bluuebunny/crossref_metadata_2025_split huggingface dataset:
Dental caries status and related factors of 5-year-old children in Shanghai
Authors: Liu Yanchen , Zeng Xiaoli , Zhang Hao , Jiang Yiwei , Wang Huning , Yu Jin , Da Dongxing , Chen Qiwen , Su Hongru , Wu Zhengang , Shi Hongyan , You Jiangtao , Zhang Ying 
Published: September 2023

Abstract
Background
Dental caries in young children is a difficult global oral health problem. In the last decade, China has put much effort into reducing the prevalence of caries. This study, which is part of the China Population Chronic Disease and Nutrition Surveillance 2021, aims to investigate the prevalence of dental caries among children aged 5 in Shanghai, China, and investigate the factors affecting the incidence of caries and the direction for future improvement.
Methods
A total of 1281 children aged 5 years from 6 districts in Shanghai were selected by a stratified sampling method. The survey consisted of an oral health questionnaire and an oral health examination. The questionnaire included questions on oral health knowledge, attitudes, and behaviours. Oral health examination using WHO standards. After screening, the data were input and analysed. Chi-square and logistic regression analyses were used to study the relevant factors affecting dental caries.
Results
The prevalence of caries in 1281 children was 51.0%, the dmft was 2.46±3.45, the Significant Caries Index (SiC) score was 6.39±2.40 and the SiC10 score was 10.35±3.17. Caries experience was related to the frequency of intaking sweet drinks, the age of starting tooth brushing, eating habits after brushing, whether they had received an oral examination provided by the government, and the mother's education level but was not related to gender, the use of fluoride toothpaste, the frequency of brushing, whether the parents assisted brushing, or the frequency of flossing. Logistic regression analysis showed that the region of young children, eating after brushing and the age of starting brushing were associated with caries.
Conclusions
The caries prevalence of 5-year-old children in Shanghai has been gradually reduced with the support of government investment and various policies, but it is still higher than that of developed countries. The government still needs to further increase investment and improve the oral awareness of the whole society.
Assessment of 3.0 Tesla Magnetic Resonance Imaging in Madelung's Deformity: Findings and Implications
Authors: Ma Yimin , Guo Zhe , Wang Ling , Wang Qianqian , Cheng Xiaoguang , Yan Dong 
Published: September 2023

Abstract
Objective
The aim of the study was to investigate the 3.0 Tesla magnetic resonance imaging (MRI) features of Madelung’s deformity.
Materials and Methods
The wrist MRI scans of 19 patients clinically diagnosed with Madelung’s deformity and 20 patients without deformity were consecutively selected from Beijing Jishuitan Hospital between April 2019 and December 2022 for observation, in the case group and control group, respectively.
Results
Madelung’s deformity significantly contributed to the tilt and thickening of the triangular fibrocartilage (TFC). In the case group, the tilting angle and thickness of TFC were (51.48 ± 9.78)° and (0.23 ± 0.06) cm, respectively, which was statistically significant (p < 0.001); the radial attachment of the TFC significantly shifted to the proximal side (χ2 = 39.00, p < 0.001), with a mean displacement of (0.97 ± 0.38) cm. Furthermore, the case demonstrated abnormally developed Vickers ligament (χ2 = 35.19, p < 0.001) and radiotriquetral ligament (χ2 = 25.66, p < 0.001).
Conclusion
MRI provides a notable advantage in diagnosing Madelung’s deformity. Compared with the control group, patients with Madelung's deformity exhibited thickening and tilting of the TFC. Additionally, the radial attachment of the fibrocartilage was significantly shifted to the proximal side with abnormal development of Vickers and radiotriquetral ligaments.
Comparative study of advanced exergy analysis of parabolic trough and linear Fresnel collectors
Authors: Maghsoudizadeh Mahdi , Ameri Mehran , Javaran Ebrahim Jahanshahi 
Published: September 2023

