bluuebunny/crossref_metadata_2025_split huggingface dataset:
Behavioural and social drivers of COVID-19 vaccination in Vietnam: a scoping review
Authors: Tran Luong , Dang Tho , Nguyen Mai , Kaufman Jessica , Overmars Isabella , Shrestha Shiva , Abdi Ikram , Nguyen Thao , Marahajan Muthu , Chu Trang , Danchin Margie , Fox Gregory , Nguyen Thu Anh 
Published: December 2023

BackgroundUnderstanding of the behavioural and social drivers (BeSD) of vaccination is key to addressing vaccine hesitancy and accessibility issues. Vietnam’s national COVID-19 vaccination programme resulted in high uptake of primary doses among adults, but lower booster doses for adults and primary doses for 5–11 years. This scoping review assessed BeSD influencing COVID-19 vaccine uptake in Vietnam to design interventions on reaching the national vaccination targets.MethodWe conducted a scoping review by searching PubMed, MedRxiv, LitCOVID, COVID-19 LOVE platform, WHO’s COVID-19 research database and seven dominant Vietnamese language medical journals published in English or Vietnamese between 28 December 2019 and 28 November 2022. Data were narratively synthesised and summarised according to the four components of the WHO BeSD framework. The drivers were then mapped along the timeline of COVID-19 vaccine deployment and the evolution of the pandemic in Vietnam.ResultsWe identified 680 records, of which 39 met the inclusion criteria comprising 224 204 participants. Adults’ intention to receive COVID-19 vaccines for themselves (23 studies) ranged from 58.0% to 98.1%. Parental intention to vaccinate their under 11-year-old children (six studies) ranged from 32.8% to 79.6%. Key drivers of vaccination uptake were perceived susceptibility and severity of disease, perceived vaccine benefits and safety, healthcare worker recommendation, and positive societal perception. Commonly reported COVID-19 vaccines’ information sources (six studies) were social and mainstream media (82%–67%), television (72.7%–51.6%) and healthcare workers (47.5%–17.5%). Key drivers of COVID-19 uptake remained consistent for both adults and children despite changes in community transmission and vaccine deployment.ConclusionKey enablers of vaccine uptake for adults and children included perceived disease severity, perceived vaccine benefits and safety and healthcare worker recommendations. Future studies should assess vaccine communication targeted to these drivers, national policies and political determinants to optimise vaccine uptake.
Prevalence of adequately iodised salt and associated factors among households in Gambela district, Southwest Ethiopia: a cross-sectional study
Authors: Tesfaye Getamesay Aynalem , Gemechu Ebissa Negera , Chanie Fentaneh Teshome , Umer Abdella Yasin 
Published: December 2023

BackgroundIodine deficiency disorders (IDDs) are among the major public health problems for populations worldwide. Although the recommended strategy for the prevention of IDD is universal salt iodisation, little is known about the availability of adequately iodised salt among households in Southwest Ethiopia. Therefore, this study aimed to determine the prevalence of adequately iodised salt and associated factors among households in Gambela district, Southwest Ethiopia.MethodsA community-based cross-sectional study was conducted in July 2019. A multistage sampling method was employed to select 422 households. A structured questionnaire and rapid test kits were used as data collection instruments. Multivariate logistic regression was used to identify associated factors.ResultsApproximately 52.8% (95% CI: 47, 57%) of households had adequately iodised salt. Higher educational status (adjusted OR (AOR)=4.27, 95% CI: 1.47, 12.44), favourable attitude toward iodised salt use (AOR=5.69, 95% CI: 2.83, 11.42), walking less than 30 min to buy iodised salt (AOR=4.69, 95% CI: 2.56, 8.60), using packed salt (AOR=2.75, 95% CI: 1.54, 4.93) and using covered salt containers (AOR=3.93, 95% CI: 2.21, 6.98) were factors positively associated with the availability of adequately iodised salt among households.ConclusionsThe prevalence of adequately iodised salt among households in Gambela district is very low. Therefore, enhancing community awareness about the benefit and good practice of iodised salt should be emphasised in addition to improving accessibility. Measures to improve the literacy of households also need to be underlined.
CLivD score modifies FIB-4 performance in liver fibrosis detection in the US general population
Authors: Åberg Fredrik , Lääperi Mitja , Männistö Ville 
Published: December 2023

