bluuebunny/crossref_metadata_2025_split huggingface dataset:
Why do older adults living alone in cities cease seeking assistance? A qualitative study in China
Authors: Du Qianqian , Gong Ni , Hu Qin , Chen Guicheng , Xie Jingyue , Luo Lan , Cheng Yu , Zhang Meifen 
Published: June 2022

AbstractBackgroundAgainst the background of an aging population, older adults living alone in cities are increasingly dependent. However, their use of home and community-based services in China is unsatisfactory. This study attempted to figure out why older adults living alone in cities do not actively seek assistance in China.MethodsIn-depth interviews were conducted. A total of 29 older adults were recruited. Content analysis was used to analyze the interview data.ResultsThree themes were identified. (1) Desire for independence, despite hardship: The lives of older adults involve many inconveniences, but they preferred to solve problems by themselves, instead of asking for help; (2) Desire to not overburden jiaren (meaning family in Chinese): older adults did not want to disturb families or burden children with caring responsibilities. Moreover, previous experience of failing to obtain care made them reluctant to seek help from jiaren; (3) Desire to not bother wairen (meaning people other than family in Chinese): The lack of trust caused by being unfamiliar with wairen, and the fear of being a burden to others if they were not able to reciprocate, made older adults reluctant to seek help from wairen.ConclusionsChanges in social, economic, and demographic structures have led to gradual failure of family care. Older adults accustomed to an “acquaintance society” have not yet adapted to seeking help from the community. When addressing the problem of care for older adults living alone in cities, it is important to focus on the profound impact of social change.
Psychiatric disorders and associated risk factors in a sample of adolescents in Gaborone, Botswana: a cross-sectional study
Authors: Olashore Anthony A. , Brooks Wendy , Roy Hlanganiso , Adebayo Fatai Adewole , Chiliza Bonginkosi 
Published: June 2022

Abstract
Background
Despite the high proportion of adolescents living with mental health issues in low- to middle-income countries (LMICs), especially in Botswana, there is a significant deficit of local research to guide an increase in prevention and treatment. We, therefore, aimed to assess the prevalence and associated risk factors of psychiatric disorders (PD) in a sample of secondary school students in Botswana.

Methods
This cross-sectional study included 750 students from the 13 public secondary schools in Gaborone using a multi-stage sampling technique. The Mini-International Neuropsychiatric Interview for Children and Adolescents (MINI-KID) was used to screen for PDs.

Results
The participant’s mean age was 15.26 and SD 1.57 years, with 53.6% being female. Approximately 34% had a PD, with depression being the commonest, of whom 35% were neither receiving treatment nor aware of the available services. Perinatal complications (AOR = 4.29; 95%CI: 1.04–17.70), a family history of mental illness (AOR = 2.19; 95%CI: 1.17–4.11) and substance-related problems (AOR = 1.80; 95% CI:1.22–2.65) predicted the likelihood of developing PD.

Conclusions
Our findings revealed that adolescents in Botswana have many mental health issues which may affect their developmental phases. A multi-sectoral collaboration is needed for the timely detection of identified risk factors and initiation of the necessary prevention and treatment measures.
Associations between children’s physical literacy and well-being: is physical activity a mediator?
Authors: Melby Paulina S. , Nielsen Glen , Brønd Jan Christian , Tremblay Mark S. , Bentsen Peter , Elsborg Peter 
Published: June 2022

Abstract
Background
Physical literacy (PL) is a multi-dimensional concept that provides a holistic understanding of movement and physical activity. PL contains an affective, a physical, and a cognitive domain, which together lay the foundation for the individual’s capacity and the tendency for participating in physical activities currently and throughout life. PL is increasingly regarded as a ‘cause of the causes’ to health promotion. Cross-sectional studies have shown associations between children’s PL, physical activity behaviours, and well-being. This study aims to examine the associations between Danish children’s PL and their physical and psychosocial well-being and whether the associations are mediated by moderate- to vigorous intensity physical activity (MVPA).

