bluuebunny/crossref_metadata_2025_split huggingface dataset:
Intelligent contour extraction approach for accurate segmentation of medical ultrasound images
Authors: Peng Tao , Wu Yiyun , Gu Yidong , Xu Daqiang , Wang Caishan , Li Quan , Cai Jing 
Published: August 2023

Introduction: Accurate contour extraction in ultrasound images is of great interest for image-guided organ interventions and disease diagnosis. Nevertheless, it remains a problematic issue owing to the missing or ambiguous outline between organs (i.e., prostate and kidney) and surrounding tissues, the appearance of shadow artifacts, and the large variability in the shape of organs.Methods: To address these issues, we devised a method that includes four stages. In the first stage, the data sequence is acquired using an improved adaptive selection principal curve method, in which a limited number of radiologist defined data points are adopted as the prior. The second stage then uses an enhanced quantum evolution network to help acquire the optimal neural network. The third stage involves increasing the precision of the experimental outcomes after training the neural network, while using the data sequence as the input. In the final stage, the contour is smoothed using an explicable mathematical formula explained by the model parameters of the neural network.Results: Our experiments showed that our approach outperformed other current methods, including hybrid and Transformer-based deep-learning methods, achieving an average Dice similarity coefficient, Jaccard similarity coefficient, and accuracy of 95.7 ± 2.4%, 94.6 ± 2.6%, and 95.3 ± 2.6%, respectively.Discussion: This work develops an intelligent contour extraction approach on ultrasound images. Our approach obtained more satisfactory outcome compared with recent state-of-the-art approaches . The knowledge of precise boundaries of the organ is significant for the conservation of risk structures. Our developed approach has the potential to enhance disease diagnosis and therapeutic outcomes.
Assessment of risk factors for suicidal behavior: results from the Tehran University of Medical Sciences Employees' Cohort study
Authors: Rezaei Zahed , Mohammadi Samira , Aghaei Abbas , Pouragha Hamidreza , Latifi Arman , Keshavarz-Mohammadi Nastaran 
Published: August 2023

IntroductionSuicide is a major issue of concern for public health. It is estimated that suicide accounts for 700,000 deaths every year. A personal history of one or more suicide attempts is the most important determinant of suicide among the general population. This study aimed to assess the major risk factors associated with suicidal behaviors among Iranian employees in a medical setting.MethodsIn this study, 3,913 employees of Tehran University of Medical Sciences who participated in the employees' cohort study conducted by the university were recruited. Suicidal behaviors (SBs) and their associated risk factors were evaluated using the World Mental Health Composite International Diagnostic Interview (CIDI) Version 3.0. Univariate and multivariate logistic regressions were performed to identify the determinants of SBs among the participants, and crude and adjusted odds ratios (ORs) with corresponding 95% confidence intervals (95% CIs) were calculated.ResultsOverall, 49.6% of respondents (n= 1,939) reported that they were tired of life and thinking about death. The lifetime prevalence rate of suicidal ideation (SI) was 8.1% (n= 317), that of suicide planning (SP) was 7.3% (n= 287), and that of suicide attempts (SA) was 3.1% (n= 122). Being female (OR: 1.87, CI: 1.64–2.12), being divorced (OR: 3.13, CI: 1.88–5.22), having a low level of education (OR: 1.57, CI: 1.15–2.14), and working in clinical and medical services (OR: 1.25, CI: 1.09–1.43) were associated with being tired of life and thinking about death. These factors were also associated with SI, SP, and SA.DiscussionThese findings highlight the need to prioritize mental health for suicide prevention, especially for high-risk groups, in workplace mental health promotion programs and policies.
Are relative educational inequalities in multiple health behaviors widening? A longitudinal study of middle-aged adults in Northern Norway
Authors: Ibarra-Sanchez Ana Silvia , Chen Gang , Wisløff Torbjørn 
Published: August 2023

