bluuebunny/crossref_metadata_2025_split huggingface dataset:
Technology-assisted task-sharing to bridge the treatment gap for childhood developmental disorders in rural Pakistan: an implementation science case study
Authors: Hamdani Syed Usman , Huma Zill-e- , Wissow Lawrence S. 
Published: September 2022

Abstract
Background
As in many low-income countries, the treatment gap for developmental disorders in Pakistan is nearly 100%. The World Health Organization (WHO) has developed the mental Health Gap Intervention guide (mhGAP-IG) to train non-specialists in the delivery of evidence-based mental health interventions in low-resource settings. However, a key challenge to scale-up of non-specialist-delivered interventions is designing training programs that promote fidelity at scale in low-resource settings. In this case study, we report the experience of using a tablet device-based application to train non-specialist, female family volunteers in leading a group parent skills training program, culturally adapted from the mhGAP-IG, with fidelity at scale in rural community settings of Pakistan.

Methods
The implementation evaluation was conducted as a part of the mhGAP-IG implementation in the pilot sub-district of Gujar Khan. Family volunteers used a technology-assisted approach to deliver the parent skills training in 15 rural Union Councils (UCs). We used the Proctor and RE-AIM frameworks in a mixed-methods design to evaluate the volunteers’ competency and fidelity to the intervention. The outcome was measured with the ENhancing Assessment of Common Therapeutic factors (ENACT), during training and program implementation. Data on other implementation outcomes including intervention dosage, acceptability, feasibility, appropriateness, and reach was collected from program trainers, family volunteers, and caregivers of children 6 months post-program implementation. Qualitative and quantitative data were analyzed using the framework and descriptive analysis, respectively.

Results
We trained 36 volunteers in delivering the program using technology. All volunteers were female with a mean age of 39 (± 4.38) years. The volunteers delivered the program to 270 caregivers in group sessions with good fidelity (scored 2.5 out of 4 on each domain of the fidelity measure). More than 85% of the caregivers attended 6 or more of 9 sessions. Quantitative analysis showed high levels of acceptability, feasibility, appropriateness, and reach of the program. Qualitative results indicated that the use of tablet device-based applications, and the cultural appropriateness of the adapted intervention content, contributed to the successful implementation of the program. However, barriers faced by family volunteers like community norms and family commitments potentially limited their mobility to deliver the program and impacted the program’ reach.

Conclusions
Technology can be used to train non-specialist family volunteers in delivering evidence-based intervention at scale with fidelity in low-resource settings of Pakistan. However, cultural and gender norms should be considered while involving females as volunteer lay health workers for the implementation of mental health programs in low-resource settings.
Feasibility, diagnostic performance and clinical value of an abbreviated echocardiography protocol in an out-patient cardiovascular setting: a pilot study
Authors: Ng Sher May , Naqvi Danial , Bingcang Jose , Cruz Gemma , Nose Richard , Lloyd Guy , Speechly-Dick Marie Elsya , Bhattacharyya Sanjeev 
Published: September 2022

Abstract
Background
There has been a growing demand for echocardiography services over the last 5 years, with this supply–demand mismatch exacerbated by the COVID-19 pandemic. Prior studies have suggested a high proportion of normal findings among echocardiograms requested for patients without known cardiovascular disease, particularly in low-risk cohorts. This pilot study investigates the role of an abbreviated echocardiography protocol in improving access to echocardiography services in a low-risk outpatient setting within the rapid access chest pain (RACP) clinic.

Method
A retrospective review of electronic medical records and transthoracic echocardiography (TTE) studies for 212 patients from RACP clinic in 2019 (cohort A), prior to the introduction of the abbreviated echocardiography protocol, and 175 patients seen in the RACP clinic in 2021 (cohort B) was performed. The outcomes measured include the echocardiography referral burden from RACP clinic, waiting time for a TTE and echocardiography findings.