Methods
Cross-sectional data from Danish schoolchildren aged 7–13 years were collected in Jan-Dec 2020 in the Danish Assessment of Physical Literacy (DAPL) project. PL was assessed with the DAPL which measures the affective, cognitive, and physical domains of PL. MVPA (min/day) was measured with accelerometers (Axivity), psychosocial well-being was measured with The Strengths and Difficulties Questionnaire, and physical well-being was measured with the KIDSCREEN questionnaire. Structural equation models were constructed with PL and MVPA as predictors of physical well-being and four aspects of psychosocial well-being.

Results
A positive moderate association between PL and physical well-being, partly mediated by MVPA was observed. PL was positively associated with the positive aspects of psychosocial well-being and negatively associated with the negative aspects (behaviour problems). None of the associations between PL and aspects of psychosocial well-being were mediated by MVPA.

Conclusions
The study contributes to evidence on the link between PL, physical activity, and health outcomes. The study found beneficial relations between PL and physical and psychosocial well-being. MVPA mediated part of the relationship between PL and physical well-being but not psychosocial well-being.
The willingness of parents to vaccinate their children younger than 12 years against COVID-19: a cross-sectional study in Malaysia
Authors: Ng Diana-Leh-Ching , Gan Gin-Gin , Chai Chee-Shee , Anuar Nur Adila Bt , Sindeh Woweham , Chua Wei-Jing , Said Asri B. , Tan Seng-Beng 
Published: June 2022

Abstract
Background
The initiation of a new drug, for instance, the coronavirus disease 2019 (COVID-19) vaccine in children could be a source of major concern for parents. This study aims to determine the willingness of parents in Malaysia to vaccinate their children younger than 12 years against COVID-19.

Methods
An online cross-sectional survey was conducted nationwide in Malaysia from August 29, 2021, to October 17, 2021. Parents with children younger than 12 years were enrolled via the snowball sampling method.

Results
The analysis included data from 3,528 parents (79.5%) of the 4,438 survey responses received. Of these parents, 2,598 (73.6%) were willing, 486 (13.8%) were not willing, and 444 (12.6%) were still hesitant to vaccinate their children against COVID-19. Single parents (odds ratio [OR], 2.0; 95% confidence interval [CI], 1.32–3.04; P = 0.001), parents with secondary or lower education (OR, 1.5; 95% CI, 1.21–1.96; P < 0.001), healthcare workers (OR, 1.7; 95% CI, 1.34–2.26; P < 0.001), parents who had significant contact with COVID-19 (OR, 1.3; 95% CI, 1.09–1.63; P = 0.006), and parents who had been vaccinated against COVID-19 (OR, 15.4; 95% CI, 9.76–24.33; P < 0.001) were found more willing to immunize their children. The common reasons for vaccination given by parents who were willing to immunize their children include protection of children (99.4%), protection of other family members (99.3%), and effectiveness (98.2%). The common reasons against vaccination given by parents who were not willing to immunize their children were uncertainty about the new vaccine (96.1%), concerns about vaccine contents (93.2%), limited vaccine information from physicians (82.3%), and the belief of vaccine was unsafe (79.8%).

Conclusions
In this study, nearly three-quarters of parents were willing to vaccinate their children younger than 12 years against COVID-19. The parents’ history of COVID-19 vaccination was the strongest independent predictor of their willingness to vaccinate their children. Therefore, future health education for the COVID-19 vaccine should focus on parents who are prone to vaccine refusal or hesitation, address the common reasons for vaccine refusal, and highlight the vaccine’s benefits.
Is total thyroidectomy with bilateral central neck dissection the only surgery for papillary thyroid carcinoma patients with clinically involved central nodes?
Authors: Back Kyorim , Lee Jiyeon , Cho Anna , Choe Jun-Ho , Kim Jung-Han , Oh Young Lyun , Kim Jee Soo 
Published: June 2022

Abstract
Background
In clinical practice, we often observed that patients who underwent total thyroidectomy due to clinically involved nodal disease (cN1a) actually had less extensive CLNM on final pathology. This study investigates whether total thyroidectomy and therapeutic bilateral CND are necessary for all PTC patients with cN1a.