IntroductionEducational inequality in multiple health behaviors is rarely monitored using data from the same individuals as they age. The aim of this study is to research changes in relative educational inequality in multiple variables related to health behavior (smoking, physical activity, alcohol intake, and body mass index), separately and collectively (healthy lifestyle), among middle-aged adults living in Northern Norway.MethodsData from adult respondents aged 32–87 in 2008 with repeated measurements in 2016 (N = 8,906) were drawn from the sixth and seventh waves of the Tromsø Study. Logistic regression was used to assess the relative educational inequality in the variables related to health behavior. The analyses were performed for the total sample and separately for women and men at both baseline and follow-up.ResultsEducational inequality was observed in all the variables related to health behavior at baseline and follow-up, in both men and women. Higher levels of educational attainment were associated with healthier categories (non-daily smoking, physical activity, normal body mass index, and a healthy lifestyle), but also with high alcohol intake. The prevalence of daily smoking and physical inactivity decreased during the surveyed period, while high alcohol intake, having a body mass index outside of the normal range and adhering to multiple health recommendations simultaneously increased. The magnitude of relative educational inequality measured at baseline increased at the follow-up in all the variables related to health behavior. Differences were larger among women when compared to men, except in physical inactivity.ConclusionPersistent and increasing relative disparities in health behavior between the highest education level and lower education levels are found in countries with well-established and comprehensive welfare systems like Norway. Addressing these inequalities is essential for reducing both the chronic disease burden and educational disparities in health.
Perceptions of the health risk from hot days and the cooling effect of urban green spaces: a case study in Xi’an, China
Authors: Zhang Tian , Huang Rong , Yang Mei , Lin Guohua , Ma Xiaoyan , Wang Xuan , Huang Qian 
Published: August 2023

BackgroundHot days are one of the typical threats to human health and sustainable cities. The exploration of residents’ perceptions of thermal environment and its mitigation measures will support the health risk prevention.MethodsA survey with a combination of closed-ended and open-ended questions was conducted in July 2021 among 13 urban parks in Xi’an City, China. With the help of ANOVA and ordinal logistic regression, this study investigated the influencing factors both on residents’ health risk perception of hot days and their perception of the effect of urban ecological landscape on reducing the thermal risk. The relationship between health risk perception and residents’ needs of urban ecological construction was also explored.ResultsAccording to 325 valid questionnaires, the male-female ratio of respondents was found to be 1:0.87, young people aged 18-29 (26.46%), the retirees (27.08%) and the ones with undergraduate education (33.23%) were, relatively, the largest groups. The results show that 92.31% of the respondents believed that their daily lives were under the influence of hot days. Housing types, occupation, cooling equipment at work, and outdoor working hours all had a significant impact on their high temperature perceptions. The proportion of respondents who were under a huge health risk and sought medical treatment due to hot days was 30.16% and 44.92%, respectively. Women were 18.52 and 2.33 times more likely to suffer health threats and experience discomforts than men. Furthermore, 73.23% of the respondents believed that the urban ecological landscapes in Xi’an had an enhanced cooling effect in recent years. Compared with the morphological characteristics, residents’ recognition of the restriction of landscape’s area on its cooling effect was higher, and the residence duration showed a significant influence.ConclusionThe cooling effect of green spaces and water effectively resisted urban thermal threats, and residents’ needs of the urban ecological landscapes was associated with their health risk perceptions of hot days. In the future, it is necessary to promote the early warning of hot days, meanwhile, the optimization of landscape patterns of green infrastructures should be implemented in urban planning for the purposes of residents’ health risk prevention.
Evolutionary game and stability analysis of elderly care service quality supervision from the perspective of government governance
Authors: Wang Qiangxiang , Liu June , Zheng Yue 
Published: August 2023