Results
33% and 45% of patients seen in the RACP clinic in 2019 and 2021, respectively, were referred for a TTE. The most common indications include chest pain (50%), dyspnoea (19%) and palpitations (11%). Abnormal findings were identified in 36% of TTEs performed in cohort A and 13% in cohort B. The median echocardiogram study time was significantly shorter in cohort B (7 min vs 13 min, p < 0.00001), with a lower number of images acquired (43 vs. 62, p < 0.00001). The median waiting time for an echocardiography in cohort B was significantly shorter (median: 14 days vs. 42 days in 2019, p < 0.00001). No major pathologies were missed on a retrospective review of these images.

Conclusion
Our study demonstrates that an abbreviated echocardiography protocol has potential to improve access to echocardiography services through increasing scheduling capacity, without compromising diagnostic performance in a low-risk outpatient population.
Estimated prevalence rates and risk factors for common mental health problems among Syrian and Afghan refugees in Türkiye
Authors: Kurt Gulsah , Ventevogel Peter , Ekhtiari Maryam , Ilkkursun Zeynep , Erşahin Merve , Akbiyik Nuriye , Acarturk Ceren 
Published: September 2022

BackgroundTürkiye hosts 4 million refugees and asylum seekers, with Syrians and Afghans being among the largest refugee groups in country. There are limited comparative data on the conflict- and displacement-related experiences of these groups and the relation with mental health status.AimsTo assess the mental health status of Syrians and Afghans in Türkiye, identify risk factors and explore to what extent differences in mental health conditions are related to potentially traumatic events and post-displacement stressors.MethodTwo parallel online survey studies were conducted between April and June 2021 among 798 Syrians and 785 Afghans in Türkiye. Data were collected on sociodemographic characteristics, traumatic events (Harvard Trauma Questionnaire), post-displacement stressors (Post-Migration Living Difficulties Checklist), symptoms of depression and anxiety (Hopkins Symptoms Checklist-25) and post-traumatic stress disorder (PTSD) (Post-Traumatic Stress Disorder Checklist for DSM-5, short form).ResultsFor Syrian and Afghan participants respectively, estimated prevalence rates were: 41.1% and 50.3% for depression; 39.6% and 41% for anxiety; and 41.6% and 46.5% for PTSD. In both groups, significant predictors were female gender, exposure to potentially traumatic events, and structural and socioeconomic post-displacement stressors. Additional risk factors were older age for Afghans and higher education for Syrians.ConclusionsSelf-reported symptoms of common mental health problems are highly prevalent among Syrian and Afghan refugees and associated with a wide range of risk factors. After controlling for conflict- and displacement-related experiences, Afghans reported higher anxiety symptoms than Syrians, which is likely related to their legal status in Türkiye.
Association Between DPP4 Inhibitor Use and the Incidence of Cirrhosis, ESRD, and Some Cancers in Patients With Diabetes
Authors: Na Yewon , Kim Soo Wan , Park Ie Byung , Choi Soo Jung , Nam Seungyoon , Jung Jaehun , Lee Dae Ho 
Published: September 2022

Abstract

Context
There are relatively few data on noncardiovascular (non-CV) long-term clinical outcomes of dipeptidyl peptidase 4 inhibitor (DPP4i) treatment.

Objective
We aimed to evaluate some non-CV effects of DPP4is in patients with diabetes.

Methods
Based on data from the National Health Insurance Service database in Korea (2007-2018), we conducted 3 pairwise comparisons of metformin-combined antidiabetic therapies in adult patients with diabetes: DPP4is vs (1) all other oral antidiabetic agents, (2) sulfonylureas/glinides, and (3) thiazolidinediones (TZDs). Major outcomes were liver cirrhosis, end-stage renal disease (ESRD), and cancers in the liver, kidney, and pancreas. Adjusted hazard ratios (HRs) and 95% CIs for the outcomes were estimated using an adjusted Cox model.

Results
Of the 747 124 patients included, 628 217 had received DPP4i therapy for a mean duration of 33.8 ± 25.0 months. Compared with TZD therapy, DPP4i therapy was associated with higher adjusted HRs [95% CIs] for liver cirrhosis (1.267 [1.108-1.449]), ESRD (1.596 [1.139-2.236]), liver cancer (1.117 [1.011-1.235]), and pancreatic cancer (1.158 [1.040-1.290]). Furthermore, apart from liver cirrhosis, a higher risk of each of these outcomes was associated with DPP4i use than with non-DPP4i use. The higher adjusted HRs associated with DPP4i use further increased when patients with long-term exposure to DPP4is were analyzed.