Abstract
Parabolic Trough collectors and Linear Fresnel reflectors are considered the most commonly used types of solar thermal systems. Numerous theoretical and practical research studies have been conducted on these collectors. The aim and the novelty of this research is to investigate and compare the performance of linear Fresnel and parabolic trough collectors from the perspective of advanced exergy analysis in order to determine the main irreversibility sources in each collector component and the potential for improving each component of the collector. The behavior of these two types of collectors in response to changes in solar radiation, collector length, flow rate, and fluid type is also analyzed. For this purpose, commercial collectors (Eurotrough ET100) and (LF-11) were selected for investigation. Simple and improved thermodynamic process methods were used to calculate the internal exergy destruction values for each component. Energy and exergy equations were solved using MATLAB software. The results indicate that the highest internal exergy destruction in both collectors is attributed to the absorber tube, but only a very small portion of it is avoidable. On the other hand, the highest avoidable internal exergy destruction occurs in the concentrator, making it the highest priority for technological improvements.
The causality between telomere length and chronic lung diseases: A Bidirectional Mendelian Randomization Analysis
Authors: Zhan Yuan , Gu Yiya , Yang Ruonan , Deng Zhesong , Chen Shanshan , Huang Qian , Wu Jixing , Chen Jinkun , Xie Jungang 
Published: September 2023

Abstract
Background
Previous studies have observed the abnormality in telomere biology and function during the process of chronic lung diseases (CLDs). However, whether alteration of telomere length (TL) causally facilitates the incidence of CLDs remains to be determined. Therefore, we here aim to estimate the causal effect of TL on the risk of CLDs using mendelian randomization (MR) analysis.
Methods
Single nucleotide polymorphisms (SNPs) strongly associated with TL and CLDs were selected as genetic variables from the genome-wide association studies (GWAS). A bidirectional two-sample MR analysis primarily based on inverse variance weighted (IVW) method was then conducted to infer the causality between TL and CLDs. Cochran’s Q test and MR-Egger regression analysis were performed to assess the heterogeneity and pleiotropy, and leave-one-out analysis was tested to determine the stability of MR results.
Results
The forward MR analysis indicated that among non-neoplastic CLDs, elevated TL was causally related to reduced risk of asthma (OR = 0.9986, 95%CI 0.9972–0.9999, P = 0.035), chronic obstructive pulmonary disease (COPD) (OR = 0.9987, 95%CI 0.9975–0.9999, P = 0.040), idiopathic pulmonary fibrosis (IPF) (OR = 0.9971, 95%CI 0.9961–0.9980, P < 0.001), and sarcoidosis (OR = 0.6820, 95%CI 0.5236–0.8884, P = 0.005). For neoplastic CLDs, increased TL genetically predicted higher risk of non-small cell lung cancer (OR = 1.8485, 95%CI 1.4074–2.4279, P < 0.001) and lung adenocarcinoma (OR = 1.9636, 95%CI 1.2275–3.1412, P = 0.005). However, there presented no significant causality between TL and pulmonary arterial hypertension, pneumoconiosis, small cell lung cancer and squamous cell lung cancer. Moreover, reverse MR analysis all showed no obvious causalities of CLDs with TL, except for sarcoidosis (OR = 0.9936, 95%CI 0.9887–0.9984, P = 0.010). Sensitivity analyses suggested the robustness of MR results with no horizonal pleiotropy despite of partial heterogeneity in reverse MR analysis.
Conclusions
Our study demonstrates that TL is causally associated with decreased risk of several non-neoplastic CLDs (asthma, COPD and IPF), whereas associated with increased risk of non-small cell lung cancer (especially adenocarcinoma). There’s mutual causality between TL attrition and sarcoidosis onset. This study comprehensively elucidated the causal associations between TL and CLDs, and might provide a promising target for the prevention of these CLDs.
The influence of widowhood and social engagement on cognitive impairment among Chinese older adults: mediation relations explored
Authors: Sheng Mingyuan , Young Kathleen , Ying Li , Zhang Yeyuan , Wang Jiale , Jiang Shuhan 
Published: September 2023