ObjectiveThe performance of government functions is an important guarantee for the standardized operation of the elderly service market. The objective of this study is to explore the optimal path for the government to govern the elderly care service market.MethodsThe tripartite evolutionary game model is proposed in the paper, which composed of local governments, private elderly care institutions and the public. Furthermore, three mechanisms, i.e. dynamic penalty and static subsidy, static penalty and dynamic subsidy, dynamic penalty and dynamic subsidy, are designed. Under these different mechanisms, the stability of each subject’s strategy choice is analyzed by using system dynamics simulation.ResultsThe introduction of dynamic mechanisms can compensate for the inability of static mechanisms to bring the system to a steady state. The dynamic penalty and dynamic subsidy mechanism allows the system to evolve to the desired point of stability. The self-discipline behavior of private elderly care institutions is positively correlated with penalties and reputation gains-losses, negatively correlated with subsidies, and not correlated with supervision rewards. Excessive subsidies will promote the collusion of private elderly institutions.ConclusionOnly when the local government adopts the dynamic penalty and dynamic subsidy mechanism will private elderly care institutions choose to operate in a fully self-disciplined manner. Reasonable adjustments of penalties, reputation gains-losses and subsidies can not only further optimize the dynamic penalty and dynamic subsidy mechanism, but also help to achieve diversified regulatory objectives of the government. This study would provide a reference for local governments seeking to develop effective regulatory policies for the elderly service market.
Racial and ethnic disparities in telehealth use before and after California's stay-at-home order
Authors: Bustamante Arturo Vargas , Martínez Laura E. , Jalal Siavash , Benitez Santos Nayelie , Félix Beltrán Lucía , Rich Jeremy , Anaya Yohualli Balderas-Medina 
Published: August 2023

IntroductionTelehealth can potentially improve the quality of healthcare through increased access to primary care. While telehealth use increased during the COVID-19 pandemic, racial/ethnic disparities in the use of telemedicine persisted during this period. Little is known about the relationship between health coverage and patient race/ethnicity after the onset of the COVID-19 pandemic.ObjectiveThis study examines how differences in patient race/ethnicity and health coverage are associated with the number of in-person vs. telehealth visits among patients with chronic conditions before and after California's stay-at-home order (SAHO) was issued on 19 March 2020.MethodsWe used weekly patient visit data (in-person (N = 63, 491) and telehealth visits (N = 55, 472)) from seven primary care sites of an integrated, multi-specialty medical group in Los Angeles County that served a diverse patient population between January 2020 and December 2020 to examine differences in telehealth visits reported for Latino and non-Latino Asian, Black, and white patients with chronic conditions (type 2 diabetes, pre-diabetes, and hypertension). After adjusting for age and sex, we estimate differences by race/ethnicity and the type of insurance using an interrupted time series with a multivariate logistic regression model to study telehealth use by race/ethnicity and type of health coverage before and after the SAHO. A limitation of our research is the analysis of aggregated patient data, which limited the number of individual-level confounders in the regression analyses.ResultsOur descriptive analysis shows that telehealth visits increased immediately after the SAHO for all race/ethnicity groups. Our adjusted analysis shows that the likelihood of having a telehealth visit was lower among uninsured patients and those with Medicaid or Medicare coverage compared to patients with private insurance. Latino and Asian patients had a lower probability of telehealth use compared with white patients.DiscussionTo address access to chronic care management through telehealth, we suggest targeting efforts on uninsured adults and those with Medicare or Medicaid coverage, who may benefit from increased telehealth use to manage their chronic care.
Social interaction trajectories and all-cause mortality in older adults: the Otassha study
Authors: Kawai Hisashi , Ejiri Manami , Ito Kumiko , Fujiwara Yoshinori , Ihara Kazushige , Hirano Hirohiko , Sasai Hiroyuki , Kim Hunkyung , Obuchi Shuichi 
Published: August 2023