Conclusion
DPP4i therapy in patients with diabetes was associated with a higher risk of liver cirrhosis and cancer, ESRD, and pancreatic cancer than TZD therapy and, except for liver cirrhosis, the risk of these outcomes was greater with DPP4i treatment than with non-DPP4i treatment.
Probability of Pregnancy With Mono vs Multiple Folliculogenesis in Women With Unexplained Infertility
Authors: Plowden Torie C , Mumford Sunni L , Wild Robert A , Cedars Marcelle I , Steiner Anne Z , Franasiak Jason M , Diamond Michael P , Santoro Nanette 
Published: September 2022

Abstract

Context
Ovarian stimulation (OS) increases pregnancy rates but can cause multiple folliculogenesis and multiple pregnancy.

Objective
To determine whether the probability of pregnancy differs in OS cycles with mono- vs multifolliculogenesis in women with unexplained infertility (UI).

Design
Secondary analysis of a multicenter, randomized controlled trial: Assessment of Multiple Intrauterine Gestations from Ovarian Stimulation with 3 treatment arms: gonadotropins, clomiphene, or letrozole, combined with intrauterine insemination. Women were categorized as having either 1 or ≥ 2 mature follicles (≥ 16 mm). Relative risk (RR) and 95% CIs for clinical pregnancy and live birth by number of follicles were estimated using generalized linear models adjusted for age, body mass index, years of infertility, and history of prior live birth.

Setting
12 US-based clinical sites.

Participants
Normally cycling women aged 18 to 40 years with a normal uterine cavity and at least 1 patent fallopian tube. Male partners with ≥ 5 million total motile sperm.

Interventions
Gonadotropins, clomiphene, or letrozole with insemination

Main Outcome Measure(s)
Clinical pregnancy rates (CPR) and live birth rates (LBR).

Results
A single mature follicle &gt; 16 mm resulted in lower CPR (RR, 0.70; 95% CI, 0.54-0.90) and LBR (RR, 0.67; 95% CI, 0.51-0.89) compared with ≥ 2 mature follicles. When stratified by treatment modality, no association of follicle number with CPR or LBR was observed for letrozole or clomiphene, but women using gonadotropins had lower CPR and LBR with monofolliculogenesis.

Conclusion
In couples undergoing gonadotropin treatment for UI, monofolliculogenesis following OS is related to a lower rate of live birth.
Hazard Versus Linear Probability Difference-in-Differences Estimators for Demographic Processes
Authors: Wu Lawrence L. , Wen Fangqi 
Published: September 2022

AbstractThis study examines the properties of the linear probability difference-in-differences estimator when the data are in fact generated by a single-decrement, continuous-time hazard process. We focus on the textbook case of two groups and two periods in which the control and treatment groups are observed before and after treatment. We provide formal derivations and illustrate matters concretely by reexamining economic studies that have relied on the linear probability difference-in-differences estimator when attempting to obtain estimates of the causal effect of unilateral and no-fault divorce. In particular, we show that the increasing then decreasing pattern of effects found by Wolfers (2006) can be generated by a time-invariant effect of treatment in a proportional hazard setting. We conclude that often implicit assumptions about how the data are generated are an important and necessary component of causal identification.
The influence of substrate size upon pulling and gripping forces in parrots (Psittaciformes: Agapornis roseicollis)
Authors: Dickinson Edwin , Young Melody W. , Kim Charles J. , Hadjiargyrou Michael , Granatosky Michael C. 
Published: September 2022

