bluuebunny/crossref_metadata_2025_split huggingface dataset:
Learning deep architectures for the interpretation of first-trimester fetal echocardiography (LIFE) - a study protocol for developing an automated intelligent decision support system for early fetal echocardiography
Authors: Ungureanu Anda , Marcu Andreea-Sorina , Patru Ciprian Laurentiu , Ruican Dan , Nagy Rodica , Stoean Ruxandra , Stoean Catalin , Iliescu Dominic Gabriel 
Published: January 2023

Abstract
Background
Congenital Heart Disease represents the most frequent fetal malformation. The lack of prenatal identification of congenital heart defects can have adverse consequences for the neonate, while a correct prenatal diagnosis of specific cardiac anomalies improves neonatal care neurologic and surgery outcomes. Sonographers perform prenatal diagnosis manually during the first or second-trimester scan, but the reported detection rates are low. This project’s primary objective is to develop an Intelligent Decision Support System that uses two-dimensional video files of cardiac sweeps obtained during the standard first-trimester fetal echocardiography (FE) to signal the presence/absence of previously learned key features.

Methods
The cross-sectional study will be divided into a training part of the machine learning approaches and the testing phase on previously unseen frames and eventually on actual video scans.
Pregnant women in their 12–13 + 6 weeks of gestation admitted for routine first-trimester anomaly scan will be consecutively included in a two-year study, depending on the availability of the experienced sonographers in early fetal cardiac imaging involved in this research.
The Data Science / IT department (DSIT) will process the key planes identified by the sonographers in the two- dimensional heart cine loop sweeps: four-chamber view, left and right ventricular outflow tracts, three vessels, and trachea view. The frames will be grouped into the classes representing the plane views, and then different state-of-the- art deep-learning (DL) pre-trained algorithms will be tested on the data set. The sonographers will validate all the intermediary findings at the frame level and the meaningfulness of the video labeling.

Discussion
FE is feasible and efficient during the first trimester. Still, the continuous training process is impaired by the lack of specialists or their limited availability. Therefore, in our study design, the sonographer benefits from a second opinion provided by the developed software, which may be very helpful, especially if a more experienced colleague is unavailable. In addition, the software may be implemented on the ultrasound device so that the process could take place during the live examination.

Trial registration
The study is registered under the name „Learning deep architectures for the Interpretation of Fetal Echocardiography (LIFE)”, project number 408PED/2020, project code PN-III-P2–2.1-PED-2019. Trial registration: ClinicalTrials.gov, unique identifying number NCT05090306, date of registration 30.10.2020.
Socio-economic inequalities in health-related quality of life among Iranian young people in the middle stage of adolescence: application of Health Equity Assessment Toolkit
Authors: Maleki Azam , Faghihzadeh Elham , Youseflu Samaneh , barjasteh Shahnaz Zamani 
Published: January 2023

Abstract
Background
One of the main concerns of public health is the increasing inequality of health status, which has an adverse effect on people’s life.

Purpose
The current study aims to analyze the role of socioeconomic inequalities in health-related quality of life (QoL) among Iranian young people in the middle stage of adolescence.

Methods
A cross-sectional descriptive study was conducted on 576 young people in the middle stage of adolescence. The samples were selected using the Multi-stage sampling method. Data were collected by a demographic checklist, and KIDSCREEN-52 questionnaire and analyzed by SPSS ver.16. The Health Equity Assessment Toolkit (HEAT) Version 4.0 (beta) was used to assess adolescents’ QoL inequalities in terms of socio-economic subgroups.

Results
The results show that 27.2 adolescents had low quality of life. The score of physical and autonomy components of QoL was significantly more in male versus school environment in female adolescents. Also, the asset index, father’s, and mother’s education, and family income in female adolescents, and the assets and family income in male adolescents were significantly related to the quality of life (p < 0.05). The risk of lower QOL in the poorest quintile was 1.12 times more than in the richest quintile. The consideration index of Asset in terms of sex was 4.5 and the modified Gini index was more than 0.5 in females and males.

