bluuebunny/crossref_metadata_2025_split huggingface dataset:
Structural and functional abnormalities of the tongue: An epidemiological study from a tertiary care center
Authors: Piplani Angela , Kumar Mathangi , Vineetha Ravindranath , Srinivasan Ranjanee , Pentapati Kalyana Chakravarthy 
Published: July 2023

Background: The tongue is a prominent muscular organ of the oral cavity and the integrity of the tongue mucosa frequently can reflect the overall health of an individual. There are a number of notable structural and functional alterations that can affect the tongue. These changes may be symptomatic or asymptomatic. Hence, the aim of the present study was to determine the prevalence of structural and functional abnormalities of the tongue in a population reporting to a tertiary care center. We also assessed the prevalence of the normal variants and evaluated the normal tongue protrusion measurement in the study population. Methods: The cross-sectional study included 1,143 dental outpatients above 18 years of age who visited the Department of Oral Medicine and Radiology between October 2021 and February 2022. Demographic details of the patients were noted. Participants were asked questions regarding any symptoms or abnormalities noticed pertaining to tongue. The tongue was examined thoroughly for any structural/ functional abnormalities. The maximal tongue protrusion for each participant was measured by asking them to extend the tongue out. Medical history, drug history and social history were recorded. Results: The study included 564 male and 579 female participants; tongue lesions were positive in 66.5% of the study population. Coated tongue (26.2%) was the most frequent structural abnormality that was noted in the present study. Taste dysfunction (4.6%) was the most frequent functional abnormality. The lesions were most in the anterior two thirds (4.2%) of the tongue. Conclusions: The results of the present study showed that tongue lesions were present in 66.5% of the population. Careful and detailed evaluation of the tongue examination is mandated in routine dental checkup. This shall help in prompt identification of various etiological factors causing structural and functional abnormalities of the tongue.
Epidemiology of traumatic spinal fractures in patients aged 50 years or less at a center in Saudi Arabia from 2005 to 2016
Authors: Aldakheel Dakheel , Ali Mir Sadat , Alothman Abdullah , Alsayed Hassan , Amer Ahmad Sh , Alhassan Mohammad A , Mutawwam Ibrahim M , Alhawas Abdulaziz M , Alshehri Abdulhakem H , Alabdullah Hussain A , Alkhateeb Mohammed A 
Published: July 2023

Background: We retrospectively reviewed traumatic spinal fractures (TSFs), including their mechanisms of injury and associated injuries in patients aged ≤50 years admitted to our center over a period of 11 years. Our secondary objective was to investigate whether spine injuries have decreased since the introduction of new transportation-related legislation applications. Methods: Between 2005 and 2016, all patients admitted to the hospital due to TSFs, including cervical, thoracic, and lumbar spinal fractures, who were aged ≤50 years were included in this study. Patient demographics, mechanism of injury, associated injuries, hospital stay duration, treatment, complications, and mortalities were reviewed and analyzed. Results: Altogether, 373 patients (81% male; 19% female; median age, 28 years) were included in the study, and 579 spinal fractures were identified. The lumbar spine was the most affected part. The most common injury mechanism was motor vehicle accidents (MVA) (69.7%), followed by falls (26.8%). Neurological injuries were detected in 9.4% of patients. Associated injuries were observed in 45.3% of patients, and 33.6% of patients were surgically treated. Thoracic injuries and lower limb fractures were the most common injuries, and the postoperative complication rate was 3.9%. Conclusions: Although there was a significant decrease in TSFs after the speed control legislation over the study period, MVA and falls remained the most common causes of spinal injuries. Associated injuries, operated patients, and female sex were all associated with a prolonged hospital stay.
Optimal Electricity Imbalance Pricing for the Emerging Penetration of Renewable and Low-Cost Generators
Authors: Ghiassi-Farrokhfal Yashar , Belo Rodrigo , Hesamzadeh Mohammad Reza , Bunn Derek 
Published: July 2023