ABSTRACT
The ability to securely grasp substrates of variable diameter is critical to arboreal animals. Arboreal specialists have emerged across several vertebrate lineages – including mammals, lizards and amphibians – and several attempts have been made to quantify their grasping performance, by measuring either gripping (i.e. forces generated about an object or substrate enclosed within the digits) or pulling (i.e. the ability to resist being removed from a substrate) forces. In this study, we present data on both pulling and gripping performance across a range of substrate diameters (0.5–17.5 mm) within a model parrot species (Agapornis roseicollis). Parrots represent an ancient arboreal lineage, allowing us to compare their abilities with those of arboreal specialists within other tetrapod groups. Data were collected using 3D-printed perches of variable diameter, and forces were registered using either an AMTI low-load force plate (grip force) or a Harvard Apparatus portable strength tester (pull force). Gripping forces peaked at a 5 mm diameter perch, while pulling forces were greatest at a 2.5 mm diameter. All forces strongly diminished above 10 mm size, suggesting grip force is optimized when utilizing small perches, a finding which corresponds to observational studies of preferential perching habits among free-ranging parrots. Relative grasping performance (adjusted for body size) in parrots is roughly equivalent to that of other arboreal specialists from other tetrapod lineages, but low when compared with that of raptorial birds that utilize their feet during aerial prey capture. Further taxonomic sampling is encouraged to contextualize how grasping performance varies in an adaptive evolutionary context.
Narrowband metamaterial absorbers based on interlaced T-shaped all-dielectric resonators for sensing application
Authors: Fan Yi , Yang Rongcao , Li Zhaohua , Zhao Yijia , Tian Jinping , Zhang Wenmei 
Published: September 2022

In this paper, a narrowband metamaterial absorber and its complementary structure absorber are proposed, which can be used for refractive index sensing in the terahertz (THz) band. The proposed two absorbers are composed of complementary rotating interlaced T-shaped all-dielectric resonators located on gold plates. It is demonstrated that the interlaced T-shaped absorber has a narrow single absorption peak with absorptivity of 99.4% at 2.987 THz; its full width at half maximum (FWHM) is 0.0219 THz, and the relative bandwidth is 0.73%. The complementary absorber has two narrow absorption peaks at 3.171 THz and 3.409 THz with absorptivity of 99.3% and 99.8%, corresponding FWHMs of 0.0133 THz and 0.0074 THz, and relative bandwidths of 0.42% and 0.22%, respectively. Based on the narrowband absorption characteristics of the absorbers, the sensing applications for different refractive indices of analyte layers are studied. The sensing sensitivity of the two absorbers can reach 1030 GHz/RIU and 3190 GHz/RIU, respectively. The proposed absorbers are promising in the fields of electromagnetic detection, imaging, and sensing.
Extracting individual characteristics from population data reveals a negative social effect during honeybee defence
Authors: Petrov Tatjana , Hajnal Matej , Klein Julia , Šafránek David , Nouvian Morgane 
Published: September 2022

Honeybees protect their colony against vertebrates by mass stinging and they coordinate their actions during this crucial event thanks to an alarm pheromone carried directly on the stinger, which is therefore released upon stinging. The pheromone then recruits nearby bees so that more and more bees participate in the defence. However, a quantitative understanding of how an individual bee adapts its stinging response during the course of an attack is still a challenge: Typically, only the group behaviour is effectively measurable in experiment; Further, linking the observed group behaviour with individual responses requires a probabilistic model enumerating a combinatorial number of possible group contexts during the defence; Finally, extracting the individual characteristics from group observations requires novel methods for parameter inference.We first experimentally observed the behaviour of groups of bees confronted with a fake predator inside an arena and quantified their defensive reaction by counting the number of stingers embedded in the dummy at the end of a trial. We propose a biologically plausible model of this phenomenon, which transparently links the choice of each individual bee to sting or not, to its group context at the time of the decision. Then, we propose an efficient method for inferring the parameters of the model from the experimental data. Finally, we use this methodology to investigate the effect of group size on stinging initiation and alarm pheromone recruitment.Our findings shed light on how the social context influences stinging behaviour, by quantifying how the alarm pheromone concentration level affects the decision of each bee to sting or not in a given group size. We show that recruitment is curbed as group size grows, thus suggesting that the presence of nestmates is integrated as a negative cue by individual bees. Moreover, the unique integration of exact and statistical methods provides a quantitative characterisation of uncertainty associated to each of the inferred parameters.
Health hazards related to using masks and/or personal protective equipment among physicians working in public hospitals in Dhaka: A cross-sectional study
Authors: Mahmud Reaz , Joy K. M. Nazmul Islam , Rassel Mohammad Aftab , Monayem Farhana Binte , Datta Ponkaj Kanti , Hossain Mohammad Sharif , Hoque Mohammad Mahfuzul , Habib S. M. Habibur Rahman , Munna Nazmul Hoque , Ahmed Mohiuddin , Sayeed S. K. Jakaria Been , Rahman Motlabur , Chowdhury Ahmed Hossain , Hossain Mohammad Zaid , Ahmed Kazi Gias Uddin , Miah Md. Titu , Rahman Md. Mujibur 
Published: September 2022

