable X-ray fluorescence spectrometer to confirm and clarify this finding.