Methods
This study retrospectively reviewed 899 PTC patients who underwent total thyroidectomy with bilateral CND from January 2012 to June 2017. The patients were divided into two groups according to pre-operative central lymph node (CLN) status: cN0, no suspicious CLNM; cN1a, suspicious CLNM. We compared the clinicopathological features of these two groups.

Results
There was no significant difference in recurrence between cN0 and cN1a groups after a mean follow-up time of 59.1 months. Unilateral cN1a was related to the largest central LN size ≥ 2 mm (OR = 3.67, p < 0.001) and number of CLNM > 5(OR = 2.24, p = 0.006). On the other hand, unilateral cN1a was not associated with an increased risk of contralateral lobe involvement (OR = 1.35, p = 0.364) and contralateral CLNM (OR = 1.31, p = 0.359). Among 106 unilateral cN1a patients, 33 (31.1%) were found to be pN0 or had ≤ 5 metastatic CLNs with the largest node smaller than 2 mm.

Conclusions
Most cN1a patients were in an intermediate risk group for recurrence and required total thyroidectomy. However, lobectomy with CND should have performed in approximately 30% of the cN1a patients. Pre-operative clinical examination, meticulous radiologic evaluation, and intra-operative frozen sections to check the nodal status are prerequisites for this approach.
Effectiveness of primary school-based interventions in improving oral health of children in low- and middle-income countries: a systematic review and meta-analysis
Authors: Akera Peter , Kennedy Sean E. , Lingam Raghu , Obwolo Mark J. , Schutte Aletta E. , Richmond Robyn 
Published: June 2022

AbstractBackgroundRisk factors for oral disease can potentially be ameliorated by school-based interventions. This review evaluates the effectiveness of primary school-based interventions in improving oral health among children in low-and middle-income countries (LMICs).MethodsOur systematic review was conducted in accordance with the Joanna Briggs Institute methodology for systematic reviews of effectiveness. Medline, Embase, Global Health, CINAHL, Emcare, Scopus, Web of Science, WHO website, Google Advanced and Google Scholar were searched for experimental and observational studies published between 1995 and 2021 in English. Quality assessment and data extraction of the articles were performed by two independent reviewers. The primary outcome was decayed, missing, and filled teeth/surfaces [dmft(s)/DMFT(S)] scores. Seven meta-analyses were conducted.ResultsThe search yielded 1178 publications and after removing duplicates, 753 remained. A further 648 publications were excluded after screening titles and abstracts. 105 publications were reviewed in full and 34 were included. Narrative synthesis showed school-based interventions had a positive effect on oral health outcomes. Meta-analysis showed a significant positive effect on dental caries measured by DMFT scores (standardised mean difference (SMD) =  − 0.33; 95% CI − 0.56 to − 0.10;P = 0.005), net increment in DMFS scores (SMD =  − 1.09; 95% CI − 1.91 to − 0.27;P = 0.009), dmft and DMFT/S score > 1 (Risk Ratio = 0.70; 95% CI 0.53 to 0.94;P = 0.02) and plaque scores (SMD =  − 0.32; 95% CI − 0.46 to − 0.18;P < 0.00001). Non-significant positive effect was observed for dental caries measured by net increment in DMFT scores (SMD =  − 0.34; 95% CI − 0.69 to 0.02;P = 0.06) and DMFS scores (SMD =  − 0.26; 95% CI − 0.70 to 0.18;P = 0.24), and gingival health (SMD = 0.12; 95% CI − 0.32 to 0.55;P = 0.60). Certainty of evidence was assessed as very low for all oral health outcomes.ConclusionSchool-based interventions can be effective in reducing the burden of oral disease among primary school children in LMICs, with skills-based education, teacher training, provision of access to oral health services and parental engagement emerging as particularly promising. Further research is required to provide evidence of effectiveness of primary school-based interventions to improve oral health.Systematic review registrationThe title of this review was registered with PROSPERO (registration number: CRD42020202599).
A comparison of Knowledge, attitude and practice (KAP) of nurses on nursing Post-stroke dysphagia patients between iii-A and ii-A hospitals in China: a propensity score-matched analysis
Authors: Deng Shumin , Mao Xiaolan , Meng Xianmei , Yu Liping , Xie Fei , Huang Guiling , Duan Zhizhou 
Published: June 2022

Abstract
Background
Whether knowledge, attitude and practice of nurses on nursing post-stroke dysphagia patients varies between different ranking hospitals is still unknown. This study aimed to compare the knowledge, attitude and practice level of nurses on nursing post-stroke dysphagia patients between iii-A and ii-A hospitals in China.