Background and aimsSteatotic liver disease (SLD) is a growing global concern. The Chronic Liver Disease (CLivD) risk score predicts liver-related outcomes in the general population using easily accessible variables with or without laboratory tests (CLivDlaband CLivDnon-lab). We assessed CLivD’s associations with liver steatosis, fibrosis and its combined performance with fibrosis-4 (FIB-4) for advanced fibrosis detection.MethodsUsing the National Health and Nutrition Examination Survey data (2017–2020), 3603 participants aged 40–70 years with valid liver stiffness measurements (LSMs) were included. Advanced fibrosis was defined as LSM ≥12 kPa, and SLD as controlled attenuation parameter ≥288 dB/m.ResultsSignificant associations were found between CLivD and SLD and advanced fibrosis. CLivDlabhad an area under the curve (AUC) for advanced fibrosis of 0.72 (95% CI 0.68 to 0.77), while CLivDnon-labhad an AUC of 0.68 (95% CI 0.64 to 0.72), both slightly higher than FIB-4 (AUC 0.66, 95% CI 0.60 to 0.72). Among participants without obesity, AUC of CLivDlabwas 0.82 (95% CI 0.76 to 0.88) and AUC of CLivDnon-labwas 0.72 (95% CI 0.65 to 0.79). The CLivD score improved FIB-4’s AUC for advanced fibrosis detection from <0.5 at minimal CLivD scores to >0.8 at high CLivD scores. A sequential CLivD→FIB-4 strategy outperformed universal FIB-4 testing, enhancing specificity from 72% to 83%, with sensitivity at 51%–53%. This strategy identified a subgroup with a 55% prevalence of advanced fibrosis, while 47% had minimal-risk CLivD scores, eliminating the need for FIB-4 testing.ConclusionsThe CLivD score, designed for predicting liver-related outcomes, effectively identifies liver steatosis and advanced fibrosis in the general population. Combining CLivD with FIB-4 enhances advanced fibrosis detection accuracy. The CLivD score could enhance population-based liver fibrosis screening, optimising resource allocation.
Enhancing pain modulation: the efficacy of synchronous combination of virtual reality and transcutaneous electrical nerve stimulation
Authors: Bi Yanzhi , Liu Xu , Zhao Xiangyue , Wei Shiyu , Li Jingwei , Wang Faguang , Luo Wenbo , Hu Li 
Published: December 2023

IntroductionVirtual reality (VR) and transcutaneous electrical nerve stimulation (TENS) have emerged as effective interventions for pain reduction. However, their standalone applications often yield limited analgesic effects, particularly in certain painful conditions.AimsOur hypothesis was that the combination of VR with TENS in a synchronous manner could produce the best analgesic effect among the four experimental conditions.MethodsTo address this challenge, we proposed a novel pain modulation strategy that synchronously combines VR and TENS, aiming to capitalise on both techniques’ complementary pain modulation mechanisms. Thirty-two healthy subjects participated in the study and underwent three types of interventions: VR alone, a combination of VR with conventional TENS, and a combination of VR with synchronous TENS. Additionally, a control condition with no intervention was included. Perceived pain intensity, pain unpleasantness, positive and negative affect scores, and electroencephalographic (EEG) data were collected before and after the interventions. To delve into the potential moderating role of pain intensity on the analgesic efficacy of VR combined with synchronous TENS, we incorporated two distinct levels of painful stimuli: one representing mild to moderate pain (ie, low pain) and the other representing moderate to severe pain (ie, high pain).ResultsOur findings revealed that both combination interventions exhibited superior analgesic effects compared with the VR-alone intervention when exposed to low and high pain stimuli. Notably, the combination of VR with synchronous TENS demonstrated greater analgesic efficacy than the combination of VR with conventional TENS. EEG data further supported these results, indicating that both combination interventions elicited a greater reduction in event-related potential magnitude compared with the VR-alone intervention during exposure to low and high pain stimuli. Moreover, the synchronous combination intervention induced a more significant reduction in N2 amplitude than the VR-alone intervention during exposure to low pain stimuli. No significant differences in EEG response changes were detected between the two combination interventions. Both combination interventions resulted in a greater reduction in negative affect compared with the VR-alone intervention.ConclusionsAltogether, our study highlights the effectiveness of the synchronous combination of VR and TENS in enhancing pain modulation. These findings offer valuable insights for developing innovative pain treatments, emphasising the importance of tailored and multifaceted therapeutic approaches for various painful conditions.
Electroencephalography microstates as novel functional biomarkers for
insomnia disorder
Authors: Guo Yongjian , Zhao Xumeng , Liu Xiaoyang , Liu Jiayi , Li Yan , Yue Lirong , Yuan Fulai , Zhu Yifei , Sheng Xiaona , Yu Dahua , Yuan Kai 
Published: December 2023