Problem definition: With the rise of renewables and the decline of fossil fuels, electricity markets are shifting toward a capacity mix in which low-cost generators (LCGs) are dominant. Within this transition, policymakers have been considering whether current market designs are still fundamentally fit for purpose. This research analyses a key aspect: the design of real-time imbalance pricing mechanisms. Currently, markets mostly use either single pricing or dual pricing as their imbalance pricing mechanisms. Single-pricing mechanisms apply identical prices for buying and selling, whereas dual-pricing mechanisms use different prices. The recent harmonization initiative in Europe sets single pricing as the default and dual pricing as the exception. This leaves open the question of when dual pricing is advantageous. We compare the economic efficiency of two dual-pricing mechanisms in current practice with that of a single-pricing design and identify conditions under which dual pricing can be beneficial. We also prove the existence of an optimal pricing mechanism. Methodology/results: We first analytically compare the economic efficiency of single-pricing and dual-pricing mechanisms. Furthermore, we formulate an optimal pricing mechanism that can deter the potential exercise of market power by LCGs. Our analytical results characterize the conditions under which a dual pricing is advantageous over a single pricing. We further compare the economic efficiency of these mechanisms with respect to our proposed optimal mechanism through simulations. We show that the proposed pricing mechanism would be the most efficient in comparison with others and discuss its practicability. Managerial implications: Our analytical comparison reveals market conditions under which each pricing mechanism is a better fit and whether there is a need for a redesign. In particular, our results suggest that existing pricing mechanisms are adequate at low/moderate market shares of LCGs but not for the high levels currently envisaged by policymakers in the transition to decarbonization, where the optimal pricing mechanism will become more attractive.Funding: R. Belo acknowledges funding by Fundação para a Ciência e a Tecnologia [UIDB/00124/2020, UIDP/00124/2020 and Social Sciences DataLab – PINFRA/22209/2016], POR Lisboa, and POR Norte [Social Sciences DataLab, PINFRA/22209/2016].Supplemental Material: The e-companion is available at https://doi.org/10.1287/msom.2021.0555 .
Utilization of mobile health applications and determinant factors among health science students at Debre Markos University, northwest Ethiopia in 2022
Authors: Hailiye Teferi Gizaw , Tadele Maru Meseret , Tizazu Getaye , Hordofa Zegeye Regasa , Shimie Aynadis Worku , Assaye Bayou Tilahun , Senishaw Andualem Fentahun , Tizie Sefefe Birhanu 
Published: July 2023

Background
High penetration of smartphones and ownership among the young generation increased the utilization of mobile health applications for health management among university students more than ever. Compared to other health service provision mechanisms mobile health service has higher advantages in promoting a healthy lifestyle since it is not limited to time and space. Even though there are numerous studies conducted in the area of mobile health utilization, this phenomenon is not well studied among university students in Ethiopia, Hence this study aims to determine the level of mobile health applications utilization among health science students.

Method
A cross-sectional study was carried out at Debre Markos University from April 05 to June 25, 2022 among health science students. For this study, 423 students were recruited from health Science College using a systematic sampling method. The data was gathered using a self-administered questionnaire. Using SPSS version 26 software descriptive analysis, bivariate and multivariable logistic regressions were performed. A P-value of .05 at a 95% confidence interval was considered statistically significant. The questionnaire’s validity was determined by expert opinion, and by calculating its reliability using cronbach alpha (α = .78).

Result
This study revealed that more than half 59% (144/244) of the study participants have installed and utilized 1–3 health-related apps. Among the students who have mobile health applications 38.6% utilize mobile health application several times a day while only 2.1% utilized rarely. Usage history shows that 40% of the study participants utilized the applications for a year, while 15.4% of the students utilized them for more than 2 years. Easiness of applications (AOR = 4.8, 95%CI: [2.1–11.2]), skill AOR = 4.2, 95%CI: [3.8–12]) and trust (AOR = 2.8, 95%CI: [1.6–4.8]) were among the factors that were associated with mobile health applications utilization. Students were asked about the barriers that limit the use mobile health applications and self-reported barriers includes Lack of knowledge and awareness of application benefits, and Lack of adequate time to use applications.