IntroductionThis longitudinal study aimed to identify aging trajectory patterns of social interaction by sex and determine the association between these patterns and all-cause mortality.MethodsParticipants were 4,065 community-dwelling older adults (1849 men) in Japan, aged 65–89 years, who responded twice or more to a mail survey conducted between 2012 and 2020. Social interaction was examined through the frequency of face-to-face and non-face-to-face contact with non-resident family and friends. The aging trajectories of the social interaction scores were identified using group-based trajectory modeling.ResultsTwo groups were identified among both men and women. Among men with high-frequency interaction, a rapid decrease in the frequency of social interaction was observed after 80 years of age. Conversely, among women, the frequency tended to remain the same, even after 80 years of age. The social interaction score among those aged 65 years in the low-frequency group was approximately 4 points for men and 6 points for women. Among men, no decrease was observed; however, it tended to decline after 85 years of age among women. Among men, the factors associated with the low-frequency group were instrumental activities of daily living score, perceived financial status, and social participation, while among women, they were self-rated health and social participation. The adjusted hazard ratio in the low-frequency group for all-cause mortality was 1.72 (95% confidence interval, 1.27–1.72) for men and 1.45 (95% confidence interval, 0.98–2.14) for women.DiscussionIn the low-frequency group, men had a higher risk of all-cause mortality than women. Daily social interaction from mid-age is important to reduce the risk of social isolation and all-cause mortality in later life.
Rural barriers and facilitators of lung cancer screening program implementation in the veterans health administration: a qualitative study
Authors: Lewis Jennifer A. , Bonnet Kemberlee , Schlundt David G. , Byerly Susan , Lindsell Christopher J. , Henschke Claudia I. , Yankelevitz David F. , York Sally J. , Hendler Fred , Dittus Robert S. , Vogus Timothy J. , Kripalani Sunil , Moghanaki Drew , Audet Carolyn M. , Roumie Christianne L. , Spalluto Lucy B. 
Published: August 2023

IntroductionTo assess healthcare professionals' perceptions of rural barriers and facilitators of lung cancer screening program implementation in a Veterans Health Administration (VHA) setting through a series of one-on-one interviews with healthcare team members.MethodsBased on measures developed using Reach Effectiveness Adoption Implementation Maintenance (RE-AIM), we conducted a cross-sectional qualitative study consisting of one-on-one semi-structured telephone interviews with VHA healthcare team members at 10 Veterans Affairs medical centers (VAMCs) between December 2020 and September 2021. An iterative inductive and deductive approach was used for qualitative analysis of interview data, resulting in the development of a conceptual model to depict rural barriers and facilitators of lung cancer screening program implementation.ResultsA total of 30 interviews were completed among staff, providers, and lung cancer screening program directors and a conceptual model of rural barriers and facilitators of lung cancer screening program implementation was developed. Major themes were categorized within institutional and patient environments. Within the institutional environment, participants identified systems-level (patient communication, resource availability, workload), provider-level (attitudes and beliefs, knowledge, skills and capabilities), and external (regional and national networks, incentives) barriers to and facilitators of lung cancer screening program implementation. Within the patient environment, participants revealed patient-level (modifiable vulnerabilities) barriers and facilitators as well as ecological modifiers (community) that influence screening behavior.DiscussionUnderstanding rural barriers to and facilitators of lung cancer screening program implementation as perceived by healthcare team members points to opportunities and approaches for improving lung cancer screening reach, implementation and effectiveness in VHA rural settings.
The Association Between Urinary Concentrations of Organophosphate Metabolites and Asthma-Related Outcomes Among Schoolchildren From Informal Settlements
Authors: Mthethwa Mashudu , Jeebhay Mohamed , Olaniyan Toyib , Wiesner Lubbe , Parker Bhawoodien , Leaner Joy , Röösli Martin , Dalvie Mohamed Aqiel 
Published: August 2023

Objectives: There is inconsistent evidence on the relationship between pesticide exposure and childhood respiratory outcomes in non-agricultural settings. This study investigated the association between organophosphate (OP) pesticide exposure and asthma-related outcomes in children residing in four informal settlements.Methods: The study was a longitudinal study of 590 schoolchildren, with a 12 months follow-up period. A standardised questionnaire adopted from the International Study of Asthma and Allergies in Childhood was administered to caregivers for child’s respiratory symptoms and household characteristics. Spirometry and fractional-exhaled nitric oxide, including a phadiatop test (atopy status) and urinary dialkyl phosphate (DAP) metabolites were measured at baseline and follow-up. DAP metabolites included diethylphosphate (DEP) and dimethyl phosphate (DMP) measured at baseline and follow-up and dimethylthiophosphate (DMTP) measured only at baseline.Results: The mean ages of schoolchildren were 9.9 ± 0.91 years and the overal incidence proportions of new doctor diagnosed asthma was 2.2%. No consistent patterns of increased risk of asthma outcomes with increasing DAP concentrations was found in multivariate analysis.Conclusion: Future studies with longer follow-up periods and repeated OP biomonitoring are recommended.
TOR Signaling Tightly Regulated Vegetative Growth, Conidiation, Oxidative Stress Tolerance and Entomopathogenicity in the Fungus Beauveria bassiana
Authors: So Lai-Hong , Jirakkakul Jiraporn , Salaipeth Lakha , Toopaang Wachiraporn , Amnuaykanjanasin Alongkorn 
Published: August 2023