Background
Insomnia disorder (ID) is one of the most common mental disorders.
Research on ID focuses on exploring its mechanism of disease, novel
treatments and treatment outcome prediction. An emerging technique in
this field is the use of electroencephalography (EEG) microstates, which
offer a new method of EEG feature extraction that incorporates
information from both temporal and spatial dimensions.

Aims
To explore the electrophysiological mechanisms of repetitive
transcranial magnetic stimulation (rTMS) for ID treatment and use
baseline microstate metrics for the prediction of its efficacy.

Methods
This study included 60 patients with ID and 40 age-matched and
gender-matched good sleep controls (GSC). Their resting-state EEG
microstates were analysed, and the Pittsburgh Sleep Quality Index (PSQI)
and polysomnography (PSG) were collected to assess sleep quality. The 60
patients with ID were equally divided into active and sham groups to
receive rTMS for 20 days to test whether rTMS had a moderating effect on
abnormal microstates in patients with ID. Furthermore, in an independent
group of 90 patients with ID who received rTMS treatment, patients were
divided into optimal and suboptimal groups based on their median PSQI
reduction rate. Baseline EEG microstates were used to build a
machine-learning predictive model for the effects of rTMS
treatment.

Results
The class D microstate was less frequent and contribute in patients
with ID, and these abnormalities were associated with sleep onset
latency as measured by PSG. Additionally, the abnormalities were
partially reversed to the levels observed in the GSC group following
rTMS treatment. The baseline microstate characteristics could predict
the therapeutic effect of ID after 20 days of rTMS, with an accuracy of
80.13%.

Conclusions
Our study highlights the value of EEG microstates as functional
biomarkers of ID and provides a new perspective for studying the
neurophysiological mechanisms of ID. In addition, we predicted the
therapeutic effect of rTMS on ID based on the baseline microstates of
patients with ID. This finding carries great practical significance for
the selection of therapeutic options for patients with ID.
Scalable generation of functional human iPSC-derived CAR-macrophages that efficiently eradicate CD19-positive leukemia
Authors: Abdin Shifaa M. , Paasch Daniela , Kloos Arnold , Oliveira Marco Carvalho , Jang Mi-Sun , Ackermann Mania , Stamopoulou Andriana , Mroch Philipp J , Falk Christine S , von Kaisenberg Constantin S , Schambach Axel , Heuser Michael , Moritz Thomas , Hansen Gesine , Morgan Michael , Lachmann Nico 
Published: December 2023