Conclusion
The study shows that mobile health applications utilization is moderate relative to previous studies. Mobile health application developers for the young generation should consider healthy lifestyle related applications like fitness and weight loss apps.
The effects of caffeine and d-amphetamine on spatial span task in healthy participants
Authors: Kassim Faiz M. , Lim J. H. Mark , Slawik Sophie V. , Gaus Katharina , Peters Benjamin , Lee Joseph W. Y. , Hepple Emily K. , Rodger Jennifer , Albrecht Matthew A. , Martin-Iverson Mathew T. 
Published: July 2023

Studies that examined the effect of amphetamine or caffeine on spatial working memory (SWM) and verbal working memory (VWM) have used various tasks. However, there are no studies that have used spatial span tasks (SSTs) to assess the SWM effect of amphetamine and caffeine, although some studies have used digit span tasks (DST) to assess VWM. Previous reports also showed that increasing dopamine increases psychosis-like experiences (PLE, or schizotypy) scores which are in turn negatively associated with WM performance in people with high schizotypy and people with schizophrenia. Therefore, the present study aimed to examine the influence of d-amphetamine (0.45 mg/kg, PO), a dopamine releasing stimulant, on SST, DST, and on PLE in healthy volunteers. In a separate study, we examined the effect of caffeine, a nonspecific adenosine receptor antagonist with stimulant properties, on similar tasks.Methods:Healthy participants (N = 40) took part in two randomized, double-blind, counter-balanced placebo-controlled cross-over pilot studies: The first group (N = 20) with d-amphetamine (0.45 mg/kg, PO) and the second group (N = 20) with caffeine (200 mg, PO). Spatial span and digit span were examined under four delay conditions (0, 2, 4, 8 s). PLE were assessed using several scales measuring various aspects of psychosis and schizotypy.Results:We failed to find an effect of d-amphetamine or caffeine on SWM or VWM, relative to placebo. However, d-amphetamine increased a composite score of psychosis-like experiences (p = 0.0005), specifically: Scores on Brief Psychiatric Rating Scale, Perceptual Aberrations Scale, and Magical Ideation Scale were increased following d-amphetamine. The degree of change in PLE following d-amphetamine negatively and significantly correlated with changes in SWM, mainly at the longest delay condition of 8 s (r = -0.58, p = 0.006).Conclusion:The present results showed that moderate-high dose of d-amphetamine and moderate dose of caffeine do not directly affect performances on DST or SST. However, the results indicate that d-amphetamine indirectly influences SWM, through its effect on psychosis-like experiences.Trial registration. Clinical Trial Registration Number:CT-2018-CTN-02561 (Therapeutic Goods Administration Clinical Trial Registry) andACTRN12618001292268(The Australian New Zealand Clinical Trials Registry) for caffeine study, andACTRN12608000610336for d-amphetamine study.
Exploring the barriers and facilitators to the uptake of smoking cessation services for people in treatment or recovery from problematic drug or alcohol use: A qualitative systematic review
Authors: Iyahen Eric Osayemwenre , Omoruyi Osazee Omoregbe , Rowa-Dewar Neneh , Dobbie Fiona 
Published: July 2023

Background
Smoking prevalence and the associated poor health and mortality is significantly higher among people with/recovering from problematic drug or alcohol (PDA) use in comparison with the general population. Evidence from existing systematic reviews shows smoking cessation enhances rather than compromises long-term abstinence from alcohol or drug use. However, these systematic reviews lack important contextual detail around the reasons why uptake of, and successful engagement with existing stop smoking services remains low for people in treatment or recovery from PDA use. This systematic review explores qualitative data on the barriers and facilitators to the uptake of smoking cessation services for people in treatment or recovery from PDA use. This key objective addresses the limited inclusion of qualitative studies in previous systematic reviews on this issue.