Conclusion
Our findings highlight the significant effects of socioeconomic inequality on the HRQL of Iranian adolescents. Requires a targeted policy approach to reach the poorest quintile for improving the quality of life of adolescents.
The prevalence and risk factors of burnout and its association with mental issues and quality of life among hungarian postal workers: a cross-sectional study
Authors: Kovács Miklós , Muity György , Szapáry Ádám , Nemeskéri Zsolt , Váradi Imre , Kapus Krisztián , Tibold Antal , Zalayné Nikoletta Magyar , Horvath Lilla , Fehér Gergely 
Published: January 2023

Abstract
Background
Burnout is one of the most extensively studied phenomena of the twenty-first century; which has been extensively studied among helping professions, although it can be broadened to several other types of occupation. Based on our knowledge and literature search, no similar studies have been carried out among postal workes to date.

Methods
This cross-sectional questionnaire-based epidemiological study was carried out between May 2021 and January 2022 in five counties in Hungary with the recruitment of postal delivery workers focusing on (1) the prevalence of burnout among postal delivery workers; (2) including the role of demographic parameters, duration of employment as well as the presence of secondary employment; (3) and also analyzed the role of several risk factors and medical conditions; (4) and we also examined the possible association between depression, insomnia and quality of life and burnout.

Results
Overall 1300 questionnaires were successfully delivered and 1034 responses received (response rate of 79.5%). Three hundred sixty-eight males (35.6%) and six hundred sixty-six females (64.4%) participated in our study. The prevalence of burnout was 50.8% (525/1034) in this study population (mean score 2.74 ± 0.33). Logistic regression analysis showed that female gender [OR = 2.380, 95% CI: 1.731 to 2.554], first workplace [OR = 1.891, 95% CI: 1.582 to 2.162] and working more than 30 years [OR = 1.901, 95% CI: 1.608 to 2.326] have significantly increased the likelyhood of burnout as well as the history of muscoskeletal pain [OR = 1.156, 95% CI: 1.009 to1.342], current quality of life [OR = 1.602, 95% CI: 1.473 to 1.669] and the presence of sleep disturbance [OR = 1.289, 95% CI: 1.066 to 1.716].

Conclusion
This is the first study in Hungary to investigate the prevalence of burnout among postal workers and to explore the relationship between burnout and mental health problems. Our study underlines the clinical importance of burnout and draws attention to the need for appropriate prevention and treatment strategies.
“It’s about being healthy”; a novel approach to the socio-ecological model using family perspectives within the Latinx community
Authors: Korom Bethany , Malloy Meghan , Remmers Caroline , Cevilla Mari , Dione Kelly , Papanek Paula , Condit Jeff , Nelson David 
Published: January 2023

AbstractBackgroundThe Latinx community is at risk for obesity, type 2 diabetes, and other chronic illnesses. Culturally appropriate, community facing physical activity (P.A.) and nutrition programs may provide the basis for families to improve their health status. Our objectives are as follows: 1. To investigate synergistic factors within this type of program that play a role in creating an environment for participants to learn and practice healthy behaviors. 2. To apply factors into a novel model of components that support health and wellness. 3. To design an intervention for future implementation and evaluation.MethodsA two-year P.A. and nutrition program,Families Inspired Together 4 Youth Empowered to Succeed(FIT 4 YES), took place in Milwaukee, WI. with Hispanic families from 2018 to 2020 through a community-academic partnership. A pair of interviewers spoke with families who provided insight into the impact of the program. A grounded theory qualitative approach to code the transcripts guided the team to identify overarching themes.ResultsTwenty-four interviews were conducted. Common themes indicated that children had a stronger belief in their abilities and confidence in peer support. Parents noticed their children increasing self-directed healthy behaviors. All families grew in their implementation of health and wellness.ConclusionsThree main components of FIT 4 YES contributed to its success: opportunities for engagement, supportive relationships, and the interplay of components that emerged from the interviews. Effective programs could include these components to make their outcomes more cohesive within the family. A novel model emerged that builds on the social-ecological model that emphasizes the dynamic interactions between these main components. Additional research is needed to evaluate the long-term effects and response by the community.
Kisspeptin regulates the proliferation and apoptosis of ovary granulosa cells in polycystic ovary syndrome by modulating the PI3K/AKT/ERK signalling pathway
Authors: Sun Pingping , Zhang Yuemin , Sun Lilan , Sun Na , Wang Jinguang , Ma Huagang 
Published: January 2023