Design
A cross-sectional study design was used.

Methods
Data were collected from eighteen hospitals in Wuhan, Hubei in May–July 2020, and a total of 824 nurses were recruited by convenient sampling. After propensity score matching, 205 participants in iii-A hospitals were matched with 205 participants in ii-A hospitals.

Results
There were no statistically differences in the socio-demographic characteristics between two groups after propensity score matching. Before matching, the regression coefficients between hospital ranking and knowledge, attitude, practice were -0.415, -0.718 and -1.855, respectively. After matching, the coefficients changed to -0.394, -0.824 and -1.278. Nurses from iii-A hospitals had higher knowledge and attitude scores than nurses from ii-A hospitals, but no significant practice scores difference was observed between various rankings of hospitals.

Conclusions
The KAP of nurses on nursing post-stroke dysphagia patients were different in iii-A and ii-A hospitals. Administrators should strengthen management, provide more learning resources and trainings to meet nurses’ needs about methods to deal with and recognize dysphagia, so as to further improve the quality of post-stroke dysphagia management.
Model-based estimation of QT intervals of mouse fetal electrocardiogram
Authors: Widatalla Namareq , Funamoto Kiyoe , Kawataki Motoyoshi , Yoshida Chihiro , Funamoto Kenichi , Saito Masatoshi , Kasahara Yoshiyuki , Khandoker Ahsan , Kimura Yoshitaka 
Published: June 2022

Abstract
Background
Abnormal prolongation in the QT interval or long QT syndrome (LQTS) is associated with several cardiac complications such as sudden infant death syndrome (SIDS). LQTS is believed to be linked to genetic mutations which can be understood by using animal models, such as mice models. Nevertheless, the research related to fetal QT interval in mice is still limited because of challenges associated with T wave measurements in fetal electrocardiogram (fECG). Reliable measurement of T waves is essential for estimating their end timings for QT interval assessment.

Results
A mathematical model was used to estimate QT intervals. Estimated QT intervals were validated with Q-aortic closure (Q-Ac) intervals of Doppler ultrasound (DUS) and comparison between both showed good agreement with a correlation coefficient higher than 0.88 (r > 0.88, P < 0.05).

Conclusion
Model-based estimation of QT intervals can help in better understanding of QT intervals in fetal mice.
Buprenorphine and naloxone access in pharmacies within high overdose areas of Los Angeles during the COVID-19 pandemic
Authors: Dadiomov David , Bolshakova Maria , Mikhaeilyan Melania , Trotzky-Sirr Rebecca 
Published: June 2022

Abstract
Background
Buprenorphine and naloxone are first-line medications for people who use opioids (PWUO). Buprenorphine can reduce opioid use and cravings, help withdrawal symptoms, and reduce risk of opioid overdose. Naloxone is a life-saving medication that can be administered to reverse an opioid overdose. Despite the utility of these medications, PWUO face barriers to access these medications. Downtown Los Angeles has high rates, and number, of opioid overdoses which could potentially be reduced by increasing distribution of naloxone and buprenorphine. This study aimed to determine the accessibility of these medications in a major urban city by surveying community pharmacies regarding availability of buprenorphine and naloxone, and ability to dispense naloxone without a prescription.

Methods
Pharmacies were identified in the Los Angeles downtown area by internet search and consultation with clinicians. Phone calls were made to pharmacies at two separate time points–September 2020 and March 2021 to ask about availability of buprenorphine and naloxone. Results were collected and analyzed to determine percentage of pharmacies that had buprenorphine and/or naloxone in stock, and were able to dispense naloxone without a prescription.