Methods
A qualitative systematic review was conducted with searches across four electronic databases (PubMed, Embase, PsycINFO and Cumulative Index to Nursing and Allied Health Literature [CINAHL]). All studies that had a qualitative component about free smoking cessation/reduction programmes for people in treatment or recovery from PDA use were included. Studies that examined electronic smoking or services that required a fee were excluded. Study quality was assessed using National Institute for Health and Care Excellence checklist. Qualitative synthesis involved inductive thematic analysis. (PROSPERO Registration number: CRD42022298521).

Results
8809 potentially eligible articles were identified, 72 full texts were screened and ten articles were included for full review. Barriers to uptake and engagement with existing stop smoking services centered on three key themes: perception of public health importance, programme structure, and intervention elements. Facilitators included supportive treatment environment and optimization of support/staff resources for smoking cessation service delivery.

Conclusion
Recommendations included influencing a change in the way people perceive the importance of smoking cessation activities during PDA use treatment or recovery. There was also some emphasis on the need to create the right environment for sustained adherence to treatment or recovery plans, and deliver the interventions within the health system as comprehensive care. The limited qualitative evidence on community-based and outpatient services highlights a research gap.
Latrine utilization and associated factors among districts implementing and not-implementing community-led total sanitation and hygiene in East Wollega, Western Ethiopia: A comparative cross-sectional study
Authors: Shama Adisu Tafari , Terefa Dufera Rikitu , Geta Edosa Tesfaye , Cheme Melese Chego , Biru Bayise , Feyisa Jira Wakoya , Lema Matiyos , Desisa Adisu Ewunetu , Feyisa Bikila Regassa , Gebre Dejene Seyoum 
Published: July 2023

IntroductionDischarge of excreta to the environment lead to surface and groundwater contamination and human exposure to disease-causing micro-organisms. There is limitation of evidences regarding the latrine utilization among community-led total sanitation and hygiene implemented and non-implemented districts of the East Wollega Zone. Hence, this study aimed to determine the magnitude and associated factors of latrine utilization among households in community-led total sanitation and hygiene implemented and non-implemented Districts in East Wollega Zone, Western Ethiopia.MethodsA cross-sectional study was conducted. A Multi-stage sampling technique was applied to select the 461 households. Data were collected using interviews and observations guided by a pre-structured questionnaire. Data were entered using Epi Data and exported to SPSS software version 25 for data recording, cleaning, and statistical analysis. Bivariable logistic regression was run to identify the candidate variables at p-value <0.25. Variables that had associations with latrine utilization in the bi-variable analysis were entered together into multivariable logistic regression. An Adjusted odds ratio with a 95% confidence interval was calculated and P-value< 0.05 was used to declare a statistically significant association.ResultThe overall prevalence of latrine utilization was found to be 52.7% (95%CI:48%, 57.3%). Religion (AOR = 0.149;95%CI:0.044,0.506), education (AOR = 3.861;95%CI:1.642,9.077), occupation, absence of children <5 years (AOR = 4.724;95%CI:2.313,9.648), toilet cleaning (AOR = 10.662;95%CI:5.571,20.403), frequency of latrine construction (AOR = 6.441;95%CI:2.203,18.826), maintenance need (AOR = 6.446; 95%CI:3.023,13.744), distance from health institution (AOR = 0.987; 95%CI:0.978, 0.996), distance from kebele office (AOR = 6.478; 95%CI:2.137,19.635), and latrine distance from dwelling (AOR = 11.656; 95%CI:2.108, 64.44) were the factors associated with latrine use.ConclusionThe latrine utilization in this study is low as compared to other studies. Religion, education, occupation, absence of children <5 years, toilet cleaning, frequency of latrine construction, maintenance need of the toilet, distance from health institution, distance from kebele, and latrine distance from dwelling are the associated factors of latrine utilization. Both households and health workers have to work together to improve latrine utilization and the safe disposal of children’s feces.
Effects of improved on-farm crop storage on perceived stress and perceived coping in pregnant women—Evidence from a cluster-randomized controlled trial in Kenya
Authors: Eichenauer Heike , Huss Matthias , Brander Michael , Bernauer Thomas , Ehlert Ulrike 
Published: July 2023