Abstract
Background
The development of polycystic ovary syndrome (PCOS) is closely correlated with apoptosis and oxidative stress in ovarian granulosa cells. Kisspeptin plays an important role in reproductive organ function. This study aimed to explore the role of kisspeptin in PCOS and oxidative stress-triggered apoptosis of ovarian granular cells.

Methods
A PCOS rat model was established by injecting dehydroepiandrosterone (DHEA) and feeding the rats a high-fat diet. The RNA and protein levels of kisspeptin were analysed by quantitative PCR, western blotting, and histological staining. Tissue damage was evaluated using haematoxylin and eosin (H&E) staining. The viability and proliferation of human granulosa cell KGN were measured using the cell counting kit-8 (CCK-8) and 5-ethynyl-2′-deoxyuridine (EdU) assays. Cell cycle and apoptosis were analysed by flow cytometry. Oxidative stress was analysed by measuring reactive oxygen species (ROS), malondialdehyde (MDA), glutathione (GSH), superoxide dismutase (SOD), and catalase (CAT) levels.

Results
Kisspeptin was downregulated in the ovarian granulosa cells of PCOS rats compared to those of control rats. Kisspeptin overexpression enhanced KGN cell proliferation and inhibited apoptosis. ROS generation was suppressed by kisspeptin, along with decreased levels of MDA and increased levels of the antioxidants GSH, SOD, and CAT. Kisspeptin activates PI3K/AKT and ERK signalling, and inactivation of ERK1/2 suppresses the protective role of kisspeptin in ovarian granulosa cells.

Conclusion
Kisspeptin improves proliferation and alleviates apoptosis and oxidative stress in ovarian granulosa cells by activating PI3K/AKT and ERK signalling.
Determinants of breast self-examination practice among women attending pastoralist health facilities, Southern Ethiopia: a cross-sectional study
Authors: Israel Eskinder , Awoke Nefsu , Yakob Tagese , Aynalem Amdehiwot , Talto Alemayehu , Bezabih Kibrework 
Published: January 2023

Abstract
Background
Breast cancer remains the most serious public health problem affecting millions of women worldwide. Despite various studies regarding breast self-examination practices conducted among health professionals and students in Ethiopia, limited information was found on women attending health care services in the pastoralist community. This study aimed to identify the determinants of breast self-examination practice (BSE) among women attending pastoralist health facilities in Southern Ethiopia.

Methods
An institutional-based cross-sectional study was conducted among 421 women who were attending family planning services in pastoralist health facilities in South Omo Zone, Southern Ethiopia from January to February 2022 using systematic random sampling to select a woman from each health facility in Jinka town. Data were collected using structured, pretested, and interviewer-administered questionnaires. Descriptive statistics such as proportions, means, and standard deviations were used to describe each relevant variable. Bivariate and multivariate logistic regression analyses were used to identify the determinants of BSE practices among women.

Result
The mean age of the women was 25.43 ± 6.66 years. Fifty-four percent (n = 173) of the women had heard of BSE from health professionals. Eighty-nine (21.1%) women had undergone BSE. Women who resided in the urban areas (AOR = 6.79, CI: 3.40, 13.56), attained at least primary education and above (AOR = 8.96, CI: 4.14, 19.35), heard about BSE (AOR = 4.07, CI: 2.07, 7.98), and had a family history of breast cancer (AOR = 7.46, CI = 3.27, 17.00) were significantly associated with BSE practice.