Background
Wearing masks or personal protective equipment (PPE) has become an integral part of the occupational life of physicians due to the coronavirus disease 2019 (COVID-19) pandemic. Most physicians have been developing various health hazards related to the use of different protective gears. This study aimed to determine the burden and spectrum of various health hazards associated with using masks or PPE and their associated risk factors.

Methods
This cross-sectional survey was conducted in Dhaka Medical College from March 01–May 30, 2021, among physicians from different public hospitals in Dhaka, Bangladesh. We analyzed the responses of 506 physicians who completed case record forms through Google forms or hard copies.

Findings
The mean (SD) age of the respondents was 35.4 [7.7], and 69.4% were men. Approximately 40% were using full PPE, and 55% were using N-95 masks. A total of 489 (96.6%) patients experienced at least one health hazard. The reported severe health hazards were syncope, severe dyspnea, severe chest pain, and anaphylaxis. Headache, dizziness, mood irritation, chest pain, excessive sweating, panic attack, and permanent facial disfigurement were the minor health hazards reported. Extended periods of work in the COVID-19-unit, reuse of masks, diabetes, obesity, and mental stress were risk factors for dyspnea. The risk factors for headaches were female sex, diabetes, and previous primary headaches. Furthermore, female sex and reusing masks for an extended period (> 6 h) were risk factors for facial disfigurement. The risk factors for excessive sweating were female sex and additional evening office practice for an extended period.

Conclusions
Healthcare workers experienced several occupational hazards after using masks and PPE. Therefore, an appropriate policy is required to reduce such risks.
Psychosocial working conditions and chronic low-grade inflammation in geriatric care professionals: A cross-sectional study
Authors: Kaltenegger Helena C. , Weigl Matthias , Becker Linda , Rohleder Nicolas , Nowak Dennis , Quartucci Caroline 
Published: September 2022

BackgroundChronic low-grade inflammation has been suggested as a key factor in the association between stress exposure and long-term health. Care work is recognized as a profession with a high degree of job stress and health risks. However, for care professionals, the study base on inflammatory activity due to adverse working conditions is limited.ObjectiveThe aim of this study was to explore associations between self-reported psychosocial working conditions and care professionals’ biomarkers of systemic low-grade inflammation.MethodsN= 140 geriatric care professionals (79.3% females, mean age = 44.1 years) of six care facilities were enrolled in a cross-sectional study consisting of standardized medical examinations and employee surveys. Standardized questionnaires were used for evaluation of psychosocial work characteristics (work overload, job autonomy, social support) based on Karasek’s job strain model. Blood samples were drawn for two biomarkers of inflammatory activity: C-reactive protein (CRP) and leukocyte count. Analyses comprised uni- and multivariate logistic and linear regression analyses.ResultsWe determined a proportion of 5.4% of care professionals with increased low-grade inflammation. We further observed a relationship between job autonomy and CRP, such that reports of high job autonomy were associated with increased levels of CRP (adjusted OR = 4.10, 95% CI [1.10, 15.26],p= .035), which was robust in additional analyses on further potential confounders. No significant associations with participants’ leukocyte numbers were found.ConclusionsThis exploratory study contributes to the research base on links between workplace stress and ensuing illness in care professionals. Our findings may help to identify risk and protective factors of the work environment for chronic low-grade inflammation. The results require further scrutiny, and future prospective studies on associations of psychosocial working conditions, low-grade inflammation and long-term health outcomes in care professionals are needed.