BackgroundMacrophages have recently become attractive therapeutics in cancer immunotherapy. The potential of macrophages to infiltrate and influence solid malignancies makes them promising targets for the chimeric antigen receptor (CAR) technology to redirect their stage of polarization, thus enhancing their anticancer capacities. Given the emerging interest for CAR-macrophages, generation of such cells so far mainly depends on peripheral blood monocytes, which are isolated from the respective donor prior to genetic manipulation. This procedure is time-intensive and cost-intensive, while, in some cases, insufficient monocyte amounts can be recovered from the donor, thus hampering the broad applicability of this technology. Hence, we demonstrate the generation and effectiveness of CAR-macrophages from various stem cell sources using also modern upscaling technologies for next generation immune cell farming.MethodsPrimary human hematopoietic stem and progenitor cells and induced pluripotent stem cells were used to derive anti-CD19 CAR-macrophages. Anticancer activity of the cells was demonstrated in co-culture systems, including primary material from patients with leukemia. Generation of CAR-macrophages was facilitated by bioreactor technologies and single-cell RNA (scRNA) sequencing was used to characterize in-depth response and behavior of CAR-macrophages.ResultsIrrespective of the stem-cell source, CAR-macrophages exhibited enhanced and antigen-dependent phagocytosis of CD19+target cancer cells with increased pro-inflammatory responses. Phagocytic capacity of CAR-macrophages was dependent on target cell CD19 expression levels with superior function of CAR-macrophages against CD19+cancer cell lines and patient-derived acute lymphocytic leukemia cancer cells. scRNA sequencing revealed CAR-macrophages to be distinct from eGFP control cells after co-culture with target cells, which includes the activation of pro-inflammatory pathways and upregulation of chemokines and cytokines associated with adaptive immune cell recruitment, favoring the repolarization of CAR-macrophages to a pro-inflammatory state. Taken together, the data highlight the unique features of CAR-macrophages in combination with the successful upscaling of the production pipeline using a three-dimensional differentiation protocol and intermediate scale bioreactors.ConclusionIn summary, our work provides insights into the seminal use and behavior of CAR-macrophages which are derived from various sources of stem cells, while introducing a unique technology for CAR-macrophage manufacturing, all dedicated to the clinical translation of CAR-macrophages within the field of anticancer immunotherapies.
‘Whether it’s your weapon or not, it’s your home’: US military spouse perspectives on personal firearm storage
Authors: Betz Marian E , Meza K , Friedman K , Moceri-Brooks J , Johnson M L , Simonetti J , Baker J C , Bryan C J , Anestis M D 
Published: December 2023

IntroductionIn the USA, an estimated 45% of veterans personally own firearms. Firearm access increases the risk of suicide, so suicide prevention efforts in the US Department of Defense (DoD) focus on lethal means safety, including reducing firearm access. Spouse input may enhance effective messaging and intervention delivery of lethal means safety. This study used qualitative methods to explore the perspectives of military spouses or partners on personal firearm storage, including at-home decisions, on-base storage and existing messaging from the DoD.Materials and methodsQualitative data were obtained using 1:1 interviews and focus groups with spouses/partners of US military service members (active duty, Reserve, National Guard, recently separated from the military) and representatives from military support organisations. Sessions focused on personal firearm storage (at home or on military installations) and military messaging around secure firearm storage and firearm suicide prevention. Data were analysed using a team-based, mixed deductive–inductive approach.ResultsAcross 56 participants (August 2022–March 2023), the themes were variability in current home firearm storage and spousal participation in decision-making; uncertainty about firearm storage protocols on military installations; mixed awareness of secure firearm storage messaging from the military; and uncertainty about procedures or protocols for removing firearm access for an at-risk person.ConclusionUS military spouses are important messengers for firearm safety and suicide prevention, but they are currently underutilised. Tailored prevention campaigns should consider spousal dynamics and incorporate education about installation procedures.
Trends in utilisation of palliative care services in COVID-19 patients and their impact on hospital resources in the USA: insights from the national inpatient sample
Authors: Garg Ishan , Gangu Karthik , Zabel Kenneth Matthew , Shuja Hina , Sohail Amir Humza , Nasrullah Adeel , Sohail Sachal , Combs Sara A , Sheikh Abu Baker 
Published: December 2023

ObjectivesPoor prognosis and lack of effective therapeutic options have made palliative care an integral part of the management of severe COVID-19. However, clinical studies on the role of palliative care in severe COVID-19 patients are lacking. The objective of our study was to evaluate the utility of palliative care in intubated COVID-19 patients and its impact on in-hospital outcomes.MethodsRate of palliative care consult, patient-level variables (age, sex, race, income, insurance type), hospital-level variables (region, type, size) and in-hospital outcome variables (mortality, cost, disposition, complications) were recorded.ResultsWe retrospectively analysed 263 855 intubated COVID-19 patients using National Inpatient Sample database from 1 January 2020 to 31 December 2020. 65 325 (24.8%) patients received palliative care consult. Factors associated with an increased rate of palliative care consults included: female gender (p<0.001), older age (p<0.001), Caucasian race (p<0.001), high household income (p<0.001), Medicare insurance (p<0.001), admission to large-teaching hospitals (p<0.001), patients with underlying comorbidities, development of in-hospital complications and the need for intensive care procedures. Patients receiving palliative consults had shorter hospital length of stay (LOS) (p<0.001) and no difference in hospitalisation cost (p=0.15).ConclusionsPalliative care utilisation rate in intubated COVID-19 patients was reflective of disease severity and disparities in healthcare access. Palliative care may help reduce hospital LOS. Our findings also highlight importance of improving access to palliative care services and its integration into the multidisciplinary management of severe COVID-19 patients.
Retro-Antegrade Technique in the Management of Severely Angulated Fourth and Fifth Metacarpal Neck Fractures: A Case Series
Authors: McMAHON Mary Ellen , IBRAHIM Safwat 
Published: December 2023