Conclusion and recommendation
Our study showed that women's practice of BSE was lower when compared with the local studies. We recommend health care professionals and others working in the area improve ways of increasing awareness about breast cancer, including its risk, and the need for BSE.
Training load of newly recruited nurses in Grade-A Tertiary Hospitals in Shanghai, China: a qualitative study
Authors: Yu Chan , Jiang Jinxia , Zhong Minhui , Zhang Han , Duan Xia 
Published: January 2023

Abstract
Background
This study aimed to provide insight into the training load of newly recruited nurses in grade-A tertiary hospitals in Shanghai, China. The lack of nurses in hospitals across China has resulted in newly recruited nurses in grade-A tertiary hospitals in Shanghai having to integrate into the work environment and meet the needs of the job quickly; thus, they undergo several training programs. However, an increase in the number of training programs increases the training load of these nurses, impacting the effectiveness of training. The extent of the training load that newly recruited nurses have to bear in grade-A tertiary hospitals in China remains unknown.

Methods
This qualitative study was conducted across three hospitals in Shanghai, including one general hospital and two specialized hospitals, in 2020. There were 15 newly recruited nurses who were invited to participate in semi-structured in-depth interviews with the purpose sampling method. A thematic analysis approach was used to analyze the data. The COREQ checklist was used to assess the overall study.

Results
Three themes emerged: external cognitive overload, internal cognitive overload, and physical and mental overload.

Conclusion
Through qualitative interviews, this study found that the training of newly recruited nurses in Shanghai’s grade-A tertiary hospitals is in a state of overload, which mainly includes external cognitive overload, internal cognitive overload, physical and mental overload, as reflected in the form of training overload, the time and frequency of training overload, the content capacity of training overload, the content difficulty of training overload, physiological load overload, and psychological load overload. The intensity and form of the training need to be reasonably adjusted. Newly recruited nurses need to not only improve their internal self-ability, but also learn to reduce internal and external load. Simultaneously, an external social support system needs to be established to alleviate their training burden and prevent burnout.
Factors associated with pregnancy and induced abortion among street-involved female adolescents in two Nigerian urban cities: a mixed-method study
Authors: Obiyan Mary O. , Olaleye Atinuke O. , Oyinlola Funmilola F. , Folayan Morenike O. 
Published: January 2023

Abstract
Objectives
This study determined the correlates of unwanted pregnancy and induced abortion among sexually active female street-involved adolescents (SIAs) aged 10–19 years in two urban cities in South-west, Nigeria.

Methods
The data for this study were extracted from a larger mixed-method survey dataset on the sexual and reproductive health (SRH) of 1505 street-involved young people aged 10 to 24 years. For the quantitative data, the explanatory variables were age, history of school attendance, employment status, religion, living arrangement and city of residence. The study outcomes were a history of pregnancy and a history of induced abortion of last pregnancy. Binomial regression analysis was performed to determine the association between the explanatory and outcome variables. For the qualitative data generated through focus group discussions and in-depth-interviews, inductive and deductive approaches were used in conducting a thematic analysis to explore the perspectives and experiences of SIA on pregnancy and induced abortion.

Results
Of the 424 female SIAs, 270 (63.7%) reported having had sex. Sixty-four (23.7%) respondents had a history of pregnancy, of which 38 (59.4%) gave a history of induced abortion of the last pregnancy. A history of school attendance significantly reduced the likelihood of being pregnant (AOR: 0.42, 95% C.I: 0.19–0.91), while 15–19-years-old SIAs who were pregnant were significantly less likely to abort (AOR: 0.13, 95% C.I: 0.02–0.77). Qualitative reports indicated that unintended pregnancy and induced abortion was a common experience among the sexually active SIAs. Many participants were aware of the methods of, and places to induce abortion.