Abstract
Background:
The transition from marriage to widowhood involves an unavoidable role adjustment, which is one of the most traumatic and difficult life experiences for older adults. Studies on the impact of widowhood on cognitive impairment in later life continue to be explored and assessed, however, most of these studies have taken place in the United States and Europe. Although there are several studies focusing on the Chinese population, the role of how lifestyle changes after widowhood in this relationship are less studied. The objective of this study was to explore the mediating role of social engagement, health behaviors, and subjective well-being underlying the association between widowhood and cognitive impairment.
Method:
This study was conducted with 7,796 older individuals from the Chinese Longitudinal Healthy and Longevity Study (2018). We employed logistic regression models to analyze the effect of widowhood situation effect on cognitive health among older adults, and designed a mediation analysis to determine this possible mediator role.
Results:
The results showed widows and widowers had a much higher risk of having cognitive impairment than married older adults (95%CI = 1.312,2.279). The results from SEM provided a good fit to the observed data (χ2 = 24.909, p = 0.003, CMIN/DF = 2.768, CFI = 0.996, TLI = 0.986, RMSEA = 0.015, RMR = 0.007 and SRMR = 0.010)and indicated the effect of widowhood on cognitive impairment was partially mediated by social engagement, lifestyle behaviors and subjective-wellbeing (β = 0.075,p < 0.01).
Conclusions:
This study contributes to the existing knowledge on the mechanisms underlying the association between widowhood and cognitive impairment among older individuals. Consequently, it is imperative to formulate policies that cater to the distinct requirements of this vulnerable population, encompassing the maintenance of social interaction, adoption of a healthy lifestyle, enhancement of subjective well-being, and provision of necessary support systems.
Causal Association Between Multiple Sclerosis and Psoriasis: A Genetic Correlation and Mendelian Randomization Study
Authors: ZHOU HAO , Qi Yajie , Qi Hui 
Published: September 2023

Abstract
Observational studies found a potential bidirectional positive association between multiple sclerosis and psoriasis, but are susceptible to confounding factors. We examined the directionality of causation using Mendelian randomization and estimated the genetic correlation using the linkage disequilibrium score. we performed Mendelian randomization analysis using large-scale genome-wide association studies datasets from the International Multiple Sclerosis Genetics Consortium (IMSGC, 115,803 individuals of European ancestry) and FINNGEN Consortium (252,323 individuals of European ancestry). We selected several Mendelian randomization methods including Causal Analysis Using Summary Effect (CAUSE), inverse variance-weighted (IVW), and pleiotropy-robust methods. CAUSE and IVW indicated that MS reduces the risk of psoriasis (CAUSE OR = 0.93, p = 0.045; IVW OR = 0.93, p = 2.51×10− 20), or vice versa (CAUSE OR = 0.72, p = 0.001; IVW OR = 0.71, p = 4.80×10− 26). Pleiotropy-robust methods with all p-values < 0.05. The linkage disequilibrium score showed no genetic correlation between psoriasis and MS (rg = − 0.071, P = 0.2852). In summary, we provide genetic evidence that MS reduces the risk of psoriasis, and vice versa.
Changing Trends in HIV Prevalence and Risk Factors Among Men Who Have Sex with Men in Mozambique: Implications for Targeted Interventions and Public Health Strategies
Authors: Banze Auria Ribeiro , Muleia Rachid , Nuvunga Samuel , Boothe Makini , Baltazar Cynthia Semá 
Published: September 2023