Results
Out of the 14 pharmacies identified in the downtown LA zip codes, 13 (92.9%) were able to be reached at either time point. The zip code with one of the highest rates of opioid-related overdose deaths did not have any pharmacies in the area. Most of the pharmacies were chain stores (69.2%). Eight of the 13 (61.5%) pharmacies were stocked and prepared to dispense buprenorphine upon receiving a prescription, and an equivalent number was prepared to dispense naloxone upon patient request, even without a naloxone prescription. All of the independent pharmacies did not have either buprenorphine or naloxone available.

Conclusions
There is a large gap in care for pharmacies in high overdose urban zip codes to provide access to medications for PWUO. Unavailability of medication at the pharmacy-level may impede PWUO ability to start or maintain pharmacotherapy treatment. Pharmacies should be incentivized to stock buprenorphine and naloxone and encourage training of pharmacists in harm reduction practices for people who use opioids.
Neutrophil activation in patients with anti-neutrophil cytoplasmic autoantibody-associated vasculitis and large-vessel vasculitis
Authors: Michailidou Despina , Duvvuri Bhargavi , Kuley Runa , Cuthbertson David , Grayson Peter C. , Khalidi Nader A. , Koening Curry L. , Langford Carol A. , McAlear Carol A. , Moreland Larry W. , Pagnoux Christian , Seo Philip , Specks Ulrich , Sreih Antoine G. , Warrington Kenneth J. , Mustelin Tomas , Monach Paul A. , Merkel Peter A. , Lood Christian 
Published: June 2022

AbstractObjectiveTo assess markers of neutrophil activation such as calprotectin and N-formyl methionine (fMET) in anti-neutrophil cytoplasmic autoantibody-associated vasculitis (AAV) and large-vessel vasculitis (LVV).MethodsLevels of fMET, and calprotectin, were measured in the plasma of healthy controls (n=30) and patients with AAV (granulomatosis with polyangiitis (GPA,n=123), microscopic polyangiitis (MPA,n=61)), and LVV (Takayasu’s arteritis (TAK,n=58), giant cell arteritis (GCA,n=68)), at times of remission or flare. Disease activity was assessed by physician global assessment. In vitro neutrophil activation assays were performed in the presence or absence of formyl peptide receptor 1 (FPR1) inhibitor cyclosporine H.ResultsLevels of calprotectin, and fMET were elevated in patients with vasculitis as compared to healthy individuals. Levels of fMET correlated with markers of systemic inflammation: C-reactive protein (r=0.82,p<0.0001), and erythrocyte sedimentation rate (r=0.235,p<0.0001). The neutrophil activation marker, calprotectin was not associated with disease activity. Circulating levels of fMET were associated with neutrophil activation (p<0.01) and were able to induce de novo neutrophil activation via FPR1-mediated signaling.ConclusionCirculating fMET appears to propagate neutrophil activation in AAV and LVV. Inhibition of fMET-mediated FPR1 signaling could be a novel therapeutic intervention for systemic vasculitides.
Bridge-over-water detection via modulated deformable convolution and attention mechanisms
Authors: Tang Rui , Dong Ganggang 
Published: June 2022

AbstractBridge-over-water detection plays vital role in urban surveillance and military reconnaissance. Bridges have arbitrary orientations and extreme aspect ratios in remote sensing images, and the preceding works cannot adequately extract bridge-related features. Small bridges are difficult to detect accurately in optical remote sensing images. The oriented bounding box annotations are required by previous deep-learning-based methods for detecting rotated objects. But obtaining the annotations is a laborious task. Though widely studied previously, they are still challenging problems. To address these problems, modulated deformable convolution and attention mechanisms were introduced in this paper. Modulated deformable convolution made the receptive field more flexible. The feature extraction capability of the network was enhanced. A new weighted structure was designed to quantify the contributions of channel and spatial attention mechanisms. A selective attention usage strategy was proposed to improve the detection performance. To locate bridge-over-water more precisely, a new bounding box conversion module was presented. There was no need for oriented bounding box annotations, and the process only relied on bridge-related prior knowledge. Multiple experiments were performed to verify the effectiveness of proposed methods.