Background
Food insecurity can be harmful to pregnant women, as pregnancy is a challenging period with increased maternal nutritional requirements to ensure optimal fetal development and health of the mother. Whether food insecurity negatively affects maternal health may depend on how stressful pregnant women perceive this food insecurity to be and how strongly they believe they can cope with it. In Sub-Saharan Africa (SSA), pregnant women from smallholder households suffer from food insecurity due to post-harvest losses (PHL), i.e., loss of crops because of inadequate storage. An agricultural intervention that improves crop storage has been shown to reduce food insecurity. However, it remains to be determined whether this agricultural intervention (treatment) has an additional positive effect on pregnant women’s perceived stress levels and coping abilities. This study examines whether pregnant women from treatment households experience lower perceived stress levels and higher perceived coping abilities compared to pregnant women from control housholds.

Methods and findings
In a randomized controlled trial (RCT), short message service (SMS)-based mobile phone surveys were conducted to assess the causal effect of a food security intervention (improved on-farm storage of maize) on perceived stress and coping in pregnant women from smallholder households. Pregnant women were identified through these monthly surveys by asking whether someone in their household was currently pregnant. The significant results revealed that pregnant women from treatment households experienced more perceived stress but better perceived coping abilities compared to pregnant women from control households. Uncertainty due to lack of experience, this might have contributed to the higher perceived stress, as the women could not easily judge the benefits and risks of the new storage technology. However, the technology itself is a tangible resource which might have empowered the pregnant women to counteract the effects of PHL and thus food insecurity.

Conclusion
Our findings indicate that pregnant women from treatment households had higher perceived coping abilities but experienced more perceived stress. More research is needed on how this technology impacts maternal mental health in a broader sense and whether biological mechanisms, such as epigenetics, may underlie this association.
Neural network-based method to stratify people at risk for developing diabetic foot: A support system for health professionals
Authors: Ferreira Ana Cláudia Barbosa Honório , Ferreira Danton Diego , Barbosa Bruno Henrique Groenner , Aline de Oliveira Uiara , Aparecida Padua Estefânia , Oliveira Chiarini Felipe , Baena de Moraes Lopes Maria Helena 
Published: July 2023

Background and objective
Diabetes Mellitus (DM) is a chronic disease with a high worldwide prevalence. Diabetic foot is one of the DM complications and compromises health and quality of life, due to the risk of lower limb amputation. This work aimed to build a risk classification system for the evolution of diabetic foot, using Artificial Neural Networks (ANN).

Methods
This methodological study used two databases, one for system design (training and validation) containing 250 participants with DM and another for testing, containing 141 participants. Each subject answered a questionnaire with 54 questions about foot care and sociodemographic information. Participants from both databases were classified by specialists as high or low risk for diabetic foot. Supervised ANN (multi-layer Perceptron—MLP) models were exploited and a smartphone app was built. The app returns a personalized report indicating self-care for each user. The System Usability Scale (SUS) was used for the usability evaluation.

Results
MLP models were built and, based on the principle of parsimony, the simplest model was chosen to be implemented in the application. The model achieved accuracy, sensitivity, specificity, positive predictive value, and negative predictive value of 85%, 76%, 91%, 89%, and 79%, respectively, for the test data. The app presented good usability (93.33 points on a scale from 0 to 100).

Conclusions
The study showed that the proposed model has satisfactory performance and is simple, considering that it requires only 10 variables. This simplicity facilitates its use by health professionals and patients with diabetes.