Background: This study introduces a novel method for the management of closed metacarpal neck fractures. Kirschner wires (K-wire) are introduced in a retrograde and the wires withdrawn through skin proximally at the base of the metacarpal. The fracture is reduced using traction and the reduction is maintained by antegrade advancement of the K-wires. The aim of this study is to report the outcomes of this technique. Methods: A total of 36 patients with severely angulated closed metacarpal neck fractures underwent reduction and fixation using this novel method from January 2017 to December 2020 in centres in Ireland and Saudi Arabia. We performed a retrospective review of these patients’ clinical data examining their outcomes. Results: Six months postoperatively, all fractures demonstrated bony union and correction of angulation. All patients exhibited excellent range of motion (ROM) with no significant impairment of hand function. Conclusions: The method detailed here is a simple, minimally invasive and reliable technique that has not previously been described. It is suitable for use in the management of closed metacarpal neck fractures of the fourth and fifth metacarpal, with dorsal angulation greater than 60°. Level of Evidence: Level IV (Therapeutic)
Does Hearing Impairment Impact Spatial Orientation, Navigation, and Rotation Abilities?
Authors: Avci Nizamettin Burak , Cicek Cinar Betul 
Published: December 2023

Objectives: Spatial cognition is a perceptual-motor function that pertains to the comprehension and processing of two-dimensional and three-dimensional space. The impairment of any sensory system can have adverse effects on cognitive functioning. The objective of this study is to examine spatial cognition in adults with hearing impairments. Methods: There were a total of 61 individuals in this study: thirty-six with hearing loss and 25 with normal hearing. The Spatial Orientation Test (SOT), the Mental Rotation test (MR), and the Money’s Road Map Test (RMT) were administered to assess participants’ spatial learning-orientation, mental imagery-rotation, and spatial navigation abilities. A high number of errors in RMT, high angle difference in SOT and a low score in MR suggest poor spatial abilities. Results: Participants with hearing loss had a greater number of RMT errors and SOT angle difference, but lower MR scores than those with normal hearing ( P < .001). Hearing impairment negatively impacted all 3 spatial cognitive assessments. Hearing loss was associated with a 6.9 increase in the number of RMT errors (95% Confidence Interval (CI): 4.8, 9), a 23.6 increase in the SOT angle difference (95% CI: 16, 31.2), and an 8.5 decrease in the MR score (95% CI: −10.8, −6.2). Conclusions: The study found that individuals with hearing loss exhibited lower performance in various cognitive tasks related to spatial orientation, navigation, spatial learning, mental imagery, and rotation abilities when compared to an age and sex matched control group. In future study, it is imperative to place greater emphasis on hearing loss as a potential detrimental factor in the prediction of spatial cognition impairment.
Priorities for the G20 Finance Track
Authors: Eichengreen Barry , Gupta Poonam 
Published: December 2023

Emerging markets and developing economies are currently facing major challenges from global shocks, including a slowdown in global growth; food and energy price increases; decline in risk appetite of international investors; unsustainable debts in low-income countries; and ongoing climate risks. National policies have not sufficed to meet these challenges. Efforts at the national level must be complemented by changes in the global economic and financial architecture designed to make the world a safer place. In this article, we focus on the financial aspects of such reforms. The financial agenda as we see it has seven key elements: (i) reform of central bank swap lines, (ii) reform of IMF-contingent credit lines, (iii) SDR reallocation, (iv) reform of credit rating agencies, (v) creation of currency hedging instruments, (vi) inclusion of climate-resilient debt clauses in new debt instruments and (vii) steps to streamline the debt restructuring process. We detail this agenda and urge the G20 members to implement the recommended measures. JEL Codes: E44, E58, E61, F34, F36, F38