Beauveria bassiana degenerates after repeated subcultures, demonstrating declined conidiation and insect virulence. The target of rapamycin (TOR) kinase conserved among eukaryotes is the master regulator of cellular physiology and is likely involved in culture degeneration. Indeed, the levels of TOR-associated proteins increase over successive subcultures. Here, CRISPR/Cas9 locus engineering introduced the inducible Tet-On promoter upstream of the TOR kinase 2 gene tor2 in B. bassiana. The mutant PTet-On tor2 ‘T41’ was verified for the Tet-On integration via PCR analyses and provided a model for evaluating the fungal phenotypes according to the tor2 expression levels, induced by doxycycline (Dox) concentrations. At 0 µg·mL−1 of Dox, T41 had 68% of the wild type’s (WT) tor2 expression level, hampered radial growth and relatively lower levels of oxidative stress tolerance, conidiation and virulence against Spodoptera exigua, compared to those under the presence of Dox. A low dose of Dox at 0.1–1 µg·mL−1 induced tor2 upregulation in T41 by up to 91% compared to 0 µg·mL−1 of Dox, resulting in significant increases in radial growth by 8–10% and conidiation by 8–27%. At 20 µg·mL−1 of Dox, which is 132% higher than T41’s tor2 expression level at 0 µg·mL−1 of Dox, T41 showed an increased oxidative stress tolerance and a decrease in growth inhibition under iron replete by 62%, but its conidiation significantly dropped by 47% compared to 0 µg·mL−1 of Dox. T41 at 20 µg·mL−1 of Dox had a strikingly increased virulence (1.2 day lower LT50) against S. exigua. The results reflect the crucial roles of TOR kinase in the vegetative growth, conidiation, pathogenicity and oxidative stress tolerance in B. bassiana. Since TOR upregulation is correlated with culture degeneration in multiple subcultures, our data suggest that TOR signaling at relatively low levels plays an important role in growth and development, but at moderate to high levels could contribute to some degenerated phenotypes, e.g., those found in successive subcultures.
Le rôle des facteurs psychologiques dans l’explication des fluctuations économiques et de leurs irrégularités
Authors: Johr Walter A. 
Published: August 2023

The part of psychological factors in the explanation of economic fluctuations and their irregularities.
The psychological factor is only one among the many factors determining fluctuations. The nolioA that business cycles are mechanically determined, that any irregularities in them are merely due to exogenous factors, is unsatisfactory. A causal explanation of cycles may be a sufficient one ; it is not necessarily the correct one.
The article recalls first the degree of integration of psychology-in economic analysis generally. It then deals with the pari played by psychology in the analysis of cyclical fluctuations : how does entrepreneurs’ behaviour reinforce or attenuate the cycle ? The elasticity of expectations concept is of little use in explaining entrepreneurs’ decisions : expectation is non-measurable and essentially uncertain, and uncertainly cannot be neutralised by insurance. The entrepreneur’s psychological environment is important as an explanation of his decisions : social psychology is interdependent ; the parallelisms it induces must be distinguished from those due to legislation, convention, coercion, etc. Transfers of feelings, ideas, motives, aims, take place in an «infectious» manner, sometimes with periods of incubation. The psychological factor explains much of the erratic nature of fluctuations. At the same lime the importance of the State as an economic agent gives it the means significantly to influence entrepreneurs’ behaviour.