Abstract
Background: Men who have sex with Men (MSM) are known to contribute to increased HIV prevalence as an integral part of key populations with high vulnerability to HIV/AIDS due to their sexual behaviours and lifestyles. Mozambique conducted two rounds of bio-behavioral surveys (BBS) in this population with the main objective of estimating HIV prevalence and associated risk behaviors among MSM in Mozambique. The present study aims to estimate the trend of HIV prevalence and determine the correlations of HIV infection among MSM.
Methods: A cross-sectional analytical study was conducted from secondary data from the first and second rounds of BBS in Mozambique conducted in 2011-2012 and 2020-2021 respectively. Each round used a similar methodology which allowed for comparison between the two surveys. Chi-square test and logistic regression was used to compare the HIV prevalence between the BBS round, identify factors associated with HIV and assess the evolution of HIV prevalence across selected risk factors.
Results: There was a significant increase in HIV prevalence among MSM (7.1% to 14.9%), living in Maputo (9.3% to 14.7%), uncircumcised (11.7% to 25.1%), and those who reported two sexual partners in the last year (5.2% to 14.4%). In contrast, there was a decrease in prevalence among adult men aged between 25 and 29 years (4.7% to 13.9%), aged 30 years or older (45.7% to 27.7%), married (29.1% to 16.8%), with higher education (16.7% to 5.9%) and moderate perception of HIV risk (10.9% to 3.4%). Multivariate analysis demonstrated that factors such as age, marital status, religion, sexual identity, circumcision, and the use of lubrication during anal sex had significant effects on the risk of HIV infection.
Conclusions: This study underscores the continuing need for HIV prevention and education efforts. The rise in prevalence among specific population segments and the sustained presence of risk factors emphasize the requirement for holistic strategies tailored to the unique requirements of each subgroup. Understanding trends and risk factors is crucial to guiding public health policies and designing efficacious prevention programs that aim to curtail HIV transmission while enhancing the well-being of those impacted by the condition.
Assessing the validity of maternal report on breastfeeding counselling in Kosovo’s primary health facilities
Authors: McKay Melinda , Munos Melinda , Kim Sunny , Bryce Emily , Bucinca Hana , Marchant Tanya 
Published: September 2023

Abstract

Background: Improving the quality of breastfeeding counselling delivered by primary care providers can improve breastfeeding outcomes and ultimately reduce mortality and morbidity of children and mothers. Accurate data on coverage and quality of primary care breastfeeding counselling is essential for monitoring progress, however global and national indicators are limited. To help address this gap, this study validated indicators of receipt and quality of breastfeeding counselling during routine consultations for infant care at seven primary health facilities across Kosovo.
Methods:Using a structured checklist, mother’s reports of breastfeeding counselling received during routine consultations for their infants (0-12 months of age) were collected by exit interview in 2019 and 2021 (n=609). Responses were compared against direct observation of their consultation (reference standard) by a trained third-party observer at the primary care facility. We assessed 13 indicators; ten were related to the receipt and content of breastfeeding counselling, and three were specific to the provider’s interpersonal skills. We calculated sensitivity, specificity, and area under the receiver operating curve (AUC) to determine individual-level reporting accuracy.
Results: Ten indicators had an agreement rate above 70% and seven indicators had high overall validity (AUC≥0.7). High prevalence indicators recorded high sensitivity and low specificity, and the inverse for low prevalence indicators. In line with other studies, more subjective indicators were less reliable e.g., mothers over-reported the prevalence of all three interpersonal indicators.
Conclusions: This study offers an original perspective on breastfeeding counselling quality by validating whether a provider discussed breastfeeding, the clinical content of that counselling and how it was delivered i.e., interpersonal behaviors. It is also situated in a primary care setting within a fragile state of which there is limited evidence. We observed that asking mothers directly to recall breastfeeding counselling services received provided an accurate reflection on what was delivered. Capturing mothers’ experience of care, the subjective aspects of counseling quality, is important. As this study and others show, as a community we need to further validate subjective questions and discuss accurate standard measures for the ‘experience of care’ quality dimension.
Inclusion of Clinical Photographs with General Dental Practitioner Electronic Referrals of Patients with Oral Mucosal Disease to Secondary Care – A Service Review
Authors: Webb Leah , Simms Melanie , Atkin Philip 
Published: September 2023

Abstract
Introduction This study looks at how the inclusion of photographs in referrals to an oral medicine specialist service can improve the adequacy of the referral for triage, prioritisation, and diagnosis.
Materials and Methods Data was prospectively collected from e-referrals over a 4 month period. We recorded any change in appointment prioritisation at the vetting stage, and the inclusion of photographs.
Results Only 29.5% of referrals included a photograph. 5% were rejected with advice, as it was clear from the photograph that the patient did not require a secondary care appointment. 14% of all referrals were upgraded in urgency, five of which were due to concerns of malignancy. Of these, 80% included photographs, and 3 were upgraded solely based on these photographs as they showed features of possible malignancy, where the written element of the referral did not describe nor raise such concerns.
Discussion and Conclusions Including a photograph with a referral can often make up for inaccurate or insufficient written content, allowing appropriate and safe prioritisation, especially where the referrer has failed to recognise possible malignancy. Photographs can also prevent unnecessary referral upgrades, ensure an appointment is necessary and can be invaluable as a baseline comparator.
An intellectual drivers' sensitivity traffic model for adapting taillight effects
Authors: Hossain Md Anowar , Jun TANIMOTO 
Published: September 2023

Abstract
In this study, a traffic flow model, the so-called Taillight Adapting traffic model, is developed considering the driver's activities impact following the taillight effect of the preceding vehicle, which is switched on and off based on the vehicle's accelerations and decelerations. To quantify a driver's sensitivity to the velocity gap, we introduced the concept of the new driver's sensitivity function, which has twofold formulations. The first formulation follows the HDDS model1, which presumes the sensitivity is dependent on a headway distance. The second formulation presumes that the sensitivity depends on a velocity gap, which might be informed by the taillight of a preceding vehicle. We have calibrated the neutralizing proficiency of a traffic flow field for the HDDS and proposed the Taillight Adapting model by utilizing the linear stability theory. Finally, a series of numerical simulations have been carried out of the improved Taillight Adapting model and conventional FVD model to investigate how the traffic flow field for the Taillight Adapting model behaves differently from the conventional FVD model.
PACS: 89.40.-a (Transportation); 87.15. Aa (Theory and modeling; Computer simulation)
The SCAN-ME Study Protocol: The Value of Surveillance Imaging for Children and Young People with Medulloblastoma and Ependymoma
Authors: Beresford Lucy , Phillips Bob , Atkin Karl , Manca Andrea 
Published: September 2023

Abstract
Background
After treatment ends, children, and young people (CYP) with medulloblastoma and ependymoma undergo surveillance imaging to check for cancer recurrence. Surveillance imaging aims to detect tumour relapse before symptoms develop, but the evidence to suggest that they improve outcomes is uncertain. Notwithstanding, scans are costly, and are an emotional burden for families.
Aims and Objectives
This mixed methods project will explore the value of surveillance imaging for children with medulloblastoma and ependymoma in three workstreams.
1) Workstream 1: Explore CYP and their parent’s experiences and expectations of surveillance imaging for detecting recurrent medulloblastoma and ependymoma.
2) Workstream 2: Using individual participant data (IPD), determine whether detecting a relapse surveillance imaging in CYP with medulloblastoma or ependymoma improves survival outcomes and treatment options.
3) Workstream 3: Determine whether surveillance imaging for CYP with medulloblastoma or ependymoma is cost-effective.
Methods
1) CYP with medulloblastoma and ependymoma who are undergoing surveillance imaging and their parents will be recruited to a qualitative study. Creative methods and semi-structured interviews will be used to understand CYP and parent’s experiences of surveillance imaging. Transcripts will be analysed using the ‘following the thread' method.
2) IPD from two UK-wide cohorts with data on CYP with relapsed ependymoma and medulloblastoma will be used to determine whether survival outcomes differ when relapse was detected symptomatically compared to asymptomatically. Multivariable survival analyses will assess the association between survival and method of relapse detection after controlling for prognostic variables (e.g., subtype, extent of surgical resection, subsequent therapies).
3) An economic model will be developed to evaluate whether surveillance imaging is value for money compared to no surveillance imaging. IPD from Workstream 2 will inform transition probabilities between health states. Costs, resource use and quality of life estimates will be obtained from systematic literature searches.
Data from each workstream will be synthesised using a convergent parallel approach following data analysis.
Discussion
This study aims to explore surveillance imaging for CYP with medulloblastoma and ependymoma in a holistic way, making it easier for decision makers to weigh up the benefits and drawbacks value of providing routine scans for this population.