Conclusion
A large proportion of SIAs are sexually active with a high incidence of unintended pregnancy and a high rate of unsafe abortion. Access of female SIAs to education can reduce the risk of unintended pregnancy. Attention needs to be paid to how SIAs can have access to contraception.
“They are gaining experience; we are gaining extra hands”: a mixed methods study to assess healthcare worker perceptions of a novel strategy to strengthen human resources for HIV in South Africa
Authors: Tollefson Deanna , Ntombela Nasiphi , Reeves Sarah , Charalambous Salome , O’Malley Gabrielle , Setswe Geoffrey , Duerr Ann 
Published: January 2023

Abstract
Background

Lay health workers (LHWs) can support the HIV response by bridging gaps in human resources for health. Innovative strategies are needed to expand LHW programs in many low- and middle-income countries. Youth Health Africa (YHA) is a novel LHW approach implemented in South Africa that places young adults needing work experience in one-year non-clinical internships at health facilities to support HIV programs (e.g., as HIV testers, data clerks). While research suggests YHA can increase HIV service delivery, we need to understand healthcare worker perceptions to know if this is an acceptable and appropriate approach to strengthen human resources for health and healthcare delivery.

Methods
We conducted a convergent mixed methods study to assess healthcare worker acceptance and perceived appropriateness of YHA as implemented in Gauteng and North West provinces, South Africa and identify issues promoting or hindering high acceptability and perceived appropriateness. To do this, we adapted the Johns Hopkins Measure of Acceptability and Appropriateness to survey healthcare workers who supervised interns, which we analyzed descriptively. In parallel, we interviewed frontline healthcare workers who worked alongside YHA interns and conducted an inductive, thematic analysis. We merged quantitative and qualitative results using the Theoretical Framework of Acceptability to understand what promotes or hinders high acceptance and appropriateness of YHA.

Results
Sixty intern supervisors responded to the survey (91% response rate), reporting an average score of 3.5 for acceptability and 3.6 for appropriateness, on a four-point scale. Almost all 33 frontline healthcare workers interviewed reported the program to be highly acceptable and appropriate. Perceptions that YHA was mutually beneficial, easy to integrate into facilities, and helped facilities be more successful promoted a strong sense of acceptability/appropriateness amongst healthcare workers, but this was tempered by the burden of training interns and limited program communication. Overall, healthcare workers were drawn to the altruistic nature of YHA.

Conclusion
Healthcare workers in South Africa believed YHA was an acceptable and appropriate LHW program to support HIV service delivery because its benefits outweighed its costs. This may be an effective, innovative approach to strengthen human resources for HIV services and the broader health sector.
Clinical application and detection techniques of liquid biopsy in gastric cancer
Authors: Ma Shuo , Zhou Meiling , Xu Yanhua , Gu Xinliang , Zou Mingyuan , Abudushalamu Gulinaizhaer , Yao Yuming , Fan Xiaobo , Wu Guoqiu 
Published: January 2023

AbstractGastric cancer (GC) is one of the most common tumors worldwide and the leading cause of tumor-related mortality. Endoscopy and serological tumor marker testing are currently the main methods of GC screening, and treatment relies on surgical resection or chemotherapy. However, traditional examination and treatment methods are more harmful to patients and less sensitive and accurate. A minimally invasive method to respond to GC early screening, prognosis monitoring, treatment efficacy, and drug resistance situations is urgently needed. As a result, liquid biopsy techniques have received much attention in the clinical application of GC. The non-invasive liquid biopsy technique requires fewer samples, is reproducible, and can guide individualized patient treatment by monitoring patients' molecular-level changes in real-time. In this review, we introduced the clinical applications of circulating tumor cells, circulating free DNA, circulating tumor DNA, non-coding RNAs, exosomes, and proteins, which are the primary markers in liquid biopsy technology in GC. We also discuss the current limitations and future trends of liquid biopsy technology as applied to early clinical